Person holding a framed picture of a drawn sad face over their own face

Major Depression: The Symptoms

Everyone gets sad sometimes. But major depression is a medical condition, and goes far beyond just feeling blue. And, like any other medical condition, it requires medical treatment.

Different people experience depression in different ways. For some, it feels like a loss of energy or enthusiasm to do anything. Others describe it as constantly living with a feeling of impending doom. The psychological symptoms can often lead to physical symptoms, as well.

A diagnosis can be scary and lonely. Often patients and their loved ones are left with feelings of “Now what?” Learning to navigate treatment options, understand medications and therapies, find support groups, all while coping with daily living tasks, can be really overwhelming. But it’s important to know that you’re not alone and that recovery for your loved one is possible. Effective treatments are being used every day to help people with depression. And as a member of their support group, it’s important that you surround yourself with support, too – and educate yourself so you can help your loved one navigate their diagnosis.

What is a Major Depressive Episode?

Major depression is a medical condition where a person experiences low mood that interferes with day-to-day functioning. It’s distinguished by one or more major depressive episodes.  A major depressive episode is when a person experiences at least two weeks of depression symptoms. For people suffering from depression, these symptoms are severe enough to interfere with their day-to-day functioning.

At least one of the symptoms present must be either (1) depressed mood or (2) loss of interest or pleasure.

  1. Depressed mood most of the day, nearly every day, as indicated by either the person’s own report (e.g., they say they feel sad or empty) or by observations made by others (e.g., he or she appears tearful). In children and adolescents, this may look like an irritable mood instead of a sad mood.
  2. Significantly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. This includes activities that were previously found enjoyable.

These symptoms must be accompanied by at least four more symptoms of depression described below.

  1. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or a decrease or increase in appetite.
  2. Insomnia or hypersomnia nearly every day. This includes difficulty falling asleep or staying asleep, or waking early in the morning and not being able to get back to sleep. Alternatively, it can mean sleeping too much (such as over 12 hours per night) and spending a lot of time in bed.
  3. Psychomotor agitation (e.g., pacing or an inability to sit still) or psychomotor retardation (e.g., slowed speech, thinking, and body movements). Changes in activity level are common in depression. Depressed people may feel agitated, “on edge,” and restless. Alternatively, they may experience a decreased activity level reflected by slowness and lethargy, both in terms of their behavior and thought processes.
  4. Fatigue or loss of energy.
  5. Feelings of worthlessness or excessive or inappropriate guilt. Depressed people may feel they are worthless or that there is no hope for improving their lives. Feelings of guilt may be present about events with which the person had no involvement, such as a catastrophe, a crime, or an illness.
  6. Diminished ability to think or concentrate, or indecisiveness. A significant decrease in the ability to concentrate makes it difficult to pay attention to others or to contemplate simple tasks. Depressed people may be quite indecisive about even minor things.
  7. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, a specific plan for committing suicide, or a suicide attempt.

Other symptoms that depressed people often experience can include:

  • Bodily aches and pains rather than feelings of sadness
  • Persistent anger, angry outbursts, and an exaggerated sense of frustration over seemingly minor events
  • Symptoms of anxiety
  • Hallucinations (false perceptions, such as hearing voices)
  • Delusions (false beliefs, such as paranoid delusions)

These symptoms usually disappear when the symptoms of depression have been controlled.

What Major Depression Disorder is NOT

Depressed mood caused by substances (such as drugs, alcohol, or medications) or depressed mood related to another medical condition is not a major depressive disorder. If your loved one is dealing with a depressed mood due to substances, they may still need medical help, however.

Major depressive disorder also cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., bipolar disorder) or if the depressed mood is better ac- counted for by schizoaffective disorder. These are conditions that also require medical help, but the treatment options are different from those available for depression.

Get Educated about Depression

A strong support system can be invaluable in a person’s recovery. As someone’s support, it’s important that you learn about depression, how to help your loved one cope, and how to find help and support for yourself, too. Tools 4 Families provides a network of others who, like you, are helping their loved ones recover. Additionally, you can find practical ways to provide support, create a stable environment, and aid your loved one in their recovery.

If you’re looking for more information about how you can help your loved one overcome depression, we can send you an education pamphlet about depression that covers prevalence, causes, course of illness, diagnosis, treatments, medication, and even ways family members can help.

Want to Learn More?

Here are some other articles you might find helpful:

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What is major depression?