A person who suffers from a major depressive disorder (sometimes also referred to as clinical depression or major depression) must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood. Social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. For instance, a person who has missed work or school because of their depression, or has stopped attending classes altogether, or attending usual social engagements.
A depressed mood caused by substances (such as drugs, alcohol, medications) is not considered a major depressive disorder, nor is one which is caused by a general medical condition. Major depressive disorder generally cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., a bipolar disorder) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder. Typically the diagnosis of major depression is also not made if the person is grieving over a significant loss in their lives.
Depression varies from person to person, and it has special traits and specifics based on the age, gender, personality and other factors, but there are some common signs and symptoms to be observed.
Clinical depression is characterized by the presence of the majority of these symptoms:
- Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
- Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. Loss of interest in activities or hobbies once pleasurable, including sex.
- Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
- Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
- Psychomotor agitation or retardation nearly every day. Either feeling “keyed up” and restless or sluggish and physically slowed down.
- Fatigue or loss of energy nearly every day. Feeling fatigued and physically drained. Even small tasks are exhausting or take longer.
- Feelings of worthlessness or excessive or inappropriate guilt nearly every day. Harsh criticism of perceived faults and mistakes.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day. Trouble focusing, making decisions, or remembering things.
- Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
- Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment.
In addition, for a diagnosis of major depression to be made, the symptoms must not be better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.
If you have 2 to 4 symptoms for a period of at least 2 years (1 year for a child), you may have a long-term form of depression called dysthymic disorder (dysthymia).
Many health professionals see people with general symptoms that may be difficult to link to depression. These symptoms, which commonly occur with depression, include:
- Having digestive problems, including constipation or diarrhea.
- Losing interest in sex or being unable to perform sexually.
- Not moving or talking for hours.
- Increased tearfulness, anger, and generally not feeling well, along with anxiety and tension.
- Sometimes, a feeling of heaviness in the arms and legs.
- Sensitivity to rejection.
- Night Sweats and sudden awakening.
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