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Signs of Clinical Depression: 9 Symptoms to Watch For

Symptoms of Depression

The symptoms of depression – technically known as major depressive disorder (also known as major depression (MDD) or clinical depression) – are characterized by an overwhelming sense of sadness, isolation, and despair that lasts for two weeks or more. Depression isn't just an occasional feeling of sadness or loneliness like most people experience from time to time. Instead, a person suffering from depression feels as if they have sunk into a deep, dark hole from which there is no way out – and little or no hope that things will ever change (ref. PsychCentral).

9 Symptoms of Clinical Depression (MDD)

What is Depression MDD

Major depressive disorder (MDD) is diagnosed when an individual has a persistently low or depressed mood, anhedonia or decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation or agitation, sleep disturbances, or suicidal thoughts.

Per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), an individual must have five of the above-mentioned symptoms, of which one must be a depressed mood or anhedonia causing social or occupational impairment, to be diagnosed with MDD. History of a manic or hypomanic episode must be ruled out to make a diagnosis of MDD. Children and adolescents with MDD may present with irritable mood. [Ref. NCBI Bookshelf]

9 Symptoms of Clinical Depression (MDD)

A person suffering from major depressive disorder (sometimes referred to as clinical depression or just depression) has experienced either a depressed mood or a loss of interest or enjoyment in daily activities for a period of at least two weeks. This depressed mood must represent a significant change from the person's normal everyday mood.

Social, occupational, educational, or other important functioning must also be adversely affected by the change in mood. For example, when a person who is depressed starts missing work or school, or stops attending classes or their usual social commitments (like hanging out with friends).

Clinical depression is characterized by the presence of 5 or more of these depressive symptoms:
  • Depressed mood most of the day, almost every day, as indicated either by a subjective report (e.g., feeling sad, blue, "down", or empty) or by observations of others (e.g., appears to be whiny or crying). (In children and adolescents, this may represent an irritable or quirky mood rather than a sad mood).
  • Significantly decreased interest or enjoyment in all or almost all activities of daily living, such as no interest in hobbies, sports, or other things the person used to enjoy doing.
  • Significant weight loss without dieting, or weight gain (e.g., a change in body weight of more than 5 percent in one month), or a decrease or increase in appetite almost daily.
  • Difficulty sitting still for several days, including constant restlessness, step control, or picking at clothes (professionals call psychomotor agitation); or the opposite, a slowing down of movements, speaking very softly with slow speech (called psychomotor retardation by professionals).
  • Fatigue, lethargy or loss of energy almost every day - even the smallest tasks, like getting dressed or washing up, seem difficult and take longer than usual.
  • Feelings of hopelessness or helplessness (like there’s nothing the person can do to feel better), worthlessness or excessive or inappropriate guilt almost every day (e.g., regurgitating minor past omissions).
  • Decreased ability to think or concentrate, or indecisiveness, almost every day (e.g., seems easily distracted, complains of memory problems).
  • Recurring thoughts of death (not just the fear of dying), recurring thoughts of suicide without a specific plan or attempting suicide or having a specific plan to commit suicide.
Depressed mood caused by substances (such as drugs, alcohol, medication) is not considered a major depressive disorder, nor is one caused by a general health condition. Major depressive disorder usually cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., bipolar disorder) or if depressed mood is better explained by schizoaffective disorder than schizophrenia, is superimposed on a delusion or a psychotic disorder.

Depression is also experienced as a loss of interest and energy in things the person normally enjoys doing, such as working, going out, or being with family and friends. Most people with this condition also have trouble eating and sleeping – either too much or too little. A depressed person's memory and ability to concentrate are also often impaired; they may also be more irritable or feel restless all the time.

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Depression and Sadness

In accordance with the updates to the criteria for the major depressive disorders in the DSM-5 (the most recent diagnostic manual for diagnosing mental disorders), a person may experience a major depressive episode during a period of mourning or bereavement, such as after the loss of a loved one Suffer. This is a significant change from previous diagnostic criteria, which did not make a diagnosis of major depression if the person was grieving a significant loss in their life. This change was made on the grounds that bereavement can bring great distress to some people, such that it can trigger an episode of major depressive disorder.

In other words, it is not normal for the symptoms of bereavement to produce significant functional impairment, a morbid preoccupation with worthlessness, suicidal thoughts, psychotic symptoms, or psychomotor retardation (a slowing down of a person's physical movements) for two months or more. Thus, when they occur together, the depressive symptoms and functional impairment are usually more severe and the prognosis worse than in bereavement that is not associated with major depressive disorder. Bereavement-related depression usually occurs in people with other predispositions to depressive disorders, and recovery may be facilitated with antidepressant treatment.

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