Major depression is the medical condition often known simply as “depression.” 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.
If you or a loved one has been diagnosed with major depression, it can feel scary and lonely. It’s important to know that you’re not alone and that recovery is possible. Effective treatments are being used every day to help people just like you or your loved one. It’s possible to improve your day-to-day functioning and have relief from many of the symptoms of depression. But first, it’s important to educate yourself so you know what depression is and what it isn’t.
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 depressed mood or loss of interest in life’s pleasures. It’s accompanied by at least four more symptoms of depression described below.
Depression is different from feeling “blue,” which most of us experience periodically throughout life. For people suffering from depression, these symptoms are severe enough to interfere with their day-to-day functioning.
What are the Symptoms of Major Depression?
To meet the criteria for a major depressive disorder, a person must:
- Meet at least five of the symptoms listed below for at least a two-week period.
- Social, occupational, and other areas of functioning must be significantly impaired or at least require increased effort.
Again, not all of these symptoms must be present for a person to be diagnosed with depression, but at least one of the symptoms must be either (1) depressed mood or (2) loss of interest or pleasure.
Here are the symptoms to look for:
- 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 be look like irritable mood instead of sad mood.
- 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.
- 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.
- 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.
- 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.
- Fatigue or loss of energy.
- 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.
- 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.
- 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 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 considered to be major depressive disorder.
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.
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