Nine Classic Symptoms of Chronic Depression

The following are the nine classic symptoms that a doctor looks for when considering a diagnosis of depression. A major depressive episode is present if five or more of the following nine symptoms are present during the same two-week period. At least one of the five symptoms must be either a depressed mood or loss of interest or pleasure.

1. Depressed mood for most of the day.
2. Disturbed appetite or change in weight.
3. Disturbed sleep.
4. Psychomotor retardation or agitation.
5. Loss of interest in previously pleasurable activities; inability to enjoy usual hobbies or activities.
6. Fatigue or loss of energy.
7. Feelings of worthlessness; excessive and/or inappropriate guilt.
8. Difficulty concentrating or thinking clearly.
9. Morbid or suicidal thoughts or actions.

Mood alterations

A change in mood is the red flag that alerts a doctor to consider a diagnosis of depression. Depressed individuals typically feel sadness or despair. They find they've lost their ability to feel pleasure, and they're no longer interested in things they normally enjoy. Some depressed patients may be more irritable or tense than sad.

Emotional changes

If you're depressed, you may notice emotional changes, including inappropriate feelings of worthlessness or guilt. Many depressed people experience a marked lack of confidence and feelings of ineptitude. Some people will avoid situations that require any sort of responsibility for fear of failure.

Changes in the way your body functions

Depression affects the body as well as the emotions. Depressed individuals may notice changes in the way their body functions. Changes in appetite are common. Typically, appetite decreases. However, depression also may be expressed by excessive appetite and weight gain.

Sleeping patterns may change as well. When people suffer from depression, they may have difficulty falling asleep, they may wake up in the middle of the night, or they may wake up in the early morning hours without being able to return to sleep. People who wake up in the early hours (terminal insomnia) tend to have the most severe depression. Occasionally, depressed individuals complain of chronic fatigue and report excessive sleeping rather than insomnia.

Loss of energy and sex drive

Loss of energy and tiring too easily are also common symptoms of depression. Sex drive may be decreased markedly in depressed people and may lead to impotence and the inability to have an orgasm (anorgasmia).

Difficulty concentrating

Many people who suffer from depression have difficulty concentrating or thinking clearly. Depressed individuals may feel that they are unable to study or that their efficiency at work is decreased. In severe cases, depressed individuals are not even able to watch television.

Masked depression

It is possible for people to suffer from major depression without their friends and loved ones realizing it. Their depression may be masked because they don't talk about their low mood. Instead, they may complain of various physical problems (e.g., indigestion, heartburn, muscle or joint pains, and chronic headaches). Further questioning may reveal that depression is responsible for their symptoms.

Psychotic Symptoms

In very severe cases of depression, patients may develop psychotic symptoms, such as hallucinations and delusions. Often, the psychotic symptoms have depressive themes, such as an unshakable belief that one is totally worthless. Some severely depressed patients hear a voice telling them to kill themselves.