Symptoms of depression, or a depressive episode

  1. lasting sad, anxious, or empty mood
  2. feelings of hopelessness or pessimism
  3. feelings of guilt, worthlessness, or helplessness
  4. loss of interest or pleasure in activities once enjoyed, including sex
  5. decreased energy, a feeling of fatigue or of being slowed down
  6. difficulty concentrating, remembering, making decisions
  7. restlessness or irritability
  8. sleeping too much, or can’t sleep
  9. change in appetite and/or unintended weight loss or gain
  10. chronic pain or other persistent bodily symptoms not caused by physical illness or injury
  11. thoughts of death or suicide, or suicide attempts

Diagnosis of depression

Depressive episodes (ICD-10), or major depressive episodes (DSM-IV) are diagnosed by two weeks of low or depressed mood and a decrease in energy, activity, interest, or pleasure.

ICD-10 specifies depressive symptoms as

  • mild (when at least four depressive symptoms* are present),
  • moderate (when six symptoms and difficulty continuing with ordinary activities), or
  • severe (when eight symptoms, which are marked and distressing).

DSM-IV also includes

  • repeated thoughts about death (other than the fear of dying) and
  • suicide (with or without a plan) or
  • suicide attempt as part of its diagnosis description.

* see list above