Major Depressive Disorder Symptoms

Major depressive disorder, commonly known as depression or clinical depression, is a medical condition caused by a chemical imbalance in the brain. It is a mood disorder that can cause you to feel low for weeks or months and lose interest in things you once enjoyed.

Everyone feels upset, sad, or low once in a while, but the feeling generally shifts and passes. However, feeling sad or disinterested for most of the day nearly every day could mean that you have major depressive disorder, particularly if the symptoms persist for over two weeks and interfere with your ability to function.

If you think you might have major depression you’re not alone. Depression affects one in six people. In fact, it is one of the most common mental health conditions in the United States.

This article explores the signs and symptoms as well as the complications and comorbidities that may accompany major depressive disorder.

Symptoms of Major Depressive Disorder

These are some of the symptoms of major depressive disorder:

• Feeling low or having an “empty” mood most of the time
• Feeling irritable, anxious, or restless
• Feeling worthless or hating oneself
• Feeling guilty, helpless, or hopeless
• Feeling tired and not having any energy
• Having no interest in anything
• Avoiding activities and responsibilities
• Having difficulty concentrating and making decisions
• Slowing down of physical activity, speech, and thinking or increased agitation and irritability
  
• Having difficulty falling asleep or sleeping too much
• Experiencing a change in appetite, which can lead to weight gain or weight loss
• Experiencing unexplained physical aches and pains, such as headaches, stomach cramps, or body pain, that don’t go away despite being treated
• Talking or thinking about death or suicide

Everyone Experiences Depression Differently

It’s important to note that everyone experiences mental health conditions such as major depressive disorder differently. While some people may have many symptoms of depression, others may have only a few. The frequency, duration, and severity of the symptoms can also vary from person to person.

The symptoms of major depressive disorder can also vary depending on a person’s age. Listed below are some symptoms people may experience, depending on their age:

Children

These are some symptoms of depression that young children may display:

• Feeling cranky or irritable
• Increased sensitivity to rejection or failure
• Changes in eating or sleeping habits
• Decreased energy
• Loss of interest or pleasure in previously enjoyed activities
• Clinging to their parent or caregiver
• Refusing to go to school
• Physical complaints such as a stomachache
• Focus on death and dying

Teenagers and Young Adults

These are some symptoms of depression teenagers and young adults may display:

• Sulking and irritability
• Feelings of sadness or numbness
• Feeling restless and frustrated
• Feeling hopeless and having a negative view of life
• Low self-esteem and feelings of worthlessness
• Sleeping excessively or insomnia
• Exaggerated self-blame or self-criticism
• Difficulty thinking, concentrating, or making decisions
• Changes in appetite
• Weight gain
• Frequent complaints of body aches or headaches
• Loss of interest or pleasure in usual activities
• Poor school performance or frequent absences from school
• Less attention to personal hygiene or appearance
• Using substances
• Social isolation
• Angry outbursts, disruptive or risky behavior, or other acting-out behaviors
• Self-harm such as cutting or burning
• Making a suicide plan or a suicide attempt
  

Early and Middle-Aged Adults

These are some symptoms of depression early and middle-aged adults may display:

• Experiencing more frequent depressive episodes
• Having decreased libido
• Experiencing decreased or increased sleep; having sleep difficulties like waking up in the middle of the night or early in the morning
• Developing gastrointestinal issues such as constipation and diarrhea
• Feelings of downheartedness and sadness
• Loss of interest in all usual activities
• Decrease in self-care and self-maintenance
• Deterioration of work functioning
• Decreased or increased appetite
• Aggression, irritability, and/or sudden anger
• Increased risk taking

Older Adults

These are some symptoms of depression older adults may display:

• Experiencing less obvious symptoms
• Having no mood or numbness, rather than a depressed mood
• Having other medical conditions that cause or contribute to depression
• Unexplained or aggravated aches and pains
• Loss of interest or pleasure in activities
• Retreat from social interaction and physical activities
• Experiencing problems with memory and other cognitive functions

Diagnostic Criteria for Major Depressive Disorder

The diagnostic process for major depressive disorder may involve:

• A detailed personal, social, substance use, and family medical history
• Questions about your symptoms, including how they’re making you feel and affecting your daily life
• Other routine tests such as blood tests, lab work, or physical or psychological examinations to rule out other health conditions that can cause similar symptoms
• Use of a screening tool such as the Patient Health Questionnaire-9 (PHQ-9), Hamilton Rating Scale for Depression (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Zung Self-Rating Depression Scale, and other questionnaires

Your healthcare provider will determine whether or not your symptoms meet the diagnostic criteria for major depressive disorder, which includes:

• Feeling depressed or irritable almost all the time and losing interest in most things
• Having at least five symptoms of depression (which may include loss of pleasure or interest in activities, unintentional and significant weight gain/loss or increase/decrease in appetite, sleep disturbance, tiredness or low energy, a sense of worthlessness or guilt, impaired ability to concentrate and make decisions, recurrent thoughts of death or suicide attempts, etc.)
• Experiencing symptoms every day for most of the day
• Experiencing symptoms for at least two weeks
• Not being able to function as you were able to before, due to the symptoms

Complications and Comorbidities

Major depressive disorder may occur along with other serious physical and mental health conditions. These conditions may include:

• Alzheimer's disease
• Anxiety disorders
• Arthritis
• Attention deficit hyperactivity disorder (ADHD)
• Cancer
• Chronic pain
• Diabetes
• Eating disorders
• Epilepsy
• Gastrointestinal issues
• Heart disease
• Human immunodeficiency virus (HIV)
• Migraine headaches
• Multiple sclerosis
• Obesity
• Obsessive-compulsive disorder (OCD)
• Panic disorder
• Parkinson’s disease
• Post-traumatic stress disorder (PTSD)
• Sleep disorders
• Stress
• Stroke
• Substance use

It’s important to note that certain medications that are prescribed to treat other health conditions may also cause depression as a side effect. 

Treatment for Major Depressive Disorder

There are many treatment options that a doctor may recommend depending on the individual and the severity of their symptoms.

Common first lines of treatment for major depressive disorder include psychotherapy, specifically, cognitive behavioral therapy (CBT). With CBT, a therapist can help you address and reframe the underlying thoughts and beliefs that contribute to your depression.

A doctor may also recommend an antidepressant such as a selective serotonin reuptake inhibitor (SSRI). SSRIs are a common class of antidepressants that work by increasing the amount of serotonin in the brain (serotonin is a neurotransmitter that regulates mood).

For severe forms of depression, somatic therapies such as electroconvulsive therapy (ECT) or vagal nerve stimulation (VNS) may be helpful. With both forms of treatment, a health professional administers electrical stimulation to the brain which may help alleviate symptoms of depression. However, there are side effects of these treatments such as nausea, vomiting, arrhythmias, and headaches.

Inpatient psychiatric treatment may be necessary, particularly for people who have persistent suicidal thoughts or display self-harm behaviors. This form of treatment allows you to be monitored and given 24-hour care until your symptoms become more manageable.

A Word From Verywell

Depression is a serious medical condition caused by an imbalance of brain chemicals. It can lead to symptoms such as sadness, lack of interest, and fatigue that can make it difficult for you to function at work or school, and maintain your relationships. 

Fortunately, treatment can reduce the symptoms of depression and help you feel better. Seek treatment from a qualified medical professional as soon as possible.