Depression Symptoms: Recognizing Major Depressive Disorder

Major Depressive Disorder (MDD) requires ≥5 symptoms for ≥2 weeks, including (1) depressed mood or (2) anhedonia:

Diagnostic Criteria (DSM-5)

1. Depressed mood most of day, nearly daily (or irritability in youth)
2. Anhedonia: Markedly diminished interest/pleasure
3. Weight/appetite change (≥5% body weight/month)
4. Sleep disturbance: Insomnia or hypersomnia
5. Psychomotor agitation/retardation (observable)
6. Fatigue/energy loss
7. Worthlessness/excessive guilt
8. Impaired concentration/indecisiveness
9. Suicidal ideation/attempt

Additional Features

• Anxiety, somatic complaints, rumination
• Melancholic, atypical, psychotic, peripartum, seasonal specifiers

Severity & Action

• Mild: Few symptoms, mild impairment → psychotherapy first-line
• Moderate: Clear functional impairment → therapy + consider medication
• Severe: Marked impairment, psychotic features, suicidality → medication + therapy + safety planning

Critical: Suicide Risk

Ask directly: "Are you thinking of killing yourself?" If yes → assess plan, means, intent → connect to crisis line (988 US), emergency services, or psychiatric care. Never leave actively suicidal person alone.

Depression is treatable. First step: professional evaluation (PCP, psychiatrist, therapist).