Understanding Major Depressive Disorder (Clinical Depression) Symptoms

Published on: 08 Jan 2021
Man slouching over his legs while sitting on bed in a dark room

Experiencing sadness or low emotions occasionally is normal. Dealing with the loss of a loved one, going through a divorce or facing other challenging situations can give you a bout of the blues, which is a natural reaction to such events. However, if you find yourself constantly sad, or experiencing persistent despair, anger, frustration, hopelessness, or other emotional challenges that make it difficult for you to carry on with daily activities, you may be dealing with symptoms of major depressive disorder. Major depressive disorder is more than just an unhappy mood that you might be able to “snap out of” or “get over,” but a more severe condition that often requires treatment. Understanding the symptoms of major depressive disorder, and reaching out for help when you need it, can guide you on your path to addressing your mental health needs.

Major Depressive Disorder Statistics

Major depressive disorder (MDD) — also known as unipolar depression or clinical depression — is a mental health condition that can affect a significant part of your life, including your mood, behavior, thoughts, sleep, and appetite. Major depressive disorder brings feelings of sadness and causes you to lose interest in activities you once enjoyed. It impacts your ability to function effectively at home and at work, and may also lead to other emotional and physical issues. A major depressive episode may occur just once in a person’s life or might happen more frequently.

Statistics from the National Institute of Mental Health show that an estimated 17.3 million U.S. adults experienced major depressive disorder symptoms in 2017, representing 7.1%of the adult population. From these figures, it was also revealed that major depressive episodes were more prevalent in adult females:8.7%of females had at least one episode compared to the 5.3% of adult males.

Additionally, according to these statistics, over 65% of adults receive treatment for major depressive disorder symptoms by a mental health professional and with prescribed medication, while 35%of adults do not receive treatment at all. Although there has been remarkable advances in depression treatment over the years, the stigma attached to depression remains, causing many to avoid treatment, even when they would likely benefit from it. 

Having no knowledge of major depressive disorder symptoms can also prevent a person from reaching out for help. Sometimes, an individual may experience symptoms that are similar to depression but aren’t classified as depression symptoms. Familiarizing yourself with the symptoms can help you determine whether the low moods and fatigue you experience could be a sign of a more serious condition. 

What Are the Symptoms of Major Depressive Disorder? 

The most common types of depressive disorders recognized under the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, include major depressive disorder and persistent depressive disorder. According to the diagnostic criteria for major depressive disorder, a person can be diagnosed if five or more of these symptoms have been present nearly everyday during a two-week period, and are severe enough to interfere with their daily activities, work, social activities, or relationships with others. Major depressive disorder symptoms can be complex and vary widely between different people.

Fatigue and Loss of Energy

Major depressive disorder is typically associated with loss of energy and fatigue, sometimes even after a good night’s rest. People who are dealing with major depression often have trouble sleeping, which can also cause extreme tiredness during the day.

Chronic fatigue syndrome is another condition that can occur alongside major depressive disorder symptoms, and it makes a person experience continuous feelings of exhaustion without any easily discernible cause. This condition can be a symptom of depression, but it’s not to be mistaken with depression.

Low Mood

According to the DSM-5, major depressive disorder is characterized by a low mood for most of the day, occurring nearly everyday for at least two weeks. Depression affects a person’s thoughts, behavior, motivation, and feelings, and this tends to be reflected in their mood. Most people dealing with depression are aware that they feel sad or empty, but in many cases, this symptom may also be observed by other people around them. 


Another major depressive disorder symptom is anhedonia, a noticeably diminished interest in most activities of the day. This symptom is marked by an inability to feel pleasure in ordinarily pleasurable activities, such as sex, food, music, and conversation. Anhedonia can also be indicated either by the person experiencing it, or by someone close to them.

Decreased or Increased Weight and Appetite

When a person experiences a decrease or increase in appetite nearly every day, significant weight loss or gain may occur. This may be a symptom of major depressive disorder, especially when the person isn’t in the process of gaining weight or dieting. The diagnostic criteria for this condition classifies significant weight loss as “a change of more than five percent of body weight in a month.”

Irregular Sleep Pattern

Insomnia or hypersomnia (excessive sleeping) that occurs nearly every day can be an indicator of major depressive disorder. An irregular sleep pattern involves difficulty falling asleep, staying asleep, or feeling sleepy after a night’s rest, which can all be signs of major depression.

Psychomotor Agitation or Retardation

Feeling slowed down or facing extreme restlessness nearly everyday may be a sign of major depressive disorder. According to the diagnostic criteria, however, this symptom must be observable by others, and not only a subjective feeling of restlessness or being slowed down.

Feelings of Worthlessness or Guilt

Major depressive disorder may also come with severe feelings of worthlessness or inappropriate guilt nearly every day. This symptom may become heightened enough to make a person have delusional thoughts. The diagnostic criteria for this condition does not recognize self-reproach or guilt about being sick as a symptom of major depressive disorder.

Poor Concentration or Indecisiveness

Major depressive disorder is also marked by a persistently decreased ability to concentrate or focus, and a difficulty in making decisions. Those battling major depressive disorder may identify this symptom in themselves, or people around them may observe that they’re facing challenges in thinking with clarity and articulating themselves.

Thoughts of Death or Suicide Attempts

Recurrent thoughts of death are one of the major depressive disorder symptoms, as well as constant suicidal thoughts without a specific plan to go ahead with it. Additionally, a suicide attempt or a specific plan for committing suicide may also be a sign that a person is dealing with major depression.

If you’re having suicidal thoughts, reach out to the National Suicide Prevention Lifeline to get support and assistance from a professional. Also, if you know someone who might be dealing with suicidal thoughts and is likely to act on them, call 911 and ask for assistance immediately.

What Causes Major Depressive Disorder Symptoms?

A single cause of major depression is as yet unknown nor could a single cause be identified in a particular depressed individual. However, research suggests that several genetic, environmental, biological and psychological factors can combine to cause depression, including an imbalance in brain chemistry or extreme changes in hormone levels during certain times like pregnancy or menopause.

Additionally, there are other risk factors that have been shown to be linked to depression. Having one or more of these factors may, though not always, make a person more prone to major depressive disorder symptoms:

  • A personal or family history of depression or substance abuse
  • Going through a traumatic or stressful event, such as childhood trauma or current situations like the death of a loved one.
  • Certain personality traits like low self-esteem and pessimism
  • A history of other mental health conditions or eating disorders
  • Substance abuse
  • Severe, terminal, or chronic illness
  • Certain medications, including some antidepressants

Major depressive disorder symptoms can begin at any age, but typically develops in adulthood. In children and adolescents, one prominent symptom of depression is irritability, rather than a low mood.

Major depression can occur comorbidly with other conditions, including diabetes, cancer, heart disease, and Parkinson’s disease, especially in older adults. Major depressive disorder symptoms often worsen these conditions when present. If you’re someone who is dealing with major depression or another illness, you can reach out to an expert who’s skilled in treating complicated conditions and work closely to come up with a suitable treatment plan.

Managing Major Depressive Disorder Symptoms

Major depression is a highly treatable condition, as many people respond positively to treatment and discover strategies to help manage their symptoms.

Major depression can be diagnosed after a mental health professional carries out a diagnostic assessment that includes an interview and a physical examination. A blood test may also be done to rule out the possibility that the symptoms are due to another condition like a vitamin deficiency. This assessment also helps indicate specific symptoms and how medical histories and other cultural or environmental factors can influence the diagnosis.

When major depression is diagnosed, treatment may consist of prescribed medication, psychotherapy, or a combination of the two.

Antidepressants can be prescribed to help improve any imbalance in brain chemistry that may contribute to depression. Psychotherapy — also called talk therapy — may be used alone for treatment of major depressive disorder symptoms, or along with prescribed antidepressants. Cognitive behavioral therapy (CBT), which focuses on a problem-solving approach to treatment, is an effective and often-used way to manage depression.

In some cases, where individuals are unable to respond to any of these treatment options, electroconvulsive therapy may be used. This treatment involves a brief electrical stimulation of the brain while the patient is under anesthesia. Years of research has made the process a lot safer and more effective as a way to treat major depressive disorder symptoms than when it was used in decades past.

If you feel little or no improvement after several weeks, or you’re experiencing side effects, it’s important to let your doctor know so your treatment can be altered or substituted with another approach.

While you receive treatment, there are also a number of significant lifestyle changes you can make in order to help in minimizing symptoms. Regular exercise can create positive thoughts and boost your mood while eating a healthy diet and avoiding alcohol and other substances can also help reduce major depressive disorder symptoms.

Major depressive disorder is a serious condition, but it’s treatable. With early and proper diagnosis and treatment, you can overcome this condition and live a healthy life. If you’re struggling with major depressive disorder consider speaking with a licensed Talkspace therapist, a convenient and inexpensive way to start feeling better today. 

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.

Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

You May Also Like
Girl sitting
Read More
Published on: 01 Feb 2019

Am I Depressed?

Published on: 01 Feb 2019
All of us feel sad and upset at times. When that sadness seems to last longer than usual,…