Clinical Depression Symptoms--Major Depressive Episode

I strongly believe there are many of you with these related depression issues. If you suspect or see yourself in this article, please do not hesitate to seek help from your healthcare provider, who will refer you to the proper resource for care and treatment.

MDD (major depressive disorder) is serious and the worst case would be suicide. It doesn’t have to be that drastic but your quality of life still can be greatly reduced.

This article will discuss major depressive episodes, related to the category of clinical depression symptoms.

Major depressive episode is a key symptom of major depressive disorder (mdd). It is characterized by severe, highly persistent depression, and emotional pain, which is often manifested by lack of appetite, chronic fatigue, and lethargy and sleep disturbances. You may think about suicide and be at increased risk for actual suicide.

Brenda told me that over a period of a few days, she once felt fatigue and lethargy that prevented her from working. Her antidepressant medicine was adjusted by her psychiatrist. Her episodes come and go without much warning she said.

Diagnosis of a major depressive episode must meet the following criteria:

Over a two week period, the patient has consistently experienced five or more of the following symptoms which are outside of your normal behaviors:

#1) Mood—For the better part of nearly every day, people like Brenda feel a depressed mood or appears depressed to others. Brenda told her psychiatrist (initial visit) that she had been feeling sad, depressed, blue, empty, “down in the dumps”, and hopeless.

She reported recent headaches, diarrhea, irritability, aches, and pains, out of the ordinary for her. At work she was “snapping” at people but well aware this was abnormal.

#2) Loss of Interest—Brenda and others with depression tend to lose interest in things they once found enjoyable. She said “I just didn’t care any more.” Or “Nothing mattered any more.” Her family and friends noticed how withdrawn she’d become and her neglect of activities she once enjoyed.

#3) Eating disorders and weight gain/loss—for Brenda it was weight loss. She was not dieting but had lost 5% of her weight in one month. She never felt hungry and would go long periods of time without wanting to eat or forget to eat or eat only a small amount of food. (She had what’s called melancholic type of depression).

Others tend toward an increase in appetite and gain weight. They may crave sweets and carbs.

#4) Sleep—nearly every day you may sleep too much or very little. Insomnia is the most common type for the depressed. You may wake up in the middle of night and can’t go back to sleep; or have difficulty falling asleep at night.

#5) Motor Activity—This means your physical activity is either agitated or reduced in terms of your mannerisms or behaviors. If agitated you may have difficulty sitting still, fidget with clothes or objects or wring your hands.

If reduced you tend to move sluggishly or very slowly, sit slumped in a chair, speak slowly, saying little.

Poor Brenda alternated with both of these at times. Her awareness of these behaviors was almost nil. However other’s noticed.

#6) Fatigue—nearly every day Brenda felt extreme fatigue, low energy which is very common for the depressed. Brenda couldn’t understand how she could wake up after a good night sleep and felt exhausted while preparing for work. After her shower and getting dressed she often sat on her bed and flopped over, no energy, and felt sleepy.

Her daily tasks at home like laundry, cleaning became hard to do and her performance on the job deteriorated gradually.

#7) Self-worth—nearly every day Brenda felt worthless or inappropriately guilty. This is more than just being depressed, it may be delusional. There was no reason for her to feel worthless because she was very accomplished in her life and never did anything to justify the guilt she felt deep down inside.

Depressed people think of themselves in very negative, unrealistic ways such as being a failure or believing minor mistakes prove their inadequacy.

Brenda has an unrealistic sense of personal responsibility and sees things beyond her control, as being her fault.

Self-loathing is common in depression and can lead to a downward spiral when combined with other symptoms. Brenda describes it as deep, internal self-hatred.

#8) Concentration—Nearly every day, you are indecisive or have trouble thinking or concentrating. Depression causes negative and pessimistic thoughts, and reports that your ability to think, concentrate, or make decisions becomes impaired.

Memory and distraction problems are common. This is notably pronounced, causing significant difficulty in functioning for those involved in intellectually demanding activities.

Brenda says this became a major issue at work, affecting her ability to multi-task, among other situations.

#9) Thoughts of death—The patient has repeated thoughts about death (excluding the fear of dying), suicide (with or without a plan) or has made a suicide attempt.

The frequency and intensity of thoughts about suicide can range from believing that friends and family would be better off if one were dead, to frequent thoughts about committing suicide (generally related to wishing to stop the emotional pain), to detailed plans about how the suicide would be carried out.

Less severely suicidal people may have regular thoughts of suicide, while those who are more severely suicidal may have made specific plans and decided upon a day and location for the suicide attempt.

Brenda is receiving regular treatment by a psychiatrist who manages her medications and a psychologist for "talk" therapy. Her condition is relatively stable and she leads a fairly normal life but with menopause and depression she has occasional "relapses."

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