Major Depression, Part I

by Colleen Sullivan

Major depression is a mental disorder chararcterized by a depressed mood or a loss of interest of pleasure in usual activites that persists for two weeks or longer. In addition the presence of changes in some (or many) of the following areas are noted in major depression:

Mood: sad, empty, hopless, apathetic, worried, irritable

Thinking: poor concentration, low self esteem, indecisiveness, preoccupation with death, thoughts of suicide, guilt etc

Behavior: slowed down or restless, crying, social withdrawl, siucidal acts

Physical: appetite decreased or increased, disturbed sleep, weight loss or gain, decreased sexual drive, digestive problems and fatigue.

In a poll taken by the National Mental Health Association, 43% of those surveyed said that they believed depression was a personal or emotional weakness rather than an illness. As a result of this thinking, fewer than one in three depressed people ever seek treatment. They choose to blame thenselves, famly members, friends or circumstances for their depressed feelings. They are wrong. Depression is a highly treatable disorder. In fact, the sooner depression is diagnosed and treatment begun, the brighter the long term outlook. With treatment, as many as 80% of those suffering with depression improve sigificantly within a few months

Types of Depression

Major depression can be classified as mild, moderate or severe. Mild depression involves a mininum number of symtoms (five are required for diagnoses). There is little interference with work or social functioning.

Moderate depression presents more symptoms and greater impairment of daily life.

In severe depression symtoms are increased both in number and severity, and take a much greater toll on the ability to function socially and at work. In extreme cases depressives are unable to work or feed, clothe or provide basic hygiene for themselves.

Major depression can be further divided into three forms, melancholic, atypical, and psychotic.

Melancholic Depression

  • feeling of sadness is profound and of a different quality than other depression
  • early morning wakening and inability to fall asleep again
  • depression most intense in morning
  • either agitated or slowed down
  • loss of appetite and weight loss
  • persistant and complete loss of joy in life's pleasures
  • excessive and unfounded guilt

Atypical Depression

  • ability to experience joys of life, however briefly, and can feel temporary happiness in respond to something pleasurable
  • may eat or sleep much more than usual
  • may report a heavy, leaden feeling in arms or legs
  • chronic and extreme sensitivity to rejection causes interference in ability to work or to socialize

Psychotic Depression (uncommon)

  • loss of touch with reality
  • hallucinations usually reflective of their sense of doom
  • hallucinations are sensotory usually visual and / or auditory in nature
  • treatment with antipsychotic medication is essential

Symptoms - Is it Depression?

If your mood has been persistently depressed (sad, blue, hopeless, down, irritable); if you have lost interest in all, or almost all usual activities and past times and have experienced at least four of the following symptoms for at least two weeks, Major Depression is a likely cause. Consultation with a professional is needed at this point.

  1. Appetite greater or less than normal. Weight gain or loss without trying
  2. Sleep Disturbances; more or less than usual
  3. Slowed movements or agitation and restlessness
  4. Fatigue, listlessness and lack of engery
  5. Hopelessness, helplessness and worthlessness
  6. Lack of concertration and inability to focus attention
  7. Inability to perform as effectively or productively as in the past
  8. Difficulty in thinking clearly and in decision making
  9. Forgetfulness
  10. Persistant and recurring thoughts of death or suicide
  11. Poor sense of self worth and self esteem
  12. Feelings of inadequacy
  13. Reflecting and brooding over the past
  14. Loss of interest in sex or less sexually active than usual
  15. Withdrawl from others
  16. Physical symptoms eg. headaches, digestive problems, aches and pains

© Colleen Sullivan

Colleen Sullivan was a contributing editor to's Bi-Polar Disorder site.