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10 Major Depressive Disorder Symptoms You Shouldn’t Ignore

The signs of depression go beyond sadness.

Medically reviewed by David Klemanski, PsyD, MPH

December 3, 2021

Illustration of a person with depression.

Major depressive disorder symptoms can manifest as feelings of hopelessness and irritability for one person or feeling really down and exhausted for another. Depression—which is one of the most common mood disorders in the U.S.—can be varied, even though it has some common characteristics. Weathering through occasional bouts of sadness is normal and simply part of being human, so it’s not always easy to notice when it’s become a persistent problem.

Major depressive disorder (MDD), which is also known as clinical depression, is more than a single feeling: It’s a debilitating mental health condition that can silently creep into every part of your life, stirring up a slew of thoughts and emotions that can make you feel that it’s nearly impossible to function or that life isn’t worth living.

It’s important to remember that feeling this way isn’t your fault, because depression is a complicated condition that often doesn’t have one clear cause, Anne H. Gilbert, M.D., a clinical psychiatrist at Indiana University Health, tells SELF. In fact, according to the National Institute of Mental Health, research suggests depression can develop due to a combination of genetic, environmental, or psychological factors, many of which can be out of your control.

Even if the condition feels all-consuming, many people with depression start to feel better with treatment. The first step in getting help, though, is recognizing the signs of depression, which you can learn more about below. Just note that some of the topics covered may be triggering for people who are experiencing severe symptoms. (If you are in a crisis and need immediate help, don’t hesitate to contact your local hospital or the confidential National Suicide Prevention Hotline at 800-273-8255, which is available 24/7.)

Major depressive disorder symptoms | Child and teen depression symptoms | Diagnosis | Depression treatment

What are the symptoms of major depressive disorder?

If you experience one of the first two symptoms (and at least four of the remaining symptoms) for most of the day for at least two weeks, you may be experiencing some form of depression, per the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).¹

You feel persistently sad, hopeless, or empty: Pay close attention to these emotions if they feel very overwhelming, don’t seem to have a specific trigger, and don’t start to ease up with time.
You’re no longer interested in your passions: Depression is often characterized by losing motivation to do activities you once enjoyed. So if you’ve always looked forward to your morning workouts, for instance, you might feel like exercising is the last thing you want to do.
You feel like you’re about to snap: Irritability can look different for everyone, but you could start to get really annoyed or angry about little things, causing you to pick fights with your best friend or partner, for example.
You’re exhausted: You may feel like it’s hard to get out of bed or like you don’t even have the energy to make yourself lunch.
And your sleep schedule isn’t helping: Despite sticking to a consistent sleep routine, you might have trouble falling asleep at night. Or you could feel so tired that you sleep until well past your typical wake-up time.
You can’t focus: Concentrating on your work may seem impossible and you may feel confused or like you’re in a haze. You may have a hard time making decisions too.
Your appetite changes are really significant: There may be times when you don’t eat at all or when you overeat, which may cause you to lose or gain weight.
You’re dealing with unexplained pain: Depression can actually be the cause of physical symptoms like muscle aches or pains, headaches, stomach cramps, or digestive issues that don’t seem to get better with treatment, according to the National Institute of Mental Health.
You feel super restless or really lethargic: You may have trouble sitting still or feel generally uneasy without any clear reason, or you might move and respond much slower than normal.
You’re having thoughts about self-harm: In serious cases, depression can lead to thoughts about death or suicide. If this happens, it’s crucial to reach out to a trusted friend or family member, seek medical care at a local hospital clinic, or call the National Suicide Prevention Hotline at 800-273-8255.

Are depression symptoms different in children and teens?

Research² suggests depression can occur in kids as young as three years old—but children don’t always show the typical signs of depression. For example, young kids (between ages three and eight) may complain more about sickness or pain, be more irritable, show signs of anxiety, or misbehave. As kids get older, they may start to develop more classic symptoms of major depressive disorder. According to the Centers for Disease Control and Prevention and the Mayo Clinic, this includes the following:

They are frequently sad or irritable.
They don’t want to do fun activities, like go out for ice cream.
They eat more or less than they normally do.
They have self-destructive behavior and get in trouble at school.
They have a hard time focusing.
They talk about feeling bad about themselves.
They become frustrated or angry over small things, like spilling their water.
They stop hanging out with their friends.
They have trouble making decisions.
They begin drinking or using drugs.

We all remember being (understandably) moody as kids, but it’s important to pay attention to really drastic behavior changes in a child or teen, according to Heidi L. Combs, M.D., a clinical psychiatrist and director of inpatient psychiatry at UW Health’s Harborview Hospital in Seattle. For example, maybe they’re suddenly not hanging out with friends, getting homework done, or going to sports practices. “These are all things that would start to perk up my sense that the person may be struggling,” Dr. Combs tells SELF.

How is major depressive disorder diagnosed?

Getting an official depression diagnosis isn’t always a straightforward process. You could notice a few of the signs above and start a conversation with a primary care doctor, who may agree that your symptoms are worth exploring further and encourage you to see a therapist. Or, you may already be in therapy and eventually receive a diagnosis once you’ve had a few sessions.

If you start with your primary care doctor, they may run some lab tests to rule out other conditions that can mimic depression symptoms, such as thyroid disorders and nutritional deficiencies, which can cause symptoms like fatigue, low mood, or irritability. They’ll also take a closer look at any medications you’re taking to pinpoint possible side effects.

If you’re seeing a licensed therapist, they’ll do a psychiatric evaluation. This may sound daunting, but you’ll simply be asked about thoughts and feelings you’ve been having, as well as any behavior patterns or changes you’ve noticed. (It’s common to fill out a questionnaire before your first appointment as well.) If you meet the DSM-5’s criteria for clinical depression, your doctor or therapist will move forward with a depression treatment plan that is customized to your personal goals and needs.

What does major depressive disorder treatment look like?

There are numerous things to consider when figuring out what depression treatment looks like for you, including your medical history, your personal symptoms, and whether or not you’ve been depressed before, according to Dr. Combs.

In general, though, your path forward will likely include some form of therapy, medication, or both. In one 2014 meta-analysis of 92 studies on psychotherapy published in the Journal of Affective Disorders³, 62% of 6,937 people with clinical depression found that just going to therapy helped reduce their symptoms to the point where they no longer met the criteria for a clinical depression diagnosis.

Feeling comfortable with your treatment is crucial (because you need to follow it!), so it’s important to speak up if you feel hesitant about anything. For example, some people may prefer to try talk therapy alone before committing to a medication. If that’s the case for you, make sure you make any concerns clear to your doctor or therapist, as they can answer questions to make you feel more at ease or recommend a different approach first.

In particular, cognitive behavioral therapy (CBT) is viewed as the gold standard form of therapy for depression because it can help you learn how to reframe the way you think⁴, according to the American Psychological Association. With the help of a licensed therapist, CBT can help you learn to identify when your thinking becomes distorted, better understand your own behaviors as well as the motivations of people around you, develop problem-solving skills to help you cope in tough moments, and build an overall sense of confidence in yourself. With time, you may start noticing negative thoughts, such as, “My life is terrible, and I’ll never amount to anything,” and how these only contribute to your depression.

We all can benefit from therapy, but the process can take some time and effort. That’s why, especially if you have severe symptoms, antidepressants are often considered. Medications like selective serotonin reuptake inhibitors (SSRIs) work by increasing your serotonin levels—a mood-boosting chemical—relatively quickly but take about six to eight weeks to fully take effect, according to the Cleveland Clinic. These are often the most popular choice for depression medication because they generally have fewer side effects⁵ than other antidepressants, but you may need to experiment a bit to figure out which one is best for your specific situation.

When you first start treatment, you may find yourself wondering if you’ll ever actually feel better. But with time, the right plan can make a huge difference in the way you feel about yourself. Of course, starting therapy can be a Big Life Moment, so check out SELF’s Guide to Caring for Your Mental Health for helpful information on how to find the best therapist for you, what to know before your first appointment, and how to get the most out of therapy—because the process can be life-changing!

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