Depression is a mood state that is characterised by significantly lowered mood and a loss of interest or pleasure in activities that are normally enjoyable. Such depressed mood is a common and normal experience in the population. However, a major depressive episode can be distinguished from this 'normal' depression by its severity, persistence, duration, and the presence of characteristic symptoms (eg sleep disturbance). The most common emotional, behavioural, and physical symptoms of a major depressive episode are listed below.

Common Presentation

  • Markedly depressed mood
  • Loss of interest or enjoyment
  • Reduced self-esteem and self-confidence
  • Feelings of guilt and worthlessness
  • Bleak and pessimistic views of the future
  • Ideas or acts of self-harm or suicide
  • Disturbed sleep
  • Disturbed appetite
  • Decreased libido
  • Reduced energy leading to fatigue and diminished activity
  • Reduced concentration and memory

The overall depressed mood is relatively constant from one day to the next, although the mood may vary somewhat during the course of the day. A pattern is often present in which mood becomes better as the day progresses.

(Ref: Management of Mental Disorders, World Health Organisation Collaborating Centre)