Symptoms of Severe Depression| How severe is ''severe''

The symptoms of severe depression are the same as in major depression, it is their intensity, frequency and number present in you that determines the severity. The presence of delusions and hallucinations is also considered as severe depression. If hallucinations and delusions are present, it is known as psychotic depression.

In Nutshell|Symptoms of Severe Depression

If you have 8 out of the following 10 symptoms you have severe depression. The first 3 symptoms are mandatory.

1.Depressed mood

2.Loss of pleasure

3.Lack of energy

4.Loss of confidence


6.Psychomotor retardation or agitation

7.Sleep disturbances

8.Appetite changes

9.Lack of concentration

10.Suicidal thoughts

Symptoms of severe depression include low mood and sadness. Lack of pleasure in life and you feel that nearly everyday. The things that made you happy previously, now are not pleasurable. You feel lethargic as if someone has drained your energy.

You may not want to get out of your bed. You can have mental slowness and the will show itself in slow talk and sluggish body movements. You will have difficulty in making decisions and concentrating. You may not be able to complete your routine work, like changing your dress, eating and going to washroom.

You have bursts of weeping and crying without any obvious reasons. You will think that you are responsible for all the wrong things happening to people around you. Thoughts will come into your mind that you are worthless and a complete failure. Thoughts that some massive catastrophe has happened or will happen and everything is destroyed.

You can have a smile on your face in severe depression as well. But this smile is different from the smile of happiness. In depressive smile there are no emotions of happiness. The eyes are telling the truth but the other person can think that you are pretty fine. Actually depressed people give this kind of smile to show to others that they are fine.

You can have severe depression along with presence of psychotic features (delusions and hallucinations) or without the presence of psychotic features.

How WHO defines Symptoms of Severe Depression

The World Health Organization (WHO) has laid down a criteria for the symptoms of severe depression. If you are having a total of 8 symptoms (explained below) from the lists given below, you are having severe depression.

A.For severe depression all of the following three symptoms must be present.

  1. Depressed or low mood is present most of the days or nearly everyday of the week and it is not changed by the circumstances. This depressed mood is abnormal for you and is present for at least 2 weeks persistently.
  2. You have lost interest in the activities of life. The activities which were pleasurable to you now seem boring. They do not amuse you any more. Life activities seem no more pleasurable to you.
  3. You feel as your energy has been drained. You get tired and fatigues easily. You find yourself without energy to do anything.

B.From the following list at least 5 symptoms must be present, any five, so that there is a total of 8 symptoms.

  1. Low self esteem or loss of self confidence. You do not value yourself and you do not believe in your abilities and yourself.
  2. Guilt or self reproach. You criticize yourself and blame yourself. You feel that you have done something wrong and you are ashamed of that. You have feelings of regret as if you have committed some crime.
  3. Difficulty thinking and making decisions. You develop lack of concentration, making decisions and sticking to them looks impossible. You also forget things easily.
  4. You develop psychomotor agitation or retardation. Psychomotor retardation - ''psych'' refers to psychological, your thinking processes and ''motor'' refers to the physical activity. Therefore you can be slow mentally and physically to an extent that others can notice this change. You will talk slowly, slow in responding to questions or situations. Your overall movements will be decreased. You can have psychomotor agitation which means restlessness.
  5. Your sleep is disturbed. It includes disturbance of any kind. You find difficulty in falling sleep or you get up in the middle of the night. It is not limited to decreased sleep. You can have increased sleep and feely sleepy throughout the day.
  6. You have changes in your appetite. It can be either ways, you eat less or you eat more.
  7. Suicidal thoughts coming into your mind. Thoughts of death can occupy your mind. You may even attempt to commit suicide.
Attention Please

If suicide thoughts are coming into your mind,please immediately seek help.
Talk to your family member, friend, colleague or talk to a doctor about it.
It is important- your life is precious.

This depression will go away and you will have a cheerful life again. It is not there to stay forever. Do not give away your life, life has so much good to offer. You will see that when you are out of it that how good life is!

So if you are having all the 3 symptoms in list A and any 5 symptoms from list B, you have total of 8 symptoms and this accounts for symptoms of severe depression.

If you are having delusions and hallucinations it will be termed severe depression with psychotic features. If you are not having delusions and hallucinations, it will be severe depression without psychotic features.

The severity of depression can be mild, moderate and severe. The severity is also assessed with the help of questionnaires. The questions are based on the diagnostic criteria of the depression and you answer them as you feel. All the answers have marks and they are added to give your score. The score depends on the particular tool/questionnaire you are using.

Patient health questionnaire 9 (PHQ-9) is an easy, reliable and effective tool that can be used to assess severity of depression. If you score more than 20 on this tool you have severe depression. It is used by the doctors to monitor the progress of the patients. It is easy to fill and interpret and reliable. You can also use this tool to determine your progress.

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