Depression is a complex mental health issue that affects roughly 21 million adults in the U.S. each year . It’s more than just feeling sad; it’s a significant struggle for many people, and it can include a wide range of symptoms, including depression brain fog, depression irritability, and depression motivation issues. In this article, we’ll cover general, moderate, and severe depression symptoms, different types of depression, and the risks of not treating it. Understanding these aspects is essential for recognizing and dealing with this condition.
General Symptoms of Depression
Depression is a mental health condition that affects individuals differently, and its symptoms can vary in intensity, duration, and frequency [9, 16-17]. If someone experiences several signs and symptoms of depression for at least two weeks, most of the day, nearly every day, they may have depression. It is important to know these signs and seek professional help if needed. Symptoms may include [9, 16-17]:
- Feelings of sadness, anxiety, or a persistent sense of emptiness.
- A deep sense of hopelessness, worthlessness, and a generally pessimistic outlook.
- Frequent episodes of crying.
- Experiencing depression irritability can lead to heightened sensitivity and frustration.
- Loss of interest in activities and hobbies that were once enjoyable.
- Reduced energy levels and persistent fatigue.
- Struggling with depression motivation, making it difficult to find the drive to engage in daily tasks.
- Dealing with depression brain fog, including memory loss, difficulties concentrating, or making decisions.
- Slower movements or speech.
- Sleep difficulties include falling asleep, waking up very early, or oversleeping.
- Changes in appetite or weight.
- Persistent physical discomforts, like unexplained headaches, aches, digestive issues, or cramps.
- Thoughts related to death, suicide, self-harm, or even suicide attempts [9, 16-17].
Primary care providers often use tools like the eight-item Patient Health Questionnaire (PHQ–8)  to assess symptom severity. This questionnaire assigns scores that range from 0 to 24. Scores of 0–4 indicate minimal or no depression symptoms, while 5–9, 10–14, or 15–24 signify mild, moderate, or severe symptoms, respectively. This scoring system assists healthcare professionals in gaining insights into the extent of distress and functional challenges faced by those grappling with depression. By using these classifications, healthcare experts can better tailor treatment and support to cater to each individual’s unique circumstances.
- Mild Depression: Individuals with mild depression typically experience a limited number of symptoms, which have a relatively minor impact on their daily functioning. Treatment options may include therapy, lifestyle modifications, or a watchful waiting approach .
- Moderate Depression: Moderate depression involves a more substantial number of symptoms that significantly affect a person’s ability to function in various aspects of life. Treatment often includes therapy and may incorporate medication, depending on the individual’s needs .
- Severe Depression: Severe depression is characterized by a high number of severe symptoms that profoundly disrupt an individual’s daily life. People with severe depression often require intensive treatment, which may involve a combination of psychotherapy and medication .
Not everyone experiences depression the same way, and depression can be unique for each person, and not everyone will fit neatly into one of these classifications. Mental health professionals use these classifications as guidelines to assess and provide appropriate care.
Types of Clinical Depression
Depression, a mood disorder marked by enduring feelings of sadness and diminished interest, is classified into several categories by the American Psychiatric Association in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These categories include the following five types :
Major Depressive Disorder (MDD)
MDD, often interchangeably referred to as “depression” or “major depression” is a common form of depression . Symptoms include:
- Persistent low mood
- Loss of interest or pleasure in activities
- Changes in appetite or weight
- Sleep disturbances
- Feelings of worthlessness or guilt
- Difficulty concentrating
- Thoughts of death or suicide .
- Major depressive episode
Disruptive Mood Dysregulation Disorder (DMDD)
DMDD primarily affects children and adolescents . To be diagnosed with DMDD, specific criteria must be met, such as severe temper outbursts occurring at least three times a week for 12 months or more . Symptoms include severe and chronic irritability, accompanied by frequent temper outbursts, which can manifest as verbal or physical aggression, self-harm, or destructive behavior .
Persistent Depressive Disorder (Dysthymia)
Persistent depressive disorder, also known as dysthymia, this condition is characterized by a long-lasting, low-level, and persistent depressed mood ; other symptoms include :
- Poor appetite
- Hypersomnia (excessive sleep)
- Low energy
- Low self-esteem
- Poor concentration
- Feelings of hopelessness
Premenstrual Dysphoric Disorder (PMDD)
PMDD primarily affects women before their menstrual period . It is marked by severe mood swings, irritability, tension, and physical symptoms such as bloating, breast tenderness, and joint pain .
Depressive Disorder Due to Another Medical Condition
Depression can result from various medical conditions [1,11-12, 18]. These conditions include infectious diseases, autoimmune disorders, cancer, stroke, neurodegenerative diseases, trauma, interferon treatment, heart disease, Huntington’s disease, Parkinson’s disease, and multiple sclerosis [1,11-12, 18]. Each of these medical conditions may contribute to depressive symptoms due to factors such as immune system activity, brain inflammation, or the emotional impact of the condition [1,11-12, 18].
Other Types of Depressive Disorders
Along with the types listed above, there are other depressive disorders and mood disorders that individuals may struggle with. These include:
- Perinatal Mood and Anxiety Disorder (PMAD): PMAD is a mental health disorder that can develop during pregnancy, after having a baby, adopting, or experiencing pregnancy and infant loss. During these events, people can experience a wide range of emotional, physical, hormonal, and social changes that can trigger depression. Furthermore, PMAD is often broken down into prenatal depression (during pregnancy) and postpartum depression (after giving birth).
- Manic Depression: Also known as bipolar disorder, manic depression is a mental health condition that causes extreme mood swings comprising emotional highs (mania) and lows (depression).
- Seasonal Affective Disorder (SAD): SAD is a type of depression that is directly linked to changes in seasons. For example, as summer ends and fall turns into winter, some individuals may begin to experience depression symptoms that can last until the seasons start to change again.
What Happens if Depression Goes Untreated
Untreated depression can lead to serious consequences, affecting mental health and physical well-being . Without appropriate treatment, depression worsens over time, potentially leading to more severe symptoms . Persistent sadness, hopelessness, and despair can significantly impact a person’s daily life, making it difficult to engage in work, relationships, and social activities .
Furthermore, untreated depression is associated with an increased risk of other mental health conditions, such as anxiety and substance abuse . It can also have adverse effects on physical health, potentially contributing to conditions like heart disease, obesity, and diabetes . In extreme cases, untreated depression can lead to self-harm or suicidal thoughts and actions .
Finally, the stigma surrounding mental health issues often prevents individuals from seeking the help they need, exacerbating the adverse outcomes of untreated depression . This stigma can adversely affect personal and professional aspects of their lives .
Treatment for Clinical Depression
Treating depression often may involve a combination of approaches. Some of the treatments for depression may include:
- Medication: Antidepressant medications, including SSRIs, SNRIs, atypical antidepressants, TCAs, and MAOIs, may alleviate depressive symptoms [13,15].
- Psychotherapy: Talk therapy, such as cognitive-behavioral therapy (CBT) and interpersonal therapy, plays a crucial role in managing depression. .
- Electroconvulsive Therapy (ECT): ECT is recommended for severe cases of depression, especially when other treatments have not been effective .
- Transcranial Magnetic Stimulation (TMS): TMS is an FDA-approved treatment for treatment-resistant depression, particularly for patients who have not responded to medication. A recent study evaluated the efficacy of depression treated with brain stimulation therapy and psychotherapy simultaneously which resulted in a response rate of 66% and a remission rate of 56% at the end of the combined treatment .
- Esketamine: Spravato (esketamine), administered as a nasal spray in combination with an oral antidepressant, is used for treatment-resistant depression [3,13]. Additionally, if an individual has tried multiple medications, yet failed to experience symptom relief, they may be a good candidate for Spravato.
Seek Treatment for Depression Symptoms
Identifying the signs of depression is a crucial first step in seeking help. Whether it’s persistent feelings of sadness or hopelessness, changes in sleep or appetite, depression brain fog, or thoughts of self-harm or suicide, it is important to recognize symptoms promptly and reach out to a mental health professional as soon as symptoms begin. With the right treatment and support, depression can be managed effectively, and individuals can regain their quality of life.
If you or a loved one is struggling with symptoms of depression, don’t hesitate to reach out for help. Contact Neuro Wellness Spa today to learn more about our innovative depression treatments and take the first step towards a brighter tomorrow. Your mental health matters and support is just a call away.
- Askin, L., Uzel, K. E., Tanrıverdi, O., Kavalcı, V., Yavcin, O., & Turkmen, S. (2020). The relationship between coronary artery disease and depression and anxiety scores. Northern clinics of Istanbul, 7(5), 523–526. https://doi.org/10.14744/nci.2020.72602
- Bains, N., & Abdijadid, S. (2023). Major Depressive Disorder. In StatPearls. StatPearls Publishing.
- Bahr, R., Lopez, A., & Rey, J. A. (2019). Intranasal Esketamine (SpravatoTM) for Use in Treatment-Resistant Depression In Conjunction With an Oral Antidepressant. P & T: a peer-reviewed journal for formulary management, 44(6), 340–375.
- Chand SP, Arif H. Depression. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430847/
- Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical Practice Guidelines for the Management of Depression. Indian journal of psychiatry, 59(Suppl 1), S34–S50. https://doi.org/10.4103/0019-5545.196973
- Hung, C. I., Liu, C. Y., & Yang, C. H. (2017). Untreated duration predicted the severity of depression at the two-year follow-up point. PloS one, 12(9), e0185119. https://doi.org/10.1371/journal.pone.0185119
- Karrouri, R., Hammani, Z., Benjelloun, R., & Otheman, Y. (2021). Major depressive disorder: Validated treatments and future challenges. World journal of clinical cases, 9(31), 9350–9367. https://doi.org/10.12998/wjcc.v9.i31.9350
- Lavu, V. K., Mohamed, R. A., Huang, R., Potla, S., Bhalla, S., Al Qabandi, Y., Nandula, S. A., Boddepalli, C. S., Gutlapalli, S. D., & Mohammed, L. (2022). Evaluation and Treatment of Depression in Stroke Patients: A Systematic Review. Cureus, 14(8), e28137. https://doi.org/10.7759/cureus.28137
- Laporte, P. P., Matijasevich, A., Munhoz, T. N., Santos, I. S., Barros, A. J. D., Pine, D. S., Rohde, L. A., Leibenluft, E., & Salum, G. A. (2021). Disruptive Mood Dysregulation Disorder: Symptomatic and Syndromic Thresholds and Diagnostic Operationalization. Journal of the American Academy of Child and Adolescent Psychiatry, 60(2), 286–295. https://doi.org/10.1016/j.jaac.2019.12.008
- National Institute of Mental Health (n.d.). Depression. https://www.nimh.nih.gov/health/topics/depression
- Patel, R. K., & Rose, G. M. (2023). Persistent Depressive Disorder. In StatPearls. StatPearls Publishing.
- Paulsen, J. S., Nehl, C., Hoth, K. F., Kanz, J. E., Benjamin, M., Conybeare, R., McDowell, B., & Turner, B. (2005). Depression and stages of Huntington’s disease. The Journal of neuropsychiatry and clinical neurosciences, 17(4), 496–502. https://doi.org/10.1176/jnp.17.4.496
- Rickards H. (2005). Depression in neurological disorders: Parkinson’s disease, multiple sclerosis, and stroke. Journal of neurology, neurosurgery, and psychiatry, 76 Suppl 1(Suppl 1), i48–i52. https://doi.org/10.1136/jnnp.2004.060426
- Ruberto, V. L., Jha, M. K., & Murrough, J. W. (2020). Pharmacological Treatments for Patients with Treatment-Resistant Depression. Pharmaceuticals (Basel, Switzerland), 13(6), 116. https://doi.org/10.3390/ph13060116
- Somani, A., & Kar, S. K. (2019). Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far. General psychiatry, 32(4), e100074. https://doi.org/10.1136/gpsych-2019-100074
- Swedish Council on Health Technology Assessment. (2004). Treatment of Depression: A Systematic Review. Swedish Council on Health Technology Assessment (SBU).
- U.S. Department of Health & Human Services (n.d.). Depression. Office on Women’s Health. https://www.womenshealth.gov/mental-health/mental-health-conditions/depression
- Villarroel, M., Terlizzi, E. Symptoms of Depression Among Adults: United States, 2019. September 2020. https://www.cdc.gov/nchs/data/databriefs/db379-H.pdf
- Yirmiya R. (2000). Depression in medical illness: the role of the immune system. The Western journal of medicine, 173(5), 333–336. https://doi.org/10.1136/ewjm.173.5.333