What are the symptoms of depression? How do you know if you have it? The DSM-IV-TR, known as the "Bible" of clinical psychology, defines a major depressive episode as having one or both of the following, lasting at least two weeks:

1. Sad, down, or "empty" mood, lasting almost all day, almost every day (dysphoria)
   
2. Loss of interest in activities you once enjoyed (anhedonia)

Other symptoms may include the following:

1. Changes in appetite (either increased appetite or loss of appetite) and/or sudden changes in weight
   
2. Sleep disturbances, particularly insomnia, early waking, or oversleeping
   
3. Physical symptoms such as digestive trouble, headaches, or backaches that do not respond to conventional medical treatment
   
4. Lack of motivation, which in severe cases may be experienced as "paralysis of the will"
   
5. Difficulty concentrating, remembering, or making decisions
   
6. Psychomotor agitation or retardation -- that is, a "speeding up" or "slowing down" of one's movements, observed by others
   
7. Irritability or restlessness
   
8. Low self-esteem and/or feelings of worthlessness, helplessness, guilt, or hopelessness
   
9. Social withdrawal
   
10. Fatigue, loss of energy, feeling run down or sluggish
    
11. Death or suicidal ideation -- that is, thoughts of one's own death, the death of others, or of taking one's own life
    
12. Suicide attempts

Major depressive disorder is diagnosed when a major depressive episode as described above is experienced without a history of mania or hypomania. If there is a history of mania or hypomania, a bipolar disorder is diagnosed.
Symptoms of mania include the following. Hypomania includes the same symptoms but is less severe than full mania.

1. Racing thoughts or "flight of ideas"
   
2. Extremely decreased need for sleep -- this is different from insomnia in that the person does not even seem to need sleep
   
3. Extremely high, happy, and euphoric mood, or a very intense and active bad (dysphoric) mood, perhaps rageful or anxious
   
4. Abnormally high energy levels
   
5. Grandiosity
   
6. Distractability, impulsiveness, and risk-taking, typically greater than what is seen in attention-deficit hyperactivity disorder (ADHD)
   
7. Pressured speech -- meaning that the person talks very fast as if there is a torrent of words pent up and the dam is bursting. A manic person with pressured speech is several steps of intensity beyond, for example, an auctioneer's calling
   
8. Hypersexuality

Take the Quick Depression Screening Quiz at Psych Central. Remember this is only a screening and cannot diagnose depression or any other illness. If you have a positive screening, it's recommended that you seek appropriate help, preferably from a psychologist or psychiatrist, or failing that, from your general physician.




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