26th January 2024

Symptoms

The following have all been described as symptoms of depression:

Core symptoms	Additional symptoms	Somatic symptoms
Low mood (that varies little from day to day and is unresponsive to circumstances) Anhedonia (reduced interest in previously enjoyed activities)	Poor concentration and memory Low self-esteem and self-confidence Feelings of guilt, hopelessness, and worthlessness Diurnal variation (symptoms worse in the morning) Deliberate self-harm Suicidal thoughts or acts	Early morning awakening / disturbed sleep Anorexia/weight loss Loss of libido Psychomotor agitation (restlessness, pacing, fidgeting) Psychomotor depression (appear slowed down, slow walking, slow or monotonous speech, blunted affect) Anergia (increased fatigability, even on limited exertion)

Source: NICE. (2021). Depression | CKS | NICE. Retrieved July 6, 2022, from https://cks.nice.org.uk/topics/depression/

WHO. (2019). ICD-10 Version: 2019. In ICD-10 Version: 2019. Retrieved from https://icd.who.int/browse10/2019/en#/V

Subthreshold depressive symptoms: When a patient has some of the core symptoms, but their number or severity is insufficient to meet the criteria for full diagnosis.
Persistent subthreshold depressive symptoms: previously known as dysthymia, the persistence of subthreshold symptoms for more than 2 years.
Recurrent depressive disorder: repeated episodes of depression without a history of episodes of elation and increased energy (mania).
Cyclothymia: a persistent instability of mood in which the patient experiences periods of mild depression and mild elation, which are not severe enough to be classed as bipolar affective disorder or recurrent depressive disorder.
Atypical depression: involves abnormal symptoms such as weight gain, hyperphagia, hypersomnia, mood reactivity (improved mood upon exposure to positive stimuli), leaden paralysis (an unusually heavy feeling in the arms or legs), rejection sensitivity (feeling anxious and hyper-reactive to rejection or perceived rejection).

Mild depression: at least 2 symptoms present; the patient is distressed by their symptoms but usually able to continue with activities
Moderate depression: at least 4 symptoms present; the patient will have considerable difficulty continuing with activities
Severe depression without psychotic symptoms: several marked, distressing symptoms present, often with somatic symptoms and/or suicidal ideation, without psychotic symptoms. The patient is often unable to continue normal activities
Severe depression with psychotic symptoms: also termed psychotic depression; an episode of severe depression with symptoms of psychosis such as hallucinations, delusions, psychomotor retardation, or stupor

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