Columbia University Health Services

How do I know if I am clinically depressed?

Only a health care professional can diagnose depression, however the following symptoms can be a signal that you may be suffering from major depression.   Major depression often includes having one symptom from Set A and four or more symptoms from Set B, lasting for at least two weeks.

Set A (One of these symptoms):

• Feeling depressed (down, sad, blue, hopeless) most of the day and almost every day. Feelings of depression may come on gradually or suddenly.
• Loss of interest and pleasure in things that are usually interesting and pleasurable. Some people may not feel better under any circumstances; others may periodically respond to positive events by feeling better.

Set B (Four of more of these symptoms):

• Loss of appetite and/or weight loss without dieting or medical cause, or increase in appetite and/or undesired weight gain.
• Insomnia (waking up and not being able to fall back asleep; difficulty falling asleep) or sleeping too much. This happens to everyone at some point, but can be a symptom of depression if persistent.
• Being slowed down physically or mentally. You and other people notice that it takes you longer than usual to accomplish activities.
• Being agitated (restless, can’t sit still, pacing, wringing hands, rubbing head).
• Fatigue, loss of energy.
• Feeling excessively guilty or worthless.
• Difficulty concentrating or feeling that your brain is slowed down. Increased difficulty in making small decisions.
• Persistent thoughts about death and/or suicide.

What other problems might I notice if I'm depressed? You may experience some of the following problems if you are depressed: 

• Criticizing, attacking, and berating yourself. 
• Skipping days of work or not going to work. 
• Inability to study or pursue serious intellectual or creative interests. 
• Loss of interest in sex. 
• Avoiding friends or usual social activities, hobbies, or recreations. 
• Inability to enjoy activities or events in which you normally take pleasure. 
• Neglecting yourself physically (in terms of grooming and hygiene). 
• F orgetfulness. 
• Crying a lot or feel like crying without knowing why. 
• Feeling irritable and getting into arguments easily. 
• Increased and excessive use of alcohol or other recreational drugs.

If you don’t have the symptoms described above, but think you are depressed, it may be that you are suffering from a milder form of depression, called dysthymia.

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