What is major/clinical depression?

Clinical depression, also called a "major depressive disorder," is much more intense than sadness or mild depressed mood and generally requires medical treatment. Symptoms vary, but may include a loss of interest in activities that were once enjoyed, fatigue, problems with memory and concentration, feelings of hopelessness, or body aches.

Just as with sadness, clinical depression might be caused by stressful experiences and emotional situations. Chemical imbalances in the brain may also be a cause. If you are clinically depressed, you are feeling very sad. However, the sadness that comes with clinical depression lasts longer and may be very strong. The activities that once brought enjoyment may no longer be of interest to you, and you could feel very tired most of the time.

Clinical depression can make normal, everyday activities very difficult. It might cause you to stay away from friends and loved ones and avoid social gatherings that you once enjoyed. Sleeping and eating habits may also change. During such a time, you may have little hope that your situation could get better. Clinical depression can hurt your ability to make good decisions and see options for getting help. In the most difficult cases of depression, there can be thoughts of harming yourself or others due to feelings of hopelessness.

There can be different reasons for some emotions including depression or anxiety. For example, certain medications can cause depression or suicidal thoughts in some people. If this could be happening to you, contact your doctor and pharmacist immediately. In some cases, there may be a need to change your medication. You may also need the support of a counselor. If you cannot reach your doctor, go to a hospital emergency room. It is important to treat serious emotional distress as quickly as possible.

Dr. Julie Hanks, PhD, LCSW, Social HealthMaker
Marriage & Family Therapy Specialist

Major depression is a serious medical illness that causes impairment in functioning in many areas of life. If left undiagnosed and untreated, major depression may result in suicide. The good news is that major depression is very treatable through medication and psychotherapy and improved mood and functioning can be restored. If you are suffering from major depression please seek help immediately from a medical or mental health professional.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Clinical depression is not a momentary sadness, but a persistent feeling of despair triggered by an imbalance of chemicals in your brain. It's a physical disease—and one with potentially lethal outcomes, such as suicide. And it's very common. A stunning stat: About 15 percent of us have clinically significant depression at some time in our lives.


You: Being Beautiful - The Owner's Manual to Inner and Outer Beauty

More About this Book

You: Being Beautiful - The Owner's Manual to Inner and Outer Beauty

Most people think that beauty revolves around such things as lipstick, sweet eyes, or skinny jeans -- all those things that we can see (and obsess over) in the mirror. But the fact is that beauty...
Dr. Douglas S. Denham, DO
Family Practitioner

Depression is a medical illness that affects the brain. It is a feeling of sadness or hopelessness, even when you have no reason to feel that way. It is the result of an imbalance of the neurotransmitter chemicals in your brain. The causes of depression are not clear: it can be inherited, related to emotional events, or even caused by medications.

To be diagnosed with major depression, you must have five or more of the following symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Symptoms can be based on your own feelings or may be based on the observations of someone else. Some of these include: depressed mood most of the day, diminished interest or feeling no pleasure in all activities, significant weight loss, insomnia or increased desire to sleep nearly every day, restlessness or slowed behavior, fatigue or loss of energy, feelings of worthlessness, or excessive or inappropriate guilt, trouble making decisions, trouble concentrating, recurrent thoughts of death or suicide, or a suicide attempt.

Depression is a mood disorder characterized by feelings of sadness or loss of interest in daily activities. To be diagnosed as clinically depressed, a person must have some of the following symptoms: significant weight gain or loss, significant change in sleep patterns, feelings of restlessness or slowed down, fatigued all the time, worthlessness or guilt, difficulty concentrating or making decisions, hopelessness, and recurrent thoughts of death or suicide. 

When a combination of these symptoms is experienced for two weeks or more, it may indicate the presence of a clinical depression. The negative feelings associated with depression may last weeks, months, or even years. Afflicted people are usually treated with antidepressant medication, psychosocial therapy, or a combination of the two. Some self-care (exercise, relaxation techniques, and nutritional supplements) and alternative treatments such as acupuncture may be helpful in alleviating depressive illness as well.

Dr. Ramani Durvasula, PhD
Psychology Specialist

Clinical depression is an illness characterized by clear diagnostic criteria—sad mood or anhedonia for two weeks or longer and then 5 or more symptoms ranging from loss of appetite to sleep disturbance to feelings of worthlessness.

Clinical depression is an episode of at least two weeks of sadness for most of the day and loss of desire to do any activities or engage in relationships. Some other symptoms include loss of appetite or increased appetite; insomnia, increased fatigue or sleeping too much; and decreased interest in normally pleasurable activities. If you have two or more of these episodes separated by at least two months you may have major depression. If you have any of these feelings or feelings of suicidality, you should see your doctor immediately.

Without treatment, clinical depression can cause professional and personal problems; social isolation; substance abuse; and suicide. People cannot ease the problem without proper treatment, and the symptoms usually do not go away on their own.

In major depression there is major impairment in social, work and family functioning and 5 or more of the symptoms described below are present. In minor depression less than 5 symptoms of depression are present.

  • Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
  • Decreased interest or pleasure in most activities, most of each day
  • Significant weight change or change in appetite (it could be increased or decreased appetite/weight)
  • Change in sleep: Poor sleep or sleeping too much
  • Change in activity: Thinking or moving slower than usual
  • Fatigue or loss of energy
  • Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
  • Concentration: diminished ability to think or concentrate, or difficulty making decisions
  • Suicidality: Thoughts of death or suicide, or having a plan to end your life

To distinguish your condition as major depression, one of your symptoms must be either depressed mood or loss of interest; five or more of the following symptoms must be present for most of the day every day or nearly every day for at least two weeks:

  • Depressed mood for most of the day
  • Decreased pleasure in normal activities
  • Difficulty sleeping or significantly increased need for sleep
  • Weight loss or weight gain
  • Feelings of guilt or worthlessnessLow energy level
  • Difficulty making decisions or concentrating
  • Suicidal thoughts

Minor depression is similar to major depression, except that you experience fewer than five of the listed symptoms.

Dr. Kathleen Hall
Preventive Medicine Specialist

According to a report from the National Institute of Mental Health (NIMH), nearly 18.8 million Americans over the age of 18 suffer from major depression. Depression is a dangerous precursor to many diseases and conditions. Suicide, linked to depression, is the third leading cause of death in 10- to 24-year olds. A study by Dr. Shamash Sonawalla of Massachusetts General Hospital surveyed college students and showed that half the students surveyed qualified as having major depression. Depression and psychological diseases are increasing enormously on college campuses as well as in the general public.

A Life in Balance: Nourishing the Four Roots of True Happiness

More About this Book

A Life in Balance: Nourishing the Four Roots of True Happiness

Nautilus Book Awards Winners for 2007 (category: Self-Help/Psychology/ Personal Growth) "Like many people, Kathleen Hall found that despite great success and material wealth, she had yet to identify...
Sheri Van Dijk
Psychiatrist (Therapist)

Major depression can occur alone (known as major depressive disorder, or "unipolar depression") or as part of bipolar disorder. Bipolar depression is the same as unipolar depression—both meet the criteria for a major depressive disorder. A depressive episode includes symptoms such as low mood, problems with sleeping and eating, feelings of hopelessness and helplessness, and suicidal thoughts.

Whether depression is part of bipolar disorder or simply occurs on its own, it can be debilitating, making it more difficult for a person to function like they normally would—sometimes people can't get to work or school; and even getting out of bed and doing things like showering can be challenging.

Continue Learning about Clinical/Major Depression

Risk Factors for Major Depressive Disorder
Risk Factors for Major Depressive Disorder
Major depression (also called clinical depression, major depressive disorder, or MDD) doesn't discriminate between different types of people. Anyone—m...
Read More
What is major depressive disorder?
Cesar Y. Figueroa, MDCesar Y. Figueroa, MD
Depression isn't a weakness; it's an illness. In this video, psychiatrist Cesar Figueroa, MD, of Col...
More Answers
Who experiences major depression?
Dr. Ramani Durvasula, PhDDr. Ramani Durvasula, PhD
ANYONE can experience major depression, at any age.  However, there are certain factors that can pla...
More Answers
Can Transcranial Magnetic Stimulation (TMS) Be Combined with Antidepressants to Treat Depression?
Can Transcranial Magnetic Stimulation (TMS) Be Combined with Antidepressants to Treat Depression?

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.