For readers like “Citizen,” I think it’s important to list the symptoms of major depression covered by the DSM-IV (the current edition of the Statistical Manual of Mental Disorders) published by the American Psychiatric Association.

According to the DSM-IV, a person is suffering from a major depressive episode if he or she experiences items number 1 or 2 from the list of symptoms below, along with any 4 others, continuously for more than 2 weeks:

1. Depressed mood with overwhelming feelings of sadness and grief
2. Apathy–loss of interest and pleasure in activities formerly enjoyed
3. Sleep problems–insomnia, early-morning waking, or oversleeping nearly every day
4. Decreased energy or fatigue
5. Noticeable changes in appetite and weight (significant weight loss or gain)
6. Inability to concentrate or think, or indecisiveness
7. Physical symptoms or restlessness or being physically slowed down
8. Feelings of guilt, worthlessness, and helplessness
9. Recurrent thoughts of death and suicide, or a suicide attempt.

And the following description of major depression comes from the 2007 Johns Hopkins White Papers on Depression and Anxiety written by Karen Swartz, one of the physicians who evaluated me in March of last year:

The diagnosis is more certain when a person also has a family history of depression; a previous episode of depression or bipolar disorder; a general medical problem likely to trigger depression, such as a recent stroke or heart attack; or is taking a medication known to cause mood disorders.

Other symptoms of depression include disorganized thinking and delusions. In addition to these disturbances in mood and cognition (thinking), people with major depression may experience physical changes such as constipation or decreased sexual drive.

Episodes of major depression range from mild to severe. In mild episodes, symptoms barely meet the requirements for a diagnosis and the person is able to get through the day without too much trouble. Severe episodes are characterized by several debilitating symptoms, including worsening mood that markedly interferes with daily life. People who are struggling with severe depression have difficulty with almost every activity–going to work, socializing, and even getting up in the morning. They may be unable to feed and dress themselves or to maintain personal hygiene. Major depression is twice as common in women as in men.