4. Sleep disorders, either insomnia or excessive sleepiness, nearly every day
5. Feelings of agitation or a sense of intense slowness
6. Loss of energy and a daily sense of tiredness
7. Sense of guilt or worthlessness nearly all the time
8. Inability to concentrate occurring nearly every day
9. Recurrent thoughts of death or suicide
In addition, other criteria must be met:
- The symptoms listed above do not follow or accompany manic episodes (such as in bipolar disorder or other disorders).
- They impair important normal functions (such as work or personal relationships).
- They are not caused by drugs, alcohol, or other substances.
- They are not caused by normal grief.
A long-term study found that episodes of major depression usually last about 20 weeks. Between 30 - 40% of depressed patients experience sudden attacks of anger that they describe as uncharacteristic and inappropriate.
 | Click the icon to see an image of childhood depression. |
Dysthymia (Chronic Depression)
Dysthymia, or chronic depression, afflicts 3 - 6% of the general population and is characterized by many of the same symptoms that occur in major depression. Symptoms of dysthymia are less intense and last much longer, at least 2 years. The symptoms of dysthymia have been described as a "veil of sadness" that covers most activities. Possibly because of the duration of the symptoms, patients who suffer from chronic minor depression do not exhibit marked changes in mood or in daily functioning, although they have low energy, a general negativity, and a sense of dissatisfaction and hopelessness.
Double Depression. Often, symptoms become more severe over time. In one long-term study, nearly all patients with dysthymia suffered at least one episode of major depression superimposed over chronic depression (sometimes called double depression) at some time in their life. Some experts believe that such double depression should be considered as part of the natural course of dysthymic disorder. Women may be more susceptible to double depression. In one study, more than one-third of those who recovered from dysthymia relapsed within 5 years.
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