The Difference Between Mild, Moderate, and Severe Depression

by Jerry Kennard, Ph.D. Medical Reviewer

Depression is really a catch-all term that encompasses a variety of symptoms. The severity of depression is largely dictated by the number of symptoms the person experiences and the effect these have on the persons ability to function. In this Sharepost I want to outline the determinants of three categories of depression; mild, moderate and severe depression.

In order to be formally diagnosed with depression at least one of a possible two core symptoms must be seen. The first of these is a persistent low mood and feelings of sadness, with or without weepiness. The second is motivational, specifically a marked lack of interest in previously pleasurable activities. Clustered around these two core symptoms are a further seven related symptoms relating to:

  • Sleep pattern disturbances.

  • Change in appetite.

  • Tiredness.

  • Sluggish movements or agitation.

  • Difficulty in concentrating or solving simple everyday problems.

  • Feelings of guilt and/or worthless.

In mild depression one of the core symptoms must be present and usually no more than four related symptoms. Although day to day functioning may feel a struggle it is rarely affected in any significant fashion. People with mild depression can get by without medication and may well find their symptoms begin to subside without treatment over time.

A diagnosis of moderate depression would suggest that both core symptoms are present as well as four or more related symptoms. With this level of depression there is a far higher chance that daily work and social activities are affected. The ability to concentrate and solve problems becomes significantly impaired. People with moderate depression often exhibit behavior that shows the way they feel. For example personal care may be neglected. The person often moves in a sluggish heavy fashion, with shoulder bent and head down. Facial characteristics of the person are those associated with misery; frowning, downturned mouth, sad distance-gazing eyes and drawn expression. Unfortunately some people are adept at masking their feelings which simply acts to delay much needed treatment. Symptoms of moderate depression point to the likelihood that antidepressant medication, with or without psychological treatment, will be advised.

Severe depression is almost certain to include both core symptoms and most if not all the related symptoms. Daily functioning ceases beyond the most rudimentary activities. Sometimes the person may experience psychotic features in the form of delusions or hallucinations. Typically these are consistent with themes of depression involving death, disease, guilt, or some sense of deserved punishment. Treatment is almost certain to include antidepressant medication and depending on the depth and severity may require a hospital admission. In the most severe cases ECT treatment may be advised.

Jerry Kennard, Ph.D.
Meet Our Writer
Jerry Kennard, Ph.D.

Jerry Kennard, Ph.D., is a Chartered Psychologist and Associate Fellow of the British Psychological Society. Jerry’s work background is in mental health and, most recently, higher education. He is the author of various self-help books and is co-founder of