Major Depression

In order to understand the term "Major Depression" we need to discuss two other terms: Major Depressive Episode and Major Depressive Disorder.

Major Depressive Episode

A Major Depressive Episode is a period of at least two weeks of severe mood disruption accompanied by a variety of other symptoms.

Briefly, the person must have a severely depressed mood most of the day nearly every day, or a marked lack of interest or pleasure in almost all activities, or both.

To count as a true episode, at least four of the following must also be present:

  • Significant change in appetite (decrease or increase; or significant change in weight that isn't the result of a deliberate dieting attempt).
  • Insomnia or excessive sleep.
  • A speeding up or slowing down of movements nearly every day.
  • Fatigue or loss of energy.
  • Feelings of worthlessness or excessive guilt.
  • Impaired concentration or decision-making ability
  • Recurrent thoughts of death (such as suicidal thoughts or a wish for death - not just a fear of dying).

To count as a Major Depressive Episode, the symptoms have to cause significant distress or impairment.

As well, the symptoms cannot be due to medication, recreational drugs (such as alcohol), a medical condition, or recent bereavement.

Major Depressive Disorder

The formal diagnostic term for major depression is Major Depressive Disorder. Usually when a professional says that a person has a serious or major depression, they mean Major Depressive Disorder.

To have Major Depressive Disorder, a person must have had at least one Major Depressive Episode - an extreme low.

In addition, the person must NOT have had the opposite: Extremely high or energetic periods. These "highs", which are called Manic or Hypomanic Episodes, typically point toward another problem altogether: Bipolar Disorder.

There are two main types of Major Depressive Disorder: Single Episode and Recurrent (for those who have had more than one Major Depressive Episode).

A diagnosis of Major Depressive Disorder might also be accompanied by other descriptions, such as an indication of severity, or seasonal pattern (meaning that the problem tends to occur at the same time each year).

If, based on this description, you believe that you may have Major Depressive Disorder, please tell your physician. As you will learn from other parts of this website, effective treatments are available for major depression. These include evidence based psychotherapy, including cognitive behaviour therapy.

Note: Information on these pages is provided for educational purposes only. It should not be taken as a substitute for care from a qualified healthcare provider.