Core symptoms:

• 3 typical core symptoms:

  • Low mood
  • Anhedonia - low interest or please in most activities
  • Anergia - lack of energy
• Other core symptoms:

  • Weight change - exclusion of intentional dieting
  • Disturbed sleep - insomnia or hypersomnia
  • Psychomotor retardation (slowed down) or psychomotor agitation (restlessness)
  • Reduced libido
  • Worthlessness or guilt feelings
  • Decreased concentration
  • Recurring thoughts of harm, death or suicide, nihilistic thoughts (life is meaningless)
• Biological symptoms:

  • Anhedonia
  • Loss of emotional reactivity
  • Diurnal mood changes - mood often worse in the morning
  • Early morning wakening - typically 2-3 hours earlier than usual
  • Psychomotor retardation or psychomotor agitation
  • Appetite and weight loss
• Psychotic symptoms (if present are usually mood congruent):

  • Delusions - often revolving around guilt and personal inadequacy
  • Hallucinations - can be auditory, olfactory or visual