What are the Signs of Severe Depression?

An individual suffering from severe depression may feel hopeless, irritable, lost of pleasure, unable to concentrate or sleep, and may even think about suicide. Technically, severe depression is not an official mental health diagnosis. Instead, it indicates a level of depression that is more debilitating in nature.

In determining the level of severity of depression, doctors consider how much symptoms interfere with a person’s daily life, such as missing school or work. Either way, severe depression help is needed.

The Depression Spectrum

Despite the fact that depression can be classified into different types, there are some common symptoms that each person may experience differently.

depressionIn terms of their duration and severity, depression symptoms can be found on a spectrum. It is common to experience mild depression during stressful periods, but it resolves with time and may not require specific treatment. Symptoms of moderate to severe depression require at least one form of treatment, if not more.

In general, severe depression requires some kind of treatment to find some relief. Furthermore, depression severity can change over time, becoming increasingly worse or alternating between mild and severe during the same depressive episode.

People with severe depression may self-harm, have suicidal thoughts, or attempt suicide. There is help available for people suffering from severe depression so they can manage their symptoms and ensure their safety.

Symptoms of severe depression

Depression isn’t defined in a standardized way. A mental health professional will assess the severity of your depression based on your level of training. Clinicians consider some key signs and symptoms when determining if depression is severe. It is certainly helpful to know what causes severe depression.


An experienced psychosis is characterized by delusions and hallucinations. An individual suffering from psychotic depression may experience the following symptoms:

  • Agitation
  • Ignoring evidence of one’s health and believing one’s symptoms are real
  • Hallucinations or delusions
  • Extreme anxiety
  • Intellectual impairment
  • Physical immobility
  • Trouble falling asleep
  • Symptoms and Behaviors of Suicidality
  • Suicidal behavior includes talking about wanting to die, making plans, or trying to end one’s own life. The following are warning signs of suicidal intent:
  • Purchasing or gathering suicide means (a gun, pills, etc.).
  • A change in eating or sleeping habits
  • Conducting self-destructive or risky behavior
  • Anxiety or extreme agitation
  • Establishing one’s affairs (for example, writing a will and giving away possessions)
  • An increase in drug and alcohol use
  • An intense change in mood or mood swings
  • The final goodbyes to family and friends
  • A feeling of hopelessness or trapped in one’s circumstances
  • We talk a lot about death, dying, and violence
  • The idea of wishing one wasn’t born or giving up on life
  • Withdrawal from family and friends


Depression is characterized by persistent and intense feelings of profound sadness. A state of melancholy when you lose interest in almost everything you do. According to research, melancholia is often worse in the morning hours and is accompanied by slow movement, difficulty in focusing, and little or no appetite.

Physical Effects of Depression

Symptoms of depression can be felt physically. Depression has physical effects such as sleep disturbance, changes in appetite, poor concentration, and loss of interest in sex. Chronic pain, gastrointestinal concerns, or excessive fatigue are also common symptoms in people with depression.

Psychomotor Changes

Depression can sometimes cause a noticeable slowing down of mental and physical activity. Often referred to as psychomotor retardation, this condition can affect fine motor function (such as difficulty picking up a coin off the floor), speech, or facial expressions.


Doctors and mental health professionals can systematically assess a person’s symptoms using tools like the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) and the International Classification of Diseases (ICD). When new research findings become available, these criteria are periodically updated.

A Lack of Standardization

For specific research purposes, quantitative scales serve as a means of measuring symptoms and of determining a “cutoff point” for what constitutes “severe depression”. Nevertheless, methodologies vary between studies and researchers, so there is no universally accepted definition of severe depression. This makes it hard to implement severe depression help.

The lack of standardization may result in inconsistent diagnoses if different providers use different scales in assessing depression symptoms. Many providers don’t use them unless a patient is taking medication, while others regularly use them.


There are several treatment options available for severe depression. Based on your symptoms, your doctor can help you decide which is best for you. Treatment plans are also determined based on your level of function and whether you are considered a risk to yourself or others.


Psychotherapy can often ease the symptoms of depressive disorders. Psychotherapy includes different forms:

  • Cognitive-behavioral therapy (CBT)
  • Interpersonal therapy (IPT)
  • Psychodynamic therapy

There are several kinds of therapies available from clinicians. Find out if any are available in your area by searching the American Psychological Association’s website. Ask your local therapist if they specialize in treating severe depression.


Severe depression is usually treated with medication. The most common meds used are selective serotonin reuptake inhibitors (SSRIs). These include antidepressants such as Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine).

Depression can also be treated with the following medications:

  • Norepinephrine-dopamine reuptake inhibitors (NDRIs)
  • Tricyclic antidepressants (TCAs)
  • Monoamine oxidase inhibitors (MAOIs)

Brain Stimulation Therapy

An individual with severe depression who has not responded well to first-line treatments such as antidepressant medications or psychotherapy may benefit from brain stimulation treatments. Depression therapy examples include:

  • Electroconvulsive therapy (ECT)
  • Transcranial magnetic stimulation (TMS)
  • Vagus nerve stimulation (VNS)

Inpatient Depression Treatment

Severe depression may require inpatient treatment. You don’t have to be weak if you’re hospitalized for depression. Simply put, it means the environment in which your treatment will be administered is more controlled.

Inpatient treatment of depression also allows doctors to monitor your response to the treatment protocol closely, keeping you safe. This allows them to make any necessary changes if your depression does not respond initially or worsens.

Complementary Treatments

In addition to treating your depression with other treatments, there are a few things you can do to alleviate it. In order to aid your recovery, your doctor may recommend one or more of these.

Cleveland Clinic reports that some remedies that were found to be effective include:

  • Acupuncture
  • Massage
  • Guided relaxation
  • Meditation
  • Yoga

Doctors and mental health care professionals can help you decide which depression treatment option is best for you, the type of depression you have, and its severity.


Although depression and its symptoms exist on a spectrum of severity, there is no set definition of severe depression. The symptoms of some illnesses get better over time and aren’t a hindrance to daily life. Symptoms of depression or schizophrenia are usually managed well with antidepressants or psychotherapy.

You are not helpless when you are dealing with severe depression symptoms, even if finding the most effective method might take some time. Consider several ways that you can support yourself during the treatment process, such as eating a nutritious diet, engaging in some physical activity, and getting plenty of rest. Perhaps getting to know your version of depression will help in understanding what causes severe depression.