The Many Faces of a Major Depressive Episode


Whether things are going well in life, staying the same or taking a turn for the worse, a major depressive episode can occur in your life or the life of the ones you love. It is often difficult to tell, especially at first, whether you or someone you know is experiencing a Major Depressive Episode (MDE) or if they’re just having a rough week. Familiarize yourself with the following symptoms if you suspect something is amiss and understand that an MDE could present itself as many different combinations of these symptoms.

The two main criteria for a Major Depressive Episode are either a depressed mood and/or loss of interest or pleasure in activities that previously sparked interest or pleasure. These symptoms usually must remain present for at least a two week period. During these two weeks people experiencing an MDE may also experience a significant change in eating patterns. Increases or decreases in appetite and weight are among the easier symptoms to notice. Insomnia and hypersomnia and generally noticeable changes in sleeping patterns are also common. A generally lower energy level, chronic fatigue, and slower voluntary movement are symptoms that could be the result of a lack of sleep but can also be observed in patients that oversleep or have no changes in their sleeping patterns. Agitated mental state and agitated voluntary movement are also potential symptoms. Some symptoms that are not objectively observable but may reoccur daily are feelings of worthlessness, excessive or misplaced guilt, indecisiveness and decreased concentration. Frequent thoughts about death, – not just fear of dying– suicidal ideation with or without a specific plan or suicide attempts are additional symptoms of an MDE that are not necessarily present.

Always keep in mind that symptoms do not have to look the same; a depressed person may report feeling “nothing” — neither sadness nor pleasure. While many symptoms are recognizable objectively, subjective feelings of sadness, emptiness or anhedonia should also raise a warning flag. The symptoms listed above can combine and affect each other in many ways, presenting different “faces” of depression. It is important to understand how differently an afflicted individual may act and that certain symptoms do not necessarily mean a more or less serious case.

If you believe that you are a loved one has or may be experiencing a Major Depressive Episode, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Contact our Bergen County, NJ or Manhattan offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment. Visit for more information.


By: Anna Straus




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