What is severe depression?

The information provided in this article may trigger some people. If you have suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-8255 to get support and help from trained counsellors. If you or someone you love is in immediate danger, call 911.

For more mental health resources, please refer to our national helpline database.

Although not a formal clinical term, it is sometimes called when clinical depression or major depression is so severe that a person can no longer complete basic life tasks, such as getting up and going to work every day, or even just taking a shower. For severe depression.

According to the National Institute of Mental Health (NIMH), approximately 7.1% of American adults will experience at least one severe depression in their lives. Severe depression is not a rare state of existence. Unfortunately, knowing that you are not alone does not necessarily make it easier to deal with the debilitating effects of this situation.

This article details the symptoms, causes, types, and how to diagnose and treat major depression.

Severe depressive symptoms

Everyone will occasionally experience a depressed day or a period of sadness. But severe depression is much more than that. Its symptoms can affect your mood and physical health. Untreated clinical depression can lead to self-harm and suicidal thoughts.

Get advice from the VigorTip Mind podcast

Hosted by the editor and therapist Amy Morin, this episode of LCSW’s “VigorTip Mind Podcast” shares how to find the courage to face depression, including Olympic gold medalist Laurie Hernandez ( Laurie Hernandez).

Follow now: Apple Podcasts / Spotify / Google Podcasts / RSS

Symptoms that affect mood and thinking processes

A person struggling with severe depression may experience many of the following conditions:

  • Persistent sadness and/or anxiety
  • Feel empty and lonely
  • Fight despair, look at every situation pessimistically
  • Can’t enjoy activities that once brought happiness
  • Irritability and lack of patience with others
  • I always feel that I am worthless, just like a burden to the people around me
  • Concentration drop
  • Unable to make a decision
  • fatigue
  • Agitated or slowed down
  • Feelings of worthlessness, hopelessness, or guilt
  • Thoughts of death or suicide

Symptoms affecting overall health

Severe depression is more than just a mental disorder. Symptoms can also be manifested physically:

  • low energy
  • Sleeping all the time or having difficulty falling asleep
  • Restlessness
  • Loss of appetite or overeating
  • Weight fluctuations
  • Headache
  • Body pain
  • Digestive problems

These symptoms vary from person to person, but general appetite and sleep changes are common in people dealing with severe depression.


The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines major depression as any period of two weeks or more in which a person experiences the following conditions almost every day for most of the time:

  • upset
  • Lost interest in activities that brought happiness in the past
  • sleep disorder
  • Appetite changes
  • Decreased concentration and memory

The diagnosis of major depression is usually made by a practicing physician or psychiatrist. Physical examinations and laboratory tests can be performed to rule out underlying physical conditions that may cause the observed symptoms, such as thyroid disease.


Studies have found that depression is highly hereditary, especially in severe cases of depression. It is estimated that approximately 50% of major depression cases may be related to genetic predisposition.

Nevertheless, heredity is not the only potential risk factor for the development of major depression. In fact, NIMH has identified four main categories that can increase a person’s risk of depression:

  1. Genetic
  2. biology
  3. environmental
  4. psychology

Severe depression does not distinguish age, gender, race, or ethnicity. It may occur in adults who have never suffered from depression before or in adolescents who have an extensive family history of depression.

It may be a common comorbidity of serious medical diseases (such as chronic diseases such as cancer or diabetes), or it may be a response to traumatic life events.

Major life changes can trigger severe depression, as can certain medications or increased stress.


There are several forms of depression that can cause severe depression episodes:

  • Persistent depression: Also known as dysthymia, this form of depression is characterized by symptoms of depression lasting for two years or more.
  • Postpartum depression or perinatal major depression: Depression that occurs during pregnancy or after childbirth can cause extreme anxiety or exhaustion, and may make it difficult for new parents to connect with babies or take care of them, let alone themselves .
  • Psychotic depression or major depression with psychotic characteristics: Depression is accompanied by psychotic symptoms, including delusions and hallucinations.
  • Seasonal affective disorder (SAD) or major depression with a seasonal pattern: depression that usually occurs in winter due to less sunlight.
  • Bipolar disorder: A person experiences extreme highs and lows emotionally, and these lows can lead to severe depressive episodes.
  • Disruptive Mood Disorder (DMDD): A mood disorder diagnosed in childhood that is characterized by extreme irritability and anger.
  • Premenstrual dysphoria (PMDD): It is more serious than premenstrual syndrome (PMS), but it is also triggered by changes in the menstrual cycle. PMDD can cause serious symptoms such as irritability, depression, and anxiety one week before the start of the menstrual cycle.


Depending on the type of depression you may be experiencing, there are various treatment options that can help you overcome a period of severe depression.


You may have heard that psychotherapy was called “talk therapy” in the past. This type of treatment requires you to work with a licensed mental health professional to discuss your experience and develop solutions that can help.

There are several different methods of psychotherapy, including:

Although some methods are generally considered more effective than others, psychotherapy as a whole is the most commonly used treatment for depression-even when using other treatment options (such as medications).

This is because a large number of studies believe that psychotherapy is an effective treatment tool against depression.


Antidepressants can help change your brain chemistry so that you can better regulate your emotions and stress responses. There are five main categories of antidepressants available, but you may be most familiar with these two categories:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Serotonin and norepinephrine reuptake inhibitor (SNRI)

Not all antidepressants are suitable for everyone with severe depression. Some drugs may cause side effects such as nausea, weight gain, and difficulty reaching orgasm.

You may need to work with your doctor to find the right antidepressant for you. But for patients who can find helpful medicines, the results can be life-changing.

Electroshock therapy

Today’s electroconvulsive therapy (ECT) is completely different from what you have seen on TV and movies before. ECT is now painless (patients are anesthetized before treatment), and it is a very effective treatment option for patients who cannot achieve results with medication or psychotherapy.

It may sound scary at first, but if you have been struggling with severe depression for a long time, it is definitely worth discussing with your doctor.

Self care

There are many self-care methods that can help you cope with a period of severe depression, which may include:

If you are currently dealing with a severe depression, participating in any of these activities may sound impossible. However, if you can force yourself to try and you can avoid isolation, you may find that your mood will gradually improve over time.


It is not easy to deal with severe depression. If you have a job or children need to take care of, it will feel weaker when you try to keep up with your daily duties.

It may seem impossible to cope with life while you are trying to overcome this kind of depressive episode, but committing to treatment and doing what you can every day will help. Reaching out to the people you love and letting them know what you are dealing with and what you might need from them also means getting the necessary support.

You deserve to live a happy and healthy life. You are not alone. And you won’t always feel this way.