What are the symptoms of depressive illness?

There are many symptoms of depression.  The most important symptom is a change in mood.  Usually this is experienced as feeling depressed, sad, or gloomy.  The feelings usually begin gradually, persist and begin to worsen with time.  Other changes in the emotional states such as anger, irritability, agitation or anxiety can also occur, and may even be the most prominent features.  The change of mood particularly as the depression deepens is accompanied by a number of other features that affect mental functioning.  These include:

   *  seeing everything in a negative light
   * being preoccupied, worried
   * dwelling on past negative events
   * having a feeling of guilt, inadequacy, failure, worthlessness
   * a loss of interest in normally pleasurable activities
   * a loss of interest in everything, referred to as anhedonia
   * a feeling of emptiness inside
   * a feeling of fatigue and a wish to withdraw and be isolated
   * a change in mental functioning so that concentration is poor, thinking
         becomes difficult and slow, and memory is impaired
   * a feeling that life is not worth living, a wish to be dead or active thoughts
         of suicide

Because depression is a biological state or syndrome, other systems in the body are affected.  Physical symptoms that are common in depression include:

   * a change in appetite.  This can be loss of appetite with a weight loss or
         episodes of overeating (bulimia) and weight gain
   * a change in sleep patterns, usually difficulty falling asleep, waking up 
         frequently and waking up too early.  However, lethargy and an increased
         need for sleep can be present
   * decreased energy, or a slowing of movements
   * decreased interest in sexual activities
   * constipation
   * headache
   * vague aches and pains or specific pains that are not typical of another
         illness

These symptoms of depression can fluctuate over the course of a day and a person may feel worse in the morning and better as the day goes on, or the reverse.  Individuals with depression can also be temporarily cheered up or respond to a joke.  Because of this, the state of depression is often deceiving.

In more extreme state of depression, a person can become very slowed up.  This is called psychomotor slowing and can progress to a state of total inactivity or stupor.  Mental process can also change and other psychiatric symptoms can appear.  These include:

   * false beliefs ( delusions) that something awful is going to happen or
        that something terrible is happening to one's body
   * hearing voices (auditory hallucinations) when no one is around.  The
        voices usually make negative comments.
   * suspiciousness (paranoia) or a feeling that others are talking about the
        individual or going to do them harm