The essential feature of major depressive episode is either depressed mood (possibly irritability in children and adolescents) or loss of interest or pleasure in all, or almost all, activities and associated symptoms for a period of a least two weeks. Appetite is frequently disturbed, and sleep disturbances, psychomotor agitation, a sense of worthlessness, difficulty in concentrating, slowed thinking, and indecisiveness are frequent. Thoughts of death are common, accompanied by suicidal thought or actions.
A depression serious enough that the person needs to be hospitalized. It is often "chronic," which means the person keeps having episodes of depression over months or years. It is also not "situational," which means it is not linked to a particular situation or event. Major depression is more serious than typical depression. Most people diagnosed with depression get help from a therapist and may take antidepressant drugs, but they do not need to go to a hospital. They can stay at home and keep up with their jobs, other responsibilities, and relationships.