Clinical Features of Depressive Episodes

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A. Occasionally no subjective depressed mood is present, only anxiety and irritability are displayed.

B. Feelings of hopelessness and helplessness are common.

C. Decreased libido is common.

D. Early morning awakening with difficulty or inability to fall back to sleep is typical.

E. Psychomotor agitation can be severe.

F. Patients may appear demented secondary to poor attention, poor concentration, and indecisiveness.

G. Guilt may become excessive, to the point of appearing delusional.

H. Obsessive rumination about the past or specific problems is common,

I. Preoccupation with physical health may occur.

J. Frank delusions and hallucinations may occur, and they are frequently nihilistic in nature. K. Family history of mood disorder or suicide is common.

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