Depression Symptoms and Signs – How to Recognize Them in Time

Depression is not just a “bad mood” or a sign of weakness — it is a common medical condition that affects more than 330 million people worldwide [1]. Early recognition is the key prerequisite for successful treatment. In this article, we will discuss the main symptoms of depression, how it differs from ordinary sadness, and some simple questions for self-assessment.

What is depression

Depression (depressive disorder, Major Depressive Disorder) is a mental health condition that affects mood, thinking, sleep, appetite, and everyday functioning. The diagnosis is made using international criteria (DSM-5-TR, ICD-11): symptoms must last for at least two weeks and significantly interfere with a person’s life [2].

9 core symptoms of depression

For a clinical diagnosis, at least five of the nine symptoms listed below must be present for a period of two weeks, and these must include either the first or the second symptom [2]:

• Low mood — feeling sad, empty, or hopeless for most of the day;
• Loss of interest or pleasure (anhedonia) — activities that used to bring joy are no longer appealing;
• Reduced energy and rapid fatigue — even small efforts feel exhausting;
• Sleep disturbances — difficulty falling or staying asleep, frequent awakenings, or, conversely, sleeping excessively;
• Noticeable changes in appetite or weight — either loss or gain;
• Difficulty concentrating — reading, working, and making decisions become harder;
• Feelings of worthlessness or excessive guilt;
• Psychomotor slowing or restlessness — people around the person notice that they have “slowed down” or cannot relax;
• Recurrent thoughts about death or self-harm.

Depression or just a bad mood?

Feeling low is a natural part of life — it usually passes within a few days and is linked to a specific reason. We should start thinking about depression when all three signs appear together:

• Duration — the condition lasts for more than two weeks;
• Intensity — mood is lowered almost every day, for most of the day;
• Functioning — work, studies, relationships, or self-care are disrupted.

It is important to understand that depression can affect even “strong” people. It is not a sign of weak willpower and never deserves blame in any circumstance.

How Depression Manifests in the Body

Depression often begins with physical complaints: headaches or back pain, gastrointestinal discomfort, heart palpitations, and persistent fatigue. If medical tests do not reveal an organic cause, it is worth assessing your mental health as well — physical symptoms are a common “language” of depression.

Self-assessment — 9 questions (PHQ-9)

In international practice, the PHQ-9 (Patient Health Questionnaire-9) [3] is the most commonly used questionnaire for depression screening, and a validated Georgian version is also available. Thinking about the last two weeks, ask yourself how often you have been bothered by the following:

• Reduced interest or loss of pleasure;
• Feeling sad or hopeless;
• Difficulty falling asleep, fragmented sleep, or excessive sleep;
• Fatigue, lack of energy;
• Decreased appetite or overeating;
• Negative thoughts about yourself — feelings of worthlessness or failure;
• Difficulty concentrating;
• Slowed movement/speech, or conversely, restlessness;
• Thoughts that it would be better if you were no longer alive, or thoughts about self-harm.

If your answer to most of these questions is “several days” or more often, this is a reason to seek a professional assessment. Remember: screening is not a diagnosis; an accurate evaluation is only possible through a visit with a specialist.

⚠️ When to seek immediate medical help

You need urgent professional help if you have thoughts of self-harm or ending your life, or if you notice such signs in a loved one. In this situation, do not wait — contact emergency services immediately (112) or call our clinic: +995 32 2 440 550. Asking for help is a sign of strength.

Treatment is effective

Depression is one of the best-studied and most treatable mental health conditions. According to international guidelines, first-line treatment includes psychotherapy (including cognitive-behavioral therapy — CBT) and, when needed, modern antidepressant medications [4]. At GSMRC, the treatment plan is tailored individually — with psychiatric consultation, psychotherapy and, when appropriate, a day center program.

See also

→ Depression treatment in Tbilisi

→ Sleep disorders and insomnia

→ Anxiety disorder

→ Psychiatrist consultation

Sources

1. World Health Organization. Depressive disorder (depression). Fact sheet. WHO; 2025. who.int/news-room/fact-sheets/detail/depression

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed, Text Revision (DSM-5-TR). Washington, DC: APA; 2022.

3. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. PMID: 11556941

4. National Institute for Health and Care Excellence. Depression in adults: treatment and management. NICE guideline NG222; 2022. nice.org.uk/guidance/ng222