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At what point do the signs and symptoms of depression become cause for concern. When do they become medical condition that needs medication treatment and/or therapy? For the signs and symptoms of depression to have clinical significance two important criteria must both be true and 5 out of 9 signs and symptoms of depression must be present.

At least two weeks experiencing the signs and symptoms of depression AND the depression symptons become disruptive to major areas of an individual’s life, i.e., depression symptoms negatively and noticeably impacting job performance, relationships, or school.

Looking in more detail, clinical depression is usually defined as at least five of nine possible symptoms. This can be any combination of five signs and symptoms of depression. To get a better understanding of each of the depression symptons, it’s useful to look at the nine symptoms in 3 categories.

The first five are the obvious physical signs and symptoms of depression: (1) Significant change in weight not due to dieting (weight gain or loss of more than 5% of body weight in a month); (2) Sleep problems nearly every day (excessive sleeping or insomnia); (3) Agitation (irritable attitude and physical tension) or marked slowing of one’s thoughts and actions (e.g., much more difficulty getting started on something than usual); (4) Fatigue or loss of energy every day; (5) Diminished ability to think or concentrate or indecisiveness, nearly every day.

The next group of signs and symptoms of depression are different. Think of these depression symptoms as what depression feels like from the inside. These are: (6) Sad mood most of the day, nearly every day; (7) Noticeable loss of interest or pleasure in nearly all activities most of every day; (8) Feelings of worthlessness or excessive (or inappropriate) guilt nearly every day.

The third group is really just one symptom in a class of it’s own. If a person is having thoughts about death that keep returning, this is almost certainly an indicator of clinical depression, whether or not the person can recognize any other signs and symptoms of depression.

Thinking about death (morbid thinking means: recurrent thoughts or images of death (not just fear of dying), recurring thoughts about suicide, frequently imagining one’s own funeral, or a suicidal attempt, or having made plans, or a suicidal gesture (deliberate carelessness in dangerous situations).

Genevieve Carsondale is a freelance contributor to Irkable.com where she writes about the signs and symptoms of depression.