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A consistently sad, empty, or hopeless mood that is present most of the day, nearly every day.

Frequent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

A marked decrease in interest or pleasure in all or almost all activities most of the day, nearly every day.

Feeling tired nearly every day, even after getting rest or minimal mental or physical activity.

Unexpected weight loss or gain, or a decrease or increase in appetite nearly every day.

Observable by others (not merely subjective feelings of restlessness or being slowed down).

Excessive and inappropriate guilt or feelings of worthlessness, not merely about being sick or the negative consequences of one's actions.

Indecisiveness or reduced ability to think or concentrate, apparent nearly every day, either by subjective report or as observed by others.