Common Signs Of Moderate Levels Of Depression

Medically reviewed by Melissa Guarnaccia, LCSW
Updated October 9, 2024by BetterHelp Editorial Team
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Depression can have an impact regardless of its severity

Moderate levels of depression are generally marked by symptoms that are greater in number and more debilitating than those of mild depression but are generally considered to be fewer in number and less debilitating than those of severe depression. 

Diagnosing moderate levels of depression

The diagnostic criteria for major depressive disorder are based on information found in the DSM-V, which is published by the American Psychiatric Association (APA). A diagnosis requires the existence of five or more symptoms, one of which must be either depressed mood or anhedonia (the loss of ability to experience pleasure). Symptoms of a major depressive episode—which, according to the DSM, “must have clearly worsened compared with the person’s pre-episode status and must persist most of the day, daily, for at least two weeks in a row”—are as follows:

  • Depressed mood
  • Anhedonia
  • Weight fluctuations or changes in appetite
  • Disruptions in sleep pattern
  • Significant slowing or speeding up of speech and movement
  • Lack of energy, fatigue, or trouble completing everyday tasks 
  • Feelings of worthlessness or guilt
  • Impaired cognitive function
  • Suicidal thoughts or self-harm

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

Meeting the threshold of five primary symptoms of depression does not indicate depression severity when considering the range of experiences associated with depressive disorder(s). 

Because there are no criteria for mild, moderate, or severe depression set forth in the DSM-V, experts have used various methods to create such categories to classify major depressive disorder. Many researchers have sought to verify the accuracy of existing depression scales for major depressive disorder to come up with criteria that help define what moderate levels of depression are.

Questionnaire and scales

Measures like the PHQ-9 (Patient Health Questionnaire-9), endorsed in peer-reviewed studies and by medical associations, have been proven accurate when determining the severity of both mild depression and severe depression. The PHQ-9 is a 9-item assessment that asks participants to rate the frequency with which they experience certain symptoms, with higher scores representing greater frequency. Moderate levels of depression are considered present if an individual has a score of 10-14 on the PHQ-9. 

Others have sought to create categories for severity adapted from the Hamilton Depression Rating Scale (HAMD) for major depression, which provides scores for various symptoms based on whether they are absent, mild, moderate, severe, or incapacitating. One study found that moderate levels of depression can be represented by a score of 17-23 on the HAMD

Some experts believe that somatic depressive symptoms—headaches, unexplained body pain, sleep disturbances, appetite changes—are most prevalent in moderate levels of depression. One study concluded that, along with low mood, these physical symptoms of depression are what primarily characterize moderate depression. This study also noted that anhedonia is a defining characteristic of severe depression but not moderate depression.

One concern that many experts have is that many of these inventories and scales only use one dimension of depression symptoms to create categories for depression, such as their number, frequency, or severity. To address this, some mental health professionals have created classifications that incorporate several different dimensions. One proposed method of categorization takes into account severity, functional impairment, duration, and course (the number of major depressive episodes an individual has experienced in their lifetime and how long the current episode has lasted). 

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Signs of depression

Though it can have unique characteristics, moderate levels of depression are typically marked by symptoms that overlap with other forms of depression. As discussed above, somatic symptoms may be more pronounced than symptoms like anhedonia. However, the exact symptoms an individual experiences will typically depend on factors like medical history, comorbid mental and physical health disorders, and lifestyle influences. If you believe you’re living with moderate levels of depression, a healthcare professional can provide you with an evaluation and help you determine whether treatment is necessary. The following are several common signs that you may be living with moderate levels of depression.

Low mood

Depression is often characterized by sadness, fatigue, irritability, and a lack of motivation that persists for over two weeks. You may experience a decrease in self-confidence or feelings of hopelessness. These symptoms may manifest as frequent crying or expressions of anger. 

Loss of interest in activities once enjoyed

Those living with depression often feel less engaged with their interests. You may find that you aren’t pursuing your passions as actively or that you don’t derive as much pleasure from the things you once enjoyed. As discussed above, though, these symptoms may be less pronounced in moderate levels of depression. 

Fluctuations in appetite

Depression is often accompanied by a near lack of appetite or a notable increase in hunger. These changes can lead to weight loss or gain in those who are living with depression. 

Sleep disruptions

Depression can lead to excessive sleep in some, but it is also closely linked to insomnia. If you notice that your sleep schedule has been off lately, consider whether those disruptions arose alongside other depressive symptoms. 

Trouble focusing

Difficulty concentrating for an extended period is a common symptom of depression. You may find that you’re more distracted than normal or are experiencing other impairments in your cognitive functioning. 

Overlapping signs with heart disease

In some cases, the signs of depression may overlap with those of heart disease. Research suggests that those who live with moderate levels of depression may have a higher risk of cardiovascular disease than those who have moderately severe depression to severe depression. In addition, there may be a link between depression and heart conditions like high blood pressure, stroke, and congestive heart failure. Lab tests and physical exams can be conducted to rule out medical conditions that could mimic or contribute to depression. 

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Depression can have an impact regardless of its severity

Treatment for depression

Though moderate levels of depression can have significant emotional, cognitive, and physical effects, depression is a treatable disorder. Depression is often addressed through psychotherapy, medication, or both. Therapy can help the participant address the emotional challenges of depression and develop coping skills for everyday life. Therapeutic methods like cognitive behavioral therapy have been shown to effectively decrease symptoms of depression. Cognitive behavioral therapy helps individuals identify and replace negative thought patterns that may be causing recurrent depression. 

Medications

Certain medications can help reduce the severity of depressive symptoms and have been proven effective for depression. Common antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Always consult with a healthcare provider prior to starting or stopping any medication. 

Alternative remedies

Alternative remedies such as herbal supplements and mindfulness practices can also play a role in managing depression. For example, St. John's wort is a widely known herbal treatment that some find helpful for moderate depression, although it should be used cautiously due to potential interactions with other medications.

Lifestyle changes

Lifestyle changes can also help with the management of depression. Exercise has been shown to reduce depressive symptoms by decreasing stress and improving mood. In one study, researchers found that aerobic training, in particular, improved symptoms of moderate depression. If you’re living with depression, consider regularly going for walks, running, or biking. 

Diet

A balanced, healthy diet has also been linked to a decrease in depression symptoms. Many experts recommend following a version of the Mediterranean diet, which is rich in whole grains, healthy fats, fruits, vegetables, legumes, nuts, and lean meats. 

Self-care

Self-care—which refers to activities that nourish your body or mind—can help you reduce stress and better address your symptoms. Self-care can include drinking a cup of tea, reading a book, taking a bath, practicing yoga, journaling, or taking a mental health day at work. Mindfulness techniques, including meditation and deep-breathing exercises, can alleviate stress and improve daily life for those with mild to severe depression.

Therapy

Therapy offers a flexible approach to treat depression, allowing people to manage negative thoughts, low self-esteem, and other symptoms from the comfort of their home. Interpersonal therapy, a form of talk therapy, focuses on improving a person’s social life by targeting specific behaviors that may contribute to mental illness and a reduced quality of life. If symptoms persist or other symptoms emerge, therapists can help develop strategies to manage mental health conditions effectively.

Managing depression symptoms with online therapy

Research suggests that online therapy can help individuals address symptoms of depression that span a range of severities. In a study published in the peer-reviewed journal PLOS One, researchers examined the effectiveness of online therapy for individuals living with mild to moderate depression, finding that participants experienced improvements in depressive symptoms and had a better chance of continuing with treatment. The trial was specifically designed for individuals who experienced comorbid cardiovascular disease, which is a sign of depression that we discussed earlier.

If you or your loved ones, including friends and family members, are living with depression or a similar mental health-related concern, consider seeking the support of a licensed therapist online. With an online therapy platform like BetterHelp, you can get matched with a mental health professional based on your needs and preferences, so you’ll have a good chance of connecting with someone who can address your specific depression symptoms. Your therapist can also connect you with useful resources, such as articles and at-home exercises geared toward helping you learn more about depression. 

Takeaway

Moderate depression is a serious, but treatable, form of major depression that can have a significant impact on your life. By being aware of the above signs, you may be better able to determine whether to pursue care from a healthcare professional. If you would like further advice and support as you work to identify and address the symptoms of depression in your life, online therapy is available. A licensed online therapist can provide you with the resources and guidance you deserve as you navigate depression symptoms and take the next step on your mental health journey.
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