A loss of interest in almost all activities, daily and consecutively for two weeks is a strong sign of a major depressive disorder. Persistent aches and pains that do not change even after treatment are often described by older women rather than sadness.49 Often, the individual’s demeanor, facial expressions and anxious feelings are used to describe behavioral characteristics observed in depression.49 Not all express or experience similar symptoms; with each gender the frequency, severity and duration of signs and symptoms will vary based on individual types of disorders (Table 5).
Additional signs and symptoms may include: psychosomatic complaints with increased visits to medical doctors; difficulty in maintaining personal relationships; phobias; frequent change and/or loss of employment; and addictive behaviors to substance abuse and gambling. Suicide attempts and family histories of completed suicides represent severe symptoms requiring immediate medical attention. When impairments are so significant that normal functioning is halted, specialized psychotherapy must be initiated.49