Depression A depressive episode has features typical of major depression; the episode must include ≥ 5 of the following during the same 2-week period, and one of them must be depressed mood or loss of interest or pleasure and, with the exception of suicidal thoughts or attempts, all symptoms must be present nearly every day: Depressed mood most of the day Markedly diminished interest or pleasure in all or almost all activities for most of the day Significant (> 5%) weight gain or loss or decreased or increased appetite Insomnia (often sleep-maintenance insomnia) or hypersomnia Psychomotor agitation or retardation observed by others (not self-reported) Fatigue or loss of energy Feelings of worthlessness or excessive or inappropriate guilt Diminished ability to think or concentrate or indecisiveness Recurrent thoughts of death or suicide, a suicide attempt, or specific plan for suicide Psychotic features are more common in bipolar depression than in unipolar depression.