Moderate depression (A guide)

In this article, we will discuss moderate depression, its symptoms, key signs, prediction and prevention, and treatment.

You can also get some information about depression classification by severity, as well as depression according to BDI, BDI-II, MDI and CES-D scoring systems.

Classification of Depression by Severity; Moderate Depression

In some sources, mild depression is mentioned as “depressive episode.”

According to the international classifier of diseases, the disorder’s code is F32. 

Depending on the symptoms identified in the patient and the severity of their manifestation, depression is classified into three types according to the severity of the manifestation:

Mild depression (ICD-10 – 32.0)

2-3 symptoms have a pronounced severity. Such depression can be difficult to differentiate from sadness; the patient is accompanied by internal mental stress, irritability, spleen, and lowered interest in activities that were previously enjoyed.

In general, mild depressive disorder does not interfere with normal life and work but brings some emotional discomfort.

Moderate or medium depression(ICD-10 – 32.1)

The manifestation of more than four symptoms is observed. It creates certain difficulties for a normal life.

It is dangerous because it can move quickly to the next, severe stage of depression.

Moderate depression is usually noticeable to others.

Severe or major depression without psychotic symptoms (ICD-10 – 32.2) 

In major depressive disorder or severe depression, the absolute number of symptoms is pronounced.

In this state, a person suffers; he/she feels worthlessness and abandonment. Often the severe degree is accompanied by suicidal thoughts.

Severe depression episodes, on average, last for six months or longer.

Major depression may cause hallucinations, stupor, delusions, and suicidal thoughts.

Symptoms of Moderate Depression

The symptoms of moderate depression are more in-depth than in mild depression.

Below are some of the main features and symptoms:

  • Lack of interest,
  • Lack of motivation,
  • Depressed mood (independent of external factors and circumstances. For moderate depression, a period of 14 days is “counted”),
  • Low self-esteem and self-confidence,
  • Insomnia,
  • Fatigue,
  • Inability to make decisions and concentrate,
  • Reduced productivity,
  • Increased sensitivity,
  • Excessive worrying.

Moderate depression shares similar symptoms of mild depression, such as:

  • Irritability,
  • Anxiety,
  • Appetite changes,
  • Weight changes,
  • A sudden disinterest in socializing,
  • Feelings of guilt and despair,
  • Drug or alcohol addiction, or gambling,
  • Hopelessness and other symptoms.

Moderate depression mainly differs from mild depression with the intensity of the symptoms, which makes difficulties in daily life at home and work.

Key Signs of Mild Depression

Mild depression has two key signs: mask sign and unhealthy activity.

Mask sign

Mask sign is determined by the facial expression of the patient and assumes a loss of muscle activity.

For example, girls with moderate depression often refuse to put on makeup and take care of themselves.

Moreover, if they need to do it (to attend an important event, or for a holiday), the effect is negative: makeup does not decorate but distorts facial features.

During a psychotherapy session, such patients often cry, but it looks playful and insincere.

At this stage, deep self-destructive processes occur, but the patient deliberately hides them behind unnatural facial expressions.

Unhealthy activity

Behind unhealthy activity, the patient is trying to hide his/her depressed state.

Patients with moderate depression can go to bed on time and fall asleep.

However, already at 4-5 a.m., such people are on their feet and begin to engage actively in something.

How to distinguish this condition from hard work?

Patients do not get pleasure from the work they do; it depresses and exhausts them, but also serves as specific protection from disturbing thoughts.

The line between mild and mild depression is fragile.

Diagnosis of the disease is complicated by the fact that the symptoms are blurry, and the patient, himself/herself, makes contact with difficulty.

Confessions “Moderate depression.”


It makes everything take a little more energy than when I am not depressed. I get physically tired a bit sooner, and my mind is not quite as sharp. I do not get as excited about things I like, but I still like them. It is harder to motivate myself to do chores around the house, and I do not feel much satisfaction when I am done with them, but I still can get them done. It is harder to motivate myself to get exercise, but I force myself to do a little every day because that is what keeps my depression from getting worse (I know I am lucky to not need medication for this, and I do not judge people who do).

There is always a temptation to stop what I am doing and relax, but I can resist it. I have this background mutter of negative self-talk, but I can resist it with a bit of effort. For instance, part of my mind is trying to tell me that this answer will not be perfect, and it is probably not worth the time, and someone else will likely write a better one — yet here I am, still writing.

For contrast, when my depression is worse, I would be thinking this answer is not good and stupid and a total waste of time, and I probably would just quit writing it. When it is worse, I sort of feel sleep-deprived all the time; my brain is sluggish, and I have very little mental or physical energy. Unfortunately, getting more sleep does not help, so it is not sleeping deprivation; that is just what it feels like.

So, in general, I am glad my depression is only minor. It would be nice to not be depressed at all, of course. I see signs of slow improvement; some of that is just getting better at living with this, but I think some are also an actual lessening of the depression itself.

That is what it is like for me.


COne year old children, painful childbirth, restless older child, sleepless nights that is all, memory lapses, second pregnancy, natural childbirth. 2 children scream at night. 

There is no sleep for three days at all, frequent illnesses, acetones in the youngest, eternal hospitals, I am mostly alone.

I have thoughts about own worthlessness, complicated relationships with my husband, quarrels, screams, health problems, inability to visit a doctor (no one to leave children with), constant complaints from my husband, self-esteem at 0, constant tremor, diarrhea for weeks, mood swings, absence physical and moral strength.

Moderate Depression Treatment

Very often, moderate depression is perceived by the patient and others as an evil character, laziness, selfishness, natural pessimism, and lack of assembly.

However, it should be understood that a depressed state is not just a bad mood.

It requires timely treatment by a specialist.

The sooner the disease is detected, the more successful the treatment will be, and a person will be able to return to a healthy life.

There are some main options for dealing with moderate depression:

  • Psychotherapy (can be useful especially CBT),
  • Drug treatment using MAO inhibitors, tricyclic and tetracyclic antidepressants (this includes a diet that excludes tyramine. This means that the patient will have to abandon alcohol, yogurts, smoked meats, aged cheeses),
  • Physical activity (physical exercises or yoga),
  • Healthy food (Are recommended, especially seafood and vegetables, as they reduce the risk of depression progression. To make up for the deficiency in the body of omega-3 and six is enough to buy unique capsules at the pharmacy,
  • Meditation (correctly affects the mental health of a person).

The treatment regimen is always selected individually by the psychotherapist.

After conducting some tests, and sometimes a medical examination, he/she can prescribe one of the options or apply a complex treatment.

Treatment of moderate depression can be both fast and gradual, which depends on the general mental state of the patient and his characteristics.

The Expediency of Treatment With Antidepressants

To establish the need for such treatment, the therapist must assess some risks for the patient from the psychological point of view:

  • Decrease or loss of social adaptation, which is manifested in problems with relatives, conflicts in the workplace and with friends,
  • A significant loss of ability to work, which may or may have already led to dismissal,
  • The patient attempts to get out of a stalemate on their own, being committed to a poor state.

Given the aforementioned factors, antidepressant therapy can be prescribed, which will be aimed to increase the patient’s ability to concentrate.

With significant problems with concentration, treatment may be ineffective or overly prolonged.

Prediction and Prevention of Moderate Depression

Overall, the outlook for a successful recovery from moderate depression is positive.

However, to no small extent, the result will depend on the timeliness of contacting a specialist.

Here the situation depends on two factors:

  • The patient’s consciousness, when he/she himself/herself understands that negative changes are occurring with him/her, requiring external intervention;
  • Care and responsibility of family members and loved ones who are, in some way, obliged to push and sometimes insist on diagnosis and treatment.

Prevention of moderate depression is a healthy lifestyle, finding a balance between all spheres of activity.

Timely treatment of other physiological or psychological diseases is required.

Depression according to BDI, BDI-II, MDI and CES-D scoring systems

Beck depression inventory (BDI)

  • Mild – <15
  • Moderate – 15-30
  • Severe – >30


  • Minimal – 0-13
  • Mild – 14-19
  • Moderate – 20-28
  • Severe – 29-63

Major depression inventory

  • Moderate to severe – >26

Center for epidemiological studies depression scale (CES-D)

  • Depression, consideration for psychiatric evaluation – >16.

  1. Cbt For Mild To Moderate Depression And Anxiety
  2. HFNE “The Hilarious World of Depression”
  3. HFNE “Types of Depression”
  4. The CBT Handbook: A Comprehensive Guide to Using CBT to Overcome Depression, Anxiety, Stress, Low Self-Esteem and Anger
  5. The Cognitive Behavioral Workbook for Depression: A Step-by-step Guide to Overcoming Depression


Moderate depression assumes that it is observed the manifestation of more than four symptoms of depression.

It creates specific difficulties for a healthy life. It is dangerous because moderate depression can move quickly to the next, severe stage of depression.

Moderate depression is usually noticeable to others.

It mainly differs from mild depression with the intensity of the symptoms, which makes difficulties in daily life at home and work.

Moderate depression can be treated by psychotherapy, antidepressants (do not forget about paying attention to expediency, which we mentioned above), meditation, physical activity, and eating healthy food.

Please feel free to comment on the content or ask any questions in the comments section below.


  1. Options for mild or moderate depression
  2. Signs and Symptoms of Mild, Moderate, and Severe Depression