Understanding Major Depression: More Than Just Feeling Sad

Major depression—also known as Major Depressive Disorder (MDD)—is one of the most commonly discussed mental health conditions, yet it remains deeply misunderstood. Many people associate depression with simply “feeling sad” or having a rough period in life. In reality, major depression is a serious mental health disorder that affects how a person feels, thinks, and functions—often in ways that are invisible to others.

This post aims to explain what major depression really is, what it can look like, and why it is far more complex than most people realize.

What Is Major Depressive Disorder?

Major Depressive Disorder is a clinical condition characterized by a persistent low mood and a loss of interest or pleasure in daily life, lasting at least two weeks and significantly interfering with functioning. While two weeks is the minimum threshold for diagnosis, major depression usually lasts much longer than that—often for months, and for some people it can persist longer without effective support. Untreated episodes of major depression are commonly estimated to last six to twelve months, and even with treatment, recovery is often gradual rather than immediate.

The length of a depressive episode can vary widely depending on factors such as whether this is a first or recurrent episode, the severity of symptoms, the presence of other mental health conditions, access to treatment, and the level of social support. Because of this, depression does not follow a single, predictable timeline. Taking longer to feel better does not mean someone is failing—it reflects the nature of the illness itself.

Depression does not resolve simply through willpower, positive thinking, or “trying harder.” It is not a character flaw, a weakness, or a personal failure—it is a medical and psychological condition that deserves understanding and care.

Prevalence of Major Depression in Canadian Society

Major depression is not rare, and it does not affect only a small portion of the population. In Canada, millions of people will experience depression at some point in their lives. National mental health data suggest that approximately one in five Canadians will experience a mood disorder, such as depression, during their lifetime.

Depression affects people of all ages, genders, cultural backgrounds, and socioeconomic circumstances. It is more frequently reported among young adults, women, and individuals experiencing chronic stress, discrimination, or economic insecurity. Despite how common it is, depression often goes underdiagnosed and undertreated due to stigma, barriers to care, and the belief that one should be able to manage it alone.

Recognizing how widespread depression is can help challenge isolation. While depression can feel profoundly personal, many others are quietly navigating similar struggles.

Common Symptoms of Major Depression

Depression can present differently from person to person, but it often involves a combination of emotional, cognitive, physical, and behavioural symptoms.

Emotional symptoms

People with major depression may experience persistent sadness, emptiness, or emotional numbness, along with feelings of hopelessness, worthlessness, or excessive guilt. Many describe a sense that life feels overwhelmingly heavy or unmanageable, as though even existing requires immense effort. Suicidal thoughts may occur, including wishing one were no longer here or feeling that life is simply too much to bear.

If you or someone you know is experiencing thoughts like these, it’s important not to delay seeking help. In Canada, immediate and confidential support is available 24/7 by calling or texting 988, the Suicide Crisis Helpline.

Cognitive symptoms

Major depression often alters the way a person thinks, processes information, and relates to themselves. Concentration may become difficult, making it hard to read, follow conversations, or complete tasks that once felt manageable. Decision-making can feel overwhelming or even paralyzing, as though every choice carries excessive weight or consequence.

Depression can also distort thought patterns. Many people experience persistent negative or self-critical thoughts, harsh internal dialogue, or a sense that they are fundamentally flawed. Rumination is common—painful memories, regrets, or worries may replay repeatedly without resolution, making mental rest feel nearly impossible. Over time, these cognitive changes can erode confidence and hope, making it difficult to imagine a different or better future. Importantly, these thoughts are symptoms of depression itself, not accurate reflections of reality or personal worth.

Physical and behavioural symptoms

Major depression frequently manifests in the body. Ongoing fatigue, low energy, and a sense of heaviness are common, and many people describe a physical heaviness in their limbs, as though their arms or legs are weighed down or difficult to move. Clinically, this experience is often related to psychomotor retardation, a symptom of depression involving slowed movement, reduced speech, and the feeling that the body is operating in slow motion.

Sleep disturbances are also common and can take different forms. Some people experience insomnia, struggling to fall asleep, stay asleep, or waking much earlier than intended. Others experience hypersomnia, sleeping for extended periods yet still feeling exhausted or unrefreshed.

Changes in appetite may involve eating significantly more or significantly less than usual, and these shifts can lead to noticeable weight changes. Clinically, depression-related appetite disturbance may be associated with weight loss or weight gain of approximately 5% or more of body weight over a relatively short period, even without intentional dieting or lifestyle changes. These changes are not about willpower, but about how depression affects energy regulation, hunger cues, and motivation.

Some people move or speak more slowly, while others feel restless and agitated. Social withdrawal is also common—not because a person doesn’t care about others, but because interacting can feel emotionally or physically exhausting.

Importantly, someone can appear outwardly “high-functioning” while still experiencing severe depression internally.

Depression Is Not the Same as Sadness

Sadness is a normal human emotion. Depression is not. Sadness tends to come and go, often in response to specific events, and usually allows moments of relief or connection. Major depression, by contrast, is persistent, pervasive, and can distort how a person sees themselves, others, and the future. People with depression often want to feel better but feel unable to access motivation, joy, or hope.

What Causes Major Depression?

Depression is one of the most complex disorders in terms of what causes it. There is no single cause of major depression. It typically arises from a combination of factors, including genetics, brain chemistry, chronic stress, trauma, major life changes, medical conditions, and long-term emotional suppression. Contrary to what some might think, depression is not caused by laziness, negativity, or a lack of gratitude.

A Note on Hope

Major depression is real, serious, and often deeply painful. But it is also treatable, and many people do find relief through therapy, medication, social support, or a combination of approaches. Recovery does not mean feeling happy all the time. More often, it means feeling lighter, regaining some energy, and rediscovering moments of interest, connection, or meaning.