Two weeks is the minimum duration required to diagnose major depressive disorder.

How long must symptoms persist to diagnose major depressive disorder?

• A. Two days
• B. One week
• C. Two weeks
• D. One month

Answer: (C)

To diagnose major depressive disorder, symptoms must persist for at least two weeks. This period is critical because it ensures that the symptoms are not just part of a temporary mood fluctuation but are instead indicative of a more serious and ongoing depressive episode. The diagnostic criteria for major depressive disorder, as outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), specify that individuals must experience a depressed mood or loss of interest or pleasure in nearly all activities, along with several other symptoms, over this two-week duration. This timeframe helps differentiate major depressive disorder from other mood disturbances, such as a brief adjustment disorder or situational depression, where symptoms may resolve more quickly. Therefore, the requirement of two weeks is essential for a thorough and accurate diagnosis, providing the clinician with a clearer understanding of the persistence and severity of the depressive symptoms.

Outline / Skeleton

• Opening question: why people wonder about “how long” symptoms must persist for a major depressive disorder diagnosis.

• The two-week rule, in plain terms: depressed mood or loss of interest plus other symptoms for at least two weeks, with clear impairment or distress.

• What counts as symptoms: the core two-week requirement plus a cluster of possible signs (sleep, appetite, energy, concentration, self-worth, thoughts of death).

• Why this duration matters: it helps distinguish a temporary mood storm from something more persistent and impairing.

• How clinicians check duration: talking through a timeline, corroborating details, and using brief screening tools.

• Real-world nuances: cultural differences, overlapping conditions, when duration alone isn’t the whole story.

• What to do if you’re worried: seeking professional input, safety considerations, and practical next steps.

• Takeaway: two weeks is the anchor; if symptoms meet that window and cause significant trouble, a clinician will assess whether major depressive disorder is the right label.

• Closing thought: you’re not alone in noticing mood changes; understanding the timeline can bring clarity and relief.

Two weeks that matter: the rule behind the diagnosis

Let’s start with the core question: how long do symptoms need to hang around to consider major depressive disorder? The concise answer is two weeks. But what does that really mean in everyday life? In clinical terms, the DSM-5 (the standard set of guidelines clinicians use) says a person must experience a depressed mood or a markedly diminished interest or pleasure in almost all activities for most of the day, nearly every day, for at least two weeks. And that’s just the beginning.

The two-week window isn’t a magic lottery; it’s a careful threshold. It helps separate a rough patch—the kind of mood swing many of us ride out—from something more persistent, which can require attention, support, and treatment. It’s a signal that the mood changes aren’t just a brief reaction to stress but part of a broader pattern that may be clinically meaningful.

What counts as symptoms?

The two-week criterion centers on mood, but diagnosis isn’t just “feeling down” for a while. Along with a depressed mood or a loss of interest or pleasure, there needs to be a cluster of additional symptoms. The DSM-5 outlines a total of nine symptoms commonly observed in major depressive episodes. To meet the diagnosis, a person typically experiences five or more of these symptoms during the same two-week period, and at least one of the symptoms is either depressed mood or diminished interest or pleasure.

Here are the common symptoms, with a quick plain-language anchor for each:

• Depressed mood most of the day, nearly every day (feels sad, empty, or hopeless)

• Diminished interest or pleasure in activities once enjoyed

• Noticeable weight change or appetite shift (gain or loss)

• Trouble sleeping (insomnia) or sleeping too much (hypersomnia)

• Fatigue or low energy that isn’t explained by another illness

• Feelings of worthlessness or excessive guilt

• Reduced ability to think clearly, concentrate, or make decisions

• Psychomotor changes (being slowed down or unusually agitated)

• Recurrent thoughts of death or suicide, or a suicide attempt

A few things to keep in mind: not every person will have all nine symptoms, and the intensity can vary. The key is that the symptoms are present most days for at least two weeks and that they cause noticeable distress or impairment in daily life—work, school, relationships, or self-care.

Why this duration matters: a bit of context

Two weeks isn’t arbitrary; there’s a practical reason behind it. Mood can swing for many reasons—grief, stress, a bad season, or a disrupted routine. If a person only has symptoms for a short spell, a clinician may consider other explanations or diagnoses, like an adjustment disorder, a brief depressive reaction, or simply temporary distress. The two-week mark helps reduce over-diagnosing and ensures that treatment decisions are grounded in a pattern that’s unlikely to resolve on its own without intervention.

Think of it like a weather forecast. A quick rain shower might be inconvenient, but it isn’t a storm. When the rain lasts for days and reorganizes plans, you start to treat it as a weather system that needs attention. The same logic applies here: two weeks of sustained symptoms signals a mood pattern worthy of careful assessment and potential treatment.

How clinicians check duration in real life

In practice, clinicians don’t rely on memory alone. They’ll begin with a clear timeline, asking questions like:

• When did you first notice these feelings or changes?

• Have the symptoms been present most of the day, every day, for the past two weeks?

• Are there days when you felt better, or did they linger without much relief?

• Have these symptoms affected sleep, appetite, energy, or responsibilities?

Sometimes a symptom timeline involves collateral information from family, friends, or coworkers who can confirm changes in behavior or function. Some clinicians also use brief screening tools, like the PHQ-9, to quantify symptom severity. Tools like these provide a numerical snapshot that helps track changes over time. They aren’t a diagnosis by themselves, but they offer a helpful piece of the puzzle when paired with a clinical interview.

Nuances and caveats that matter in the real world

Duration is essential, but it’s not a stand-alone verdict. Several nuances can color the picture:

• Context matters. Distress tied to a specific loss, trauma, or life event could show similar patterns but require a nuanced interpretation.

• Cultural and individual differences. Expressions of distress vary; in some cultures, somatic symptoms (aches, fatigue) may predominate. Clinicians tailor questions to respect these differences.

• Co-occurring conditions. Anxiety disorders, substance use, thyroid problems, or chronic pain can overlap with depressive symptoms. The timeline helps, but clinicians also assess other possible causes.

• Chronic depression versus a new episode. For someone with a long history of depression, distinguishing between persistent depressive disorder (dysthymia) and a major depressive episode can hinge on duration, pattern, and symptom clustering.

• Grief and sadness aren’t automatically major depression. Prolonged grief can mimic depressive symptoms, but clinicians will weigh the overall pattern, duration, and functional impact.

What to do if you’re worried about symptoms

If you or someone you care about suspects major depressive disorder, here are practical steps to take:

• Start with a conversation. Reach out to a trusted clinician, counselor, or primary care provider. You don’t have to wait for a formal diagnosis to seek help.

• Track the timeline. A simple diary or note about when symptoms started and how they’ve evolved can be incredibly helpful in a first visit.

• Prioritize safety. If there are any thoughts of self-harm or suicide, seek urgent help immediately. If you’re in the United States, you can contact emergency services or a crisis line; if you’re elsewhere, contact your local emergency number or a trusted mental health resource.

• Be honest about impact. Explain how the symptoms affect sleep, appetite, concentration, work or school performance, and relationships. The more accurate your picture, the easier it is to tailor support.

A few quick myths to hold lightly

• Myth: It has to be all-day, every day. Reality: the pattern can wax and wane, but the two-week threshold helps capture persistence.

• Myth: Depression is just “sadness.” Reality: while sadness is a core feature, major depressive disorder is characterized by a broader set of symptoms that disrupt daily life.

• Myth: Symptoms must be severe to count. Reality: many people experience a mix of moderate symptoms that are distressing and function-impairing, which can still meet diagnostic criteria when the two-week rule is met.

Takeaway: the anchor is two weeks

Two weeks is the anchor clinicians use to separate fleeting mood shifts from a more persistent mood disorder. It’s not the only factor they consider, but it’s a critical starting point. If someone has a depressed mood or a marked lack of interest for at least two weeks, accompanied by several other symptoms, and those signs are causing noticeable trouble in daily life, a professional evaluation is warranted. The goal isn’t to label quickly but to understand the lived experience as accurately as possible and identify the best path to support and recovery.

Closing thought: you’re not alone in noticing the pattern

Mood changes happen to all of us. Some weeks are tougher, some mornings feel heavier, and that’s human. What helps is recognizing when a pattern sticks around long enough to begin affecting daily life, and then reaching out for a thoughtful, compassionate assessment. The two-week rule is a practical compass—designed to guide conversations, not to stigmatize. If you’re on the edge of that window, or if you’ve already crossed it, remember you don’t have to navigate it solo. A clinician can walk with you, help map the timeline, and explore options that fit your life.

In essence, the duration answer is straightforward: symptoms must persist for at least two weeks to meet the diagnostic threshold for major depressive disorder. But the real story lives in how those two weeks play out in daily life—the days of struggle, the moments of clarity, the impact on work, sleep, appetite, and relationships. And if you’re reading this because you’re trying to understand your own experience or someone you know, know that a thoughtful conversation with a professional can make a meaningful difference. The timeline is there to guide care, not to define you. And with support, clarity often follows.