Table 2.

Examples of Verbatim Quotes from Focus-Group Participants Describing Their Symptoms of Major Depressive Disorder

Symptom	Verbatim Quote(s)
Fatigue	“I get tired very quickly, and I have to push myself.” “The other big thing for me is time with my kids. When I have just this unrelenting exhaustion, it’s really hard to be as involved in their lives as I want to be, and I feel guilty about it.” “ … I don’t like to commit to plans sometimes in case I’m going to be too tired or just not feel up for it.”
Low motivation/loss of interest	“Yeah, there were weeks, like a period of time where it was like two or three weeks I couldn’t leave my bed. I couldn’t leave my bed, didn’t shower, didn’t brush my teeth.” “Things that I know I need to do, responsibilities, I tend to push them away to the point where I let bills get out of control. Everything gets out of control and becomes a mess. So it’s really hard. It affects every aspect of everything.”
Anxiety	“I felt like that was part of my life, just feeling that panic, like something horrible was in the middle of happening, and there was nothing I could do about it.”
Cognitive symptoms	“I mean, a big one I can think of that I have struggled with for a couple of years now is reading. I used to be a super big reader. And I have a lot of books, like I keep on buying books that I would love to read, and they just sit on my bedside table and don't get read.” “It’s like a funky fogginess … I can’t think, I can’t concentrate. My words end up not even coming out the way that they should.” “Inability to concentrate. Sometimes when it comes over me, I’m like paralyzed. I can’t do anything at all.”
Weight gain/overeating	“During the worst time, I gained a lot of weight, because I emotionally eat.”
Sleep problems (mostly excess sleep)	“I just got to a point where I was cancelling social engagements and stuff because I just wanted to stay in bed and sleep.” “When I’m depressed I like to sleep a lot. I’ll sleep my Saturday away or something and then it’s like you feel like you’re missing out on life just sleeping.”
Agitation/irritability	“I get angry and irritable entirely too quickly.”
Overwhelmed/inability to cope	“The feeling of being completely overwhelmed with emotion. It feels like it cripples me so that I can’t even function.” “Just being able to cope with life. I don’t feel like I can cope with anything sometimes. It’s just everything overwhelms me.”
Hopelessness	“Feeling hopeless, so I think it’s like when you feel depressed like you don’t feel like you’ll get out of it. Like that’s all you know.”
Lack of enjoyment	“ … lack of interest in activities I used to enjoy.”
Negative outlook	“Pessimism, to where I’m feeling like the world’s going to end every little thing that happens.”
Aches and pains	“I was getting really bad tension headaches … like really bad painful, stressful, from stress and worry.”
Suicidal thoughts	“How about suicidality? That’s the top one on my list because I fight Satan every single day to stay alive and that’s been going on since I was 12.”
Lack of self-worth/self-esteem	“I’ve always been sad and always feeling like I didn’t measure up to other people.”
Fear	“One of my main ones [symptoms] was fear. I had a fear of change, fear of dying, fear of failure, fear of success, fear of being alone, which paralyzed me for years and years and years. It stopped me from being able to accept myself for who I was.”
Weight loss/low appetite	“I lost 30 pounds in two months and I was crying every single day. I’m like something is definitely wrong.” “Eating, my appetite wasn’t there, and I knew something was up. I think I lost maybe 20 pounds or something like that … ”
Laziness	“Overeating, tiredness, aches and pains, laziness.”
Guilt	“That’s [guilt] been a recurring issue for me … just to the point where I can’t function.”