Cognitive Symptoms:

1. Abnormal self-reproach or inappropriate guilt:
   1. This disorder usually causes a marked lowering of self-esteem and self-confidence with increased thoughts of pessimism, hopelessness, and helplessness. In the extreme, the person may feel excessively and unreasonably guilty.
   2. The "negative thinking" caused by depression can become extremely dangerous as it can eventually lead to extremely self-defeating or suicidal behavior.


2. Abnormal poor concentration or indecisiveness:
   1. Poor concentration is often an early symptom of this disorder. The depressed person quickly becomes mentally fatigued when asked to read, study, or solve complicated problems.
   2. Marked forgetfulness often accompanies this disorder. As it worsens, this memory loss can be easily mistaken for early senility (dementia).


3. Abnormal morbid thoughts of death (not just fear of dying) or suicide:
   1. The symptom most highly correlated with suicidal behavior in depression is hopelessness.

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