SIGECAPS is a mnemonic used to remember the eight symptoms of major depressive disorder as defined by the DSM-5, the standard diagnostic manual for mental health conditions. Along with depressed mood itself, these eight symptoms form the nine total criteria a clinician evaluates when screening for depression. A diagnosis requires at least five of the nine to be present for two or more consecutive weeks.
What Each Letter Stands For
S: Sleep disturbances. This can go in either direction. Some people develop insomnia, struggling to fall or stay asleep. Others swing the opposite way, sleeping far more than usual.
I: Interest. A noticeable drop in interest or pleasure in activities you previously enjoyed. Clinically, this is called anhedonia. It’s not just feeling bored. It’s the inability to feel enjoyment from things that once reliably brought it, whether that’s hobbies, socializing, food, or sex.
G: Guilt. Persistent feelings of guilt or worthlessness that are often unrealistic or out of proportion to the situation. This might look like obsessively replaying minor mistakes or feeling fundamentally flawed as a person.
E: Energy. A significant decrease in energy, covering both mental and physical fatigue. Everyday tasks like showering, cooking, or getting to work can feel exhausting in a way that rest doesn’t fix.
C: Concentration. Difficulty focusing, making decisions, or remembering things. You might find yourself reading the same paragraph repeatedly, struggling to follow conversations, or feeling unable to choose between simple options.
A: Appetite. A meaningful change in appetite, either a sharp decrease or increase. This often comes with corresponding weight changes. Some people lose their appetite entirely, while others turn to food for comfort and eat significantly more than usual.
P: Psychomotor changes. This refers to observable changes in physical movement and speech. Psychomotor retardation looks like slowed movement, sluggish walking, slumped posture, reduced facial expressions, and soft or monotone speech. Psychomotor agitation is the opposite: restlessness, fidgeting, pacing, or an inability to sit still driven by a feeling of inner tension. Either pattern counts.
S: Suicidal ideation. Recurrent thoughts of death or suicide, which can range from passive wishes (“I wish I wouldn’t wake up”) to active planning.
How It’s Used in Practice
SIGECAPS is not a test you take or a score you receive. It’s a checklist that helps clinicians remember what to ask about during an evaluation. The mnemonic covers eight of the nine criteria for major depressive disorder. The ninth, depressed mood, isn’t in the acronym because it’s considered the starting point of the conversation.
For a diagnosis of major depression, five of the nine total symptoms need to be present during the same two-week period, and at least one of those five must be either depressed mood or loss of interest. The symptoms also need to represent a change from how you normally function. Someone who has always been a light sleeper, for example, wouldn’t count insomnia as a new symptom unless it worsened noticeably.
Clinicians also rule out other explanations before landing on a depression diagnosis. Symptoms caused directly by a substance (alcohol, drugs, or medication side effects) or another medical condition don’t count toward the criteria. Grief after a significant loss, like the death of a loved one or a financial catastrophe, can produce many of the same symptoms, so clinicians distinguish between normal grief responses and a depressive episode. Other psychiatric conditions like bipolar disorder and schizoaffective disorder must also be ruled out, since mania or psychotic features would point toward a different diagnosis.
SIGECAPS vs. the PHQ-9
If you’ve been screened for depression in a doctor’s office, you likely filled out a PHQ-9 questionnaire, a nine-item form that asks you to rate how often you’ve experienced each symptom over the past two weeks. The PHQ-9 produces a numerical score (0 to 27) that categorizes severity as minimal, mild, moderate, moderately severe, or severe.
SIGECAPS and the PHQ-9 cover essentially the same nine symptoms. The difference is in who’s using them and how. The PHQ-9 is a patient-facing screening tool designed for quick administration in primary care settings. SIGECAPS is a clinician-facing memory aid, helping providers conduct a thorough clinical interview without forgetting a symptom category. Think of the PHQ-9 as the standardized quiz and SIGECAPS as the mental checklist a provider uses when talking with you in more depth.
Why the Mnemonic Matters
Depression is more than feeling sad. The SIGECAPS framework captures the full picture: it’s a condition that disrupts sleep, energy, appetite, movement, thinking, and motivation all at once. Many people experiencing depression don’t realize how many of these symptoms they’re carrying because each one develops gradually. Recognizing that your sleep problems, brain fog, and loss of interest in friends are all connected, rather than separate issues, is often the first step toward getting help.
The mnemonic is also useful for tracking your own patterns over time. If you notice several of these symptoms clustering together and lasting more than two weeks, that’s meaningful information to bring to a healthcare provider. You don’t need to diagnose yourself, but knowing what the criteria actually are puts you in a better position to describe what you’re experiencing.