What cognitive symptom is most evident in a patient experiencing a major depressive episode?

In a major depressive episode, individuals often experience significant cognitive symptoms, one of the most prominent being low self-esteem. This aspect of depression manifests as negative self-perception and feelings of worthlessness. During such an episode, the individual may become overly critical of themselves, focusing on perceived failures and inadequacies, which exacerbates feelings of hopelessness and despair. This cognitive distortion contributes to the overall severity of the depressive state, impacting the individual's ability to think positively about themselves or their situation.

In comparison, other options such as increased energy levels, delusions of grandeur, and high levels of motivation are not typically associated with major depressive episodes. Instead, individuals often experience a lack of energy, diminished motivation, and, in many cases, an absence of any grandiose thoughts. Understanding that low self-esteem is central to the cognitive disturbances in depression can help in both identifying the disorder and guiding appropriate therapeutic interventions.