Which of the following symptoms is often associated with Major Depressive Disorder?

Suicidal ideation is a significant symptom often associated with Major Depressive Disorder (MDD). It refers to the thoughts or considerations of self-harm or ending one's own life, which can emerge as a response to the intense emotional pain and hopelessness characteristic of this disorder. Individuals experiencing MDD may feel overwhelmed by their symptoms, which can include feelings of worthlessness, despair, and a lack of interest in activities they once enjoyed, leading them to contemplate suicide as a way to escape their suffering.

In contrast, the other symptoms listed do not align with MDD in the same way. Psychotic episodes, while they can occur in severe cases of depression or as part of other disorders, are not a defining symptom of MDD itself. Elevated energy levels generally contradict the low energy and fatigue commonly seen in MDD. Increased appetite can occur in some individuals but is not as universally recognized as a core symptom, as many individuals with MDD experience a decrease in appetite instead. Thus, suicidal ideation is a critical and concerning symptom directly linked to the severity and implications of Major Depressive Disorder.