Users of social platforms often perceive these sites as supportive spaces to post about their mental health issues. Those conversations contain important traces about individuals’ health risks. Recently, researchers have exploited this online information to construct mental health detection models, which aim to identify users at risk on platforms like Twitter, Reddit or Facebook. Most of these models are focused on achieving good classification results, ignoring the explainability and interpretability of the decisions. Recent research has pointed out the importance of using clinical markers, such as the use of symptoms, to improve trust in the computational models by health professionals. In this paper, we introduce transformer-based architectures designed to detect and explain the appearance of depressive symptom markers in user-generated content from social media. We present two approaches: (i) train a model to classify, and another one to explain the classifier’s decision separately and (ii) unify the two tasks simultaneously within a single model. Additionally, for this latter manner, we also investigated the performance of recent conversational Large Language Models (LLMs) utilizing both in-context learning and finetuning. Our models provide natural language explanations, aligning with validated symptoms, thus enabling clinicians to interpret the decisions more effectively. We evaluate our approaches using recent symptom-focused datasets, using both offline metrics and expert-in-the-loop evaluations to assess the quality of our models’ explanations. Our findings demonstrate that it is possible to achieve good classification results while generating interpretable symptom-based explanations.