What are the Signs and Symptoms of Depression?
Depression is a mood disorder that causes negative thoughts and depressed moods that persist and cannot simply be shaken. Symptoms typically last for periods of at least two weeks or more and may include feelings of sadness, hopelessness and guilt, lack of interest in normal activities, changes in sleeping and eating patterns, weight loss or gain, fatigue, physical pains, difficulty concentrating, inability to make decisions, and thoughts of suicide.
Depression is a mental illness classified as a mood disorder. It may be called major depression, clinical depression, or major depressive disorder. As a mood disorder, depression causes negative and persistent patterns of thinking that affect mood and interfere with everyday life. Specifically, depression causes intense feelings of sadness and hopelessness, regardless of a person’s circumstances. Depression can also cause other symptoms, like insomnia, weight gain, or irritability.
While depression is a chronic illness that has no cure, it is also a condition that is treatable and manageable. It is important to understand and to be able to recognize the signs of depression in oneself and in others, to reach out for help or to offer help. Depression will not get better on its own. Only a diagnosis followed by treatment will allow a person with depression to start to feel better again.
The Diagnostic Criteria for Major Depression
There are several diagnostic criteria used by mental health professionals to determine if an individual can be diagnosed with major depression. These include nine symptoms, and a person must experience at least five of them during a two-week period or longer. The symptoms must also cause significant distress or impairment and cannot be attributed to substance abuse or another mental illness. The nine symptoms are:
- A depressed, sad mood that lasts nearly all day on most days
- A loss of interest or pleasure in normal or previously enjoyed activities
- Significant weight loss or gain
- Inability to sleep or oversleeping most days
- Agitation or slowed down affect
- Daily fatigue
- Feelings of guilt or worthlessness
- Inability or difficulty with thinking, concentrating, and making decisions
- Thoughts of death or suicide, potentially with attempted suicide
These symptoms are used to diagnose depression, but it is important to understand that they describe how a person feels nearly every day during a depressive episode. Having depression does not mean always being depressed. These episodes may last for a few weeks, go away, and return again later.
What Depression Feels Like
To list the official symptoms of depression does not entirely express what it feels like to go through a depressive episode. For individuals struggling with depression, it can be difficult to identify these signs, and it helps to have a description of what it feels like internally to have major depression:
- Intense sadness, a hopeless feeling that seems like it will never go away
- Feeling as if there is no solution, no way to feel better
- Feeling unworthy
- Having no interest in things that used to be enjoyable
- Lacking the energy to perform even basic personal hygiene or even to get out of bed
- Having no ability to imagine a future
- Feeling stuck in dark place, like a deep well, with no hope of getting out
- Being unable to make even simple decisions
- Struggling to spend time with friends or family
- Feeling as if going to work or school is impossible
- Thinking about dying
It can also be difficult to determine if negative feelings and mood are the result of a temporary and perfectly normal period of depression or if they are caused by clinical depression. It is normal to feel depressed sometimes, but major depression changes thoughts, feelings, and the ability to function. It interferes with the ability to maintain relationships, go to school, or hold down a job. Depression causes feelings of hopelessness that can be intense and overwhelming.
Signs of Depression in a Loved One
It is often easier to recognize depression traits and signs in someone else than in oneself. It is important to reach out to a friend or loved one showing the signs for this reason. Warning signs of depression in someone else may include:
- Seeming not to care about anything anymore
- A lot of talk about negative feelings or thoughts
- Eating more or less than usual
- Sleeping more or less than usual
- Drinking more than usual or abusing drugs
- Talking about death or suicide
- Withdrawal from family and friends
- Lack of personal hygiene
- Struggles at work or school
A list of signs of depression may not necessarily be useful, as individuals act differently and respond in unique ways to depression. However, it is important to take note of something not being right, changes in behavior, and the way a person acts or talks. Any kind of unusual changes may indicate depression or another type of mental illness that requires diagnosis and treatment.
Depression Differences by Type, Gender, and Age
Anyone with any type of depression may exhibit the diagnostic symptoms of depression, but may also have unique or different symptoms depending on the type of depression or the person’s gender or age. For instance, men tend to exhibit more aggression, irritability, risky behaviors, and physical pains when depressed than women do.
Children and teenagers with depression may be more likely to have physical symptoms, like indigestion and headaches. Children are more likely to become clingy, while teens tend to withdraw. Teenagers struggling with depression may self-harm, experiment with drugs and alcohol, and struggle in school. Older adults are more likely to have physical pain with depression, as well as changes in personality and trouble remembering things.
The signs and symptoms of depression may also vary by type. In addition to major depression, there are several variations that occur at certain times and cause specific symptoms:
- Premenstrual dysphoric disorder. This type of depression occurs in some women before menstruation and may include depression symptoms, but also irritability, mood swings, anger, physical symptoms, and emotional sensitivity.
- Perinatal and postpartum depression. Perinatal depression occurs in some women during pregnancy, and postpartum depression occurs after pregnancy. In addition to typical depression symptoms, these women may struggle to bond with their babies, experience panic attacks, cry excessively, have mood swings, and even have thoughts of harming their babies or themselves.
- Seasonal affective disorder. SAD is a type of depression that is triggered by the change of the seasons to fall and winter and by fewer daylight hours.
- Persistent depressive disorder. The symptoms of PDD are similar to those of major depression, but may be less severe and persist for about two years with little to no relief. Someone with PDD may be able to hide their symptoms because they are better able to function.
- Bipolar depression. Bipolar depression is similar to major depression, but it cycles with periods of mania.
- Adjustment disorder. Also known as situational depression, this kind of depression is triggered by a life event or a stressful situation, like a death of a loved one.
- Psychotic depression. Anyone with depression may develop psychotic symptoms, which may include hallucinations, delusions, paranoia, and suspicion of others.
Complications of Depression
In addition to the specific depressive traits and symptoms, depression can cause complications. These are not direct symptoms of the condition, but they can indicate that something is wrong. Even if a person is good at hiding depressive symptoms, complications may be more difficult or impossible to hide. Some of the possible complications in someone struggling with depression include:
- Significant weight gain or weight loss
- Physical pains that have no obvious explanation
- Self-harm injuries, such as cuts or burns
- Damaged or difficult relationships, fighting and conflicts
- Struggles at work or school, poor performance
- Isolation from peers and friends
- Panic attacks, anxiety attacks, or fear of social situations
- Alcohol abuse or drug use, which may lead to incarceration
- Suicide and death
When to Get Help or Offer Help for Depression
For anyone struggling with the signs and symptoms of depression, it is essential to get professional help. Depression does not go away without treatment, and to get treatment requires an accurate diagnosis by a mental health professional. It is very difficult for most people to reach out and ask for help, for many reasons, and so it becomes even more important for others to offer help. Any signs of depression are cause for concern and should lead to a visit with a doctor or mental health caregiver.
Of special concern is any sign of suicidal thoughts or plans. Speaking up is better than assuming a person won’t really commit suicide. In a crisis situation, call 911 to get professional and medical assistance. Most importantly, reaching out, speaking up, and talking about depression are necessary for getting help for oneself or another.
There are several signs and symptoms of depression, but each person is unique and will respond differently to the changes in moods and thoughts that depression causes. It is crucial to understand what depression can look like and feel like in order to reach out for help, to get a diagnosis, and to get treatment for this chronic condition.