Depression Symptoms and Warning Signs
Recognizing Depression and Getting the Help You Need
Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won't go away, you may have depression. Depression makes it tough to function and enjoy life like you once did. Just trying to get through the day can be overwhelming. But no matter how hopeless you feel, you can get better. By understanding the cause of your depression and recognizing the different symptoms and types of depression, you can take the first step to feeling better and overcoming the problem.
What is depression?
Depression is a common and debilitating mood disorder. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. The feelings of helplessness, hopelessness, and worthlessness can be intense and unrelenting, with little, if any, relief.
While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular can feel angry and restless. No matter how you experience depression, left untreated it can become a serious health condition. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation. There are plenty of powerful self-help steps you can take to lift your mood, overcome depression, and regain your joy of life.
What are the symptoms of depression?
Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.
10 common symptoms of depression:
- Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
- Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
- Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
- Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
- Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
- Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
- Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
- Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
- Concentration problems. Trouble focusing, making decisions, or remembering things.
- Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.
- Talking about killing or harming one’s self
- Expressing strong feelings of hopelessness or being trapped
- An unusual preoccupation with death or dying
- Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
- Calling or visiting people to say goodbye
- Getting affairs in order (giving away prized possessions, tying up loose ends)
- Saying things like “Everyone would be better off without me” or “I want out”
- A sudden switch from being extremely depressed to acting calm and happy
Am I depressed?
These questions can help you and your physician figure out if you may be suffering from depression.
Interpreting the score:
0 to 4: Minimal depression.
5 to 9: Mild depression.
10 to 14: Moderate depression.
15 to 19: Moderately severe depression.
20 to 27: Severe or major depression.
This questionnaire is not intended to replace professional diagnosis.
Adapted from: "The PHQ-9: Validity of a Brief Depression Severity Measure", J Gen Intern Med. 2001 Sep; 16(9): 606–613.
Is it depression or bipolar disorder?
Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This can be a serious problem as taking antidepressants for bipolar depression can actually make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder.
Depression and suicide risk
Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and watch for the warning signs:
If you think a friend or family member is considering suicide, express your concern and seek help immediately. Talking openly about suicidal thoughts and feelings can save a life.
If You Are Feeling Suicidal...
When you’re feeling depressed or suicidal, your problems don’t seem temporary—they seem overwhelming and permanent. But with time, you will feel better, especially if you get help. There are many people who want to support you during this difficult time, so please reach out!
How depression symptoms vary with gender and age
Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults.
Women are more likely to experience depression symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain. Depression in women is also impacted by hormonal factors during menstruation, pregnancy, and menopause. In fact, postpartum depression affects up to 1 in 7 women experience depression following childbirth.
Irritability, anger, and agitation are often the most noticeable symptoms in depressed teens—not sadness. They may also complain of headaches, stomachaches, or other physical pains.
Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression: things like fatigue, unexplained aches and pains, and memory problems. They may also neglect their personal appearance and stop taking critical medications for their health.
Types of depression
Depression comes in many shapes and forms. Knowing what type of depression you have can help you manage your symptoms and get the most effective treatment.
Major depression is much less common than mild or moderate depression and is characterized by severe, relentless symptoms.
- Left untreated, major depression typically lasts for about six months.
- Some people experience just a single depressive episode in their lifetime, but major depression can be a recurring disorder.
Atypical depression is a common subtype of major depression with a specific symptom pattern. It responds better to some therapies and medications than others, so identifying it can be helpful.
- People with atypical depression experience a temporary mood lift in response to positive events, such as after receiving good news or while out with friends.
- Other symptoms of atypical depression include weight gain, increased appetite, sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to rejection.
Dysthymia (recurrent, mild depression)
Dysthymia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood.
- The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years).
- Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.”
- If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.”
Seasonal affective disorder (SAD)
For some people, the reduced daylight hours of winter lead to a form of depression known as seasonal affective disorder (SAD). SAD affects about 1% to 2% of the population, particularly women and young people. SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love. SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring.
Depression causes and risk factors
While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics.
Risk factors that make you more vulnerable to depression include:
The cause of your depression helps determine the treatment
Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead-end job, the best treatment might be finding a more satisfying career rather than simply taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.
What you can do to feel better
When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.
To cope with depression
Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. He or she just needs to be a good listener—someone who’ll listen attentively without being distracted or judging you.
Get moving. When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there.
Eat a mood boosting diet. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids.
Find ways to engage again with the world. Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better.
When to seek professional help
If support from family and friends and positive lifestyle changes aren’t enough,it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:
Therapy. Effective treatment for depression often includes consulting a therapist who can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent depression from coming back.
Medication may be imperative if you’re feeling suicidal or violent. But while it can help relieve symptoms of depression in some people, it isn’t a cure and is not usually a long-term solution. It also comes with side effects and other drawbacks so it’s important to learn all the facts to make an informed decision.
Understanding Depression: The many faces of depression and how to find relief – Harvard Medical School Special Health Report
Signs and Symptoms of Mood Disorders – Lists the common signs and symptoms of depression and bipolar disorder. (Depression and Bipolar Support Alliance)
Male Depression: Don't Ignore the Symptoms – Learn about the distinct symptoms of depression in men and the dangers of leaving them untreated. (Mayo Clinic)
Atypical Depression: What's in a Name? – Article on the symptoms, diagnosis, and treatment of atypical depression. (American Psychiatric Association)
Depression and Other Illnesses – An overview of the mental and physical illnesses that often co-exist with depression, and how this impacts treatment. (Depression and Bipolar Support Alliance)
Co-occurring Disorders and Depression – How medical disorders can affect depression and vice versa. (Mental Health America)