The simple definition of depression is a constant feeling of sadness and loss of interest which stops you from doing your normal activities. However, depression is no simple issue. There are different types of depression ranging from mild to chronic and debilitating.
If you are concerned about someone in your life who is battling with their mental health, here is a list of classic symptoms of depression and ones that may alert you that your loved one needs medical help.
What causes depression?
Research shows that depression does not occur from a single event but is usually bought on from a mix of events and factors. Possible causes of depression cover everything from too much or too little of certain brain chemicals to genetic vulnerability, stressful life events, medication, ill-health and daily stress.
Symptoms of depression occur along a spectrum, both in how long the symptoms last and how severe they are. Each person’s experience is different and the severity can change over time.
- Mild depression can occur during periods of stress but it will resolve with time and may not require any specific treatment.
- Moderate to severe depression causes chronic symptoms and usually requires at least one or multiple forms of treatment.
- Severe depression usually requires medical-supervised treatment and therapy for the person to find some relief. Severe depression is where your symptoms grow increasingly worse or fluctuate between mild and moderate to severe. It can lead to self-harm, risky behaviour and worse, suicide.
If you or a loved one is experiencing one or more of these symptoms for longer than two to three weeks, it’s possible depression has set in. It’s important you visit your doctor for a diagnosis and information on treatment before depression progresses from mild to severe.
Appetite and weight changes
A hidden sign of depression includes loss of appetite and weight loss. Similarly, it could be increased appetite and weight gain.
Some people lose interest in eating and some people turn to food for comfort, depending on their mood. Dramatic weight gain or loss can make your depression worse as it affects your self-esteem. There is also a link between excess fat and increased inflammation in your body which will take a toll on your physical wellbeing.
Changes in sleep habits
A lack of sleep can bring on depression and depression can bring on insomnia or over-sleeping. There is a strong link between mood and sleep habits, where neurochemical changes in the brain can lead to sleeping too much or too little.
Sleeping too much is often a sign of wanting to ‘escape’ from situations that make your mood worsen. Sleeping too little is often a sign of an overactive mind, where troubled or dark thoughts are preventing you from relaxing and falling asleep.
Depression may come with a lack of energy, even when you’re getting enough sleep and are not overly worked or stressed. Lack of energy is also part of the reason you might stop doing things you usually find pleasurable or seeing people you love and care about.
Feeling fatigued can often lead to excessive sleeping. It’s also linked to insomnia, where a person feels overwhelmed by extreme fatigue but is too anxious to relax and sleep soundly. Likewise, a lack of quality sleep can lead to anxiety.
Loss of interest
A clear sign that someone you love is suffering from depression is when he or she loses interest in people, activities or events that would ordinarily make them happy and give them joy. This includes family, friends, sport, exercise, sex, hobbies and pastimes.
Feeling a loss of interest can make it harder to do the things you need to do each day, whether it’s at home or at work. It can leave you feeling listless, disinterested and unmotivated to do even the most simple tasks.
This feeling of loss of interest in depression is known as anhedonia. It’s the inability to feel pleasure in normally pleasurable activities. A depressed person may withdraw from activities or people that ordinarily would bring them joy. Major depression can cause a decreased sex drive and even impotence in men.
Everyday stress makes us irritable but when you feel annoyed, agitated and irritable on an almost constant basis, this is a major depression symptom. Feeling irritable is when small things that would not usually bother you can make you feel unreasonably aggravated or upset.
The tension that builds up can make you more sensitive to situations or people that usually bring you joy and happiness. Irritability can trigger risky behaviour, substance abuse or misplaced anger.
There are a number of causes of irritability and not all of them have to do with depression. Irritability can be bought on by life stress, lack of sleep, low blood sugar levels, lack of magnesium and hormonal changes. It can even be bought on by an infection or diabetes.
Feeling irritable for an extended period of time can be a depression symptom but it may be something simple that can be treated with exercise, relaxation therapy or over-the-counter medication. Speak to your doctor and check your overall physical health if you cannot shake this feeling of irritability.
Depression often brings on a hopeless outlook, where you look on your life with no sense of hope. Hopelessness means having no expectation of good or success.
Hopeless or helplessness is one of the major depression symptoms and usually is triggered by internal and external negative messages that affect how you view yourself and/or the world.
Other feelings that accompany hopelessness include self-hate and feeling guilty for no real reason. Hopelessness is often vocalised as, “What’s the point in life” or “It’s all my fault”.
Depression and anxiety often occur hand-in-hand. Symptoms of anxiety often mirror depression symptoms and the two conditions feed off each other.
Anxiety symptoms include:
- rapid heart rate
- rapid breathing
- feeling restless, nervous or tense
- feelings of panic, danger or dread
- heavy sweating
- trembling or muscle twitching
- confusion, poor memory or concentration
Melancholia is a feeling of sadness that “you just can’t shake”. It may be mild or persistent and intense. Melancholia is perfectly normal but melancholic depression is a lot more serious. It leads to you losing interest in all or almost everything that used to give you pleasure. It also lessens or eliminates your natural ability to ‘react with pleasure’ to stimuli.
Melancholic depression is a form of major depressive disorder (MDD) that is characterised by a profound presentation of severe depression. Melancholia itself has a strong genetic connection, where there is often a family history of depression, bipolar disorder or suicide.
One minute you’re full of the joys of spring and the next you’re in a dark space. Laughing and joyful and then crying uncontrollably or in a rage. Sound familiar?
It’s natural to experience mood swings, we’re only human. However, unexplained, wild mood swings that seem to get worse over time are a symptom of depression. It may also be a symptom of a condition that’s a lot more serious, like bipolar disorder, schizoaffective disorder or a personality disorder.
You’ve heard the saying, “Fake it until you make it”. It’s good advise unless the person is suffering from depression or a serious mental disorder.
When a person feels depressed but they hide it behind fake smiles and laughter, we call this ‘smiling depression’. This depression is often the most serious because while you keep up this forced happiness, the people who love and care about you are oblivious to your pain and can’t help you.
On the outside, someone with smiling depression is an active, high-functioning individual who can hold down a steady job and appears cheerful and optimistic. However, on the inside, the person is feeling sad, lonely, hopeless and possibly even suicidal.
Some of us are “glass half full people” and some of us are “glass half empty” people. That’s perfectly natural; you either have an optimistic disposition or fairly pessimistic tendencies.
However, if you or a loved one is becoming increasingly more pessimistic, it could be red flag for depression. Therapists also call it ‘depressive realism’ or ‘catastrophic thinking’. This means you don’t see the world with an optimism filter, only a more accurate or realistic view on personal or world events where there is ‘no silver lining’.
People with depression often describe their emotional pain as “feeling broken”. They have the mindset that something is wrong with them; that they feel useless, worthless, hopeless and helpless. Feeling broken can bring on intense anxiety coupled with low self-esteem, pessimism and suicidal thoughts.
It can be very hard for loved ones to understand depression or even empathise with how you’re feeling because there are no physical symptoms. Nothing is broken on the outside, only deep inside. You might have a heavy, laden feeling in your chest or feel like you’re disconnected from the world and viewing it through a sheet of thick, opaque glass. Often, only a fellow depressed person or a psychologist can grasp what you mean by “feeling broken”.
Loss of concentration
Do you find yourself trailing off in the middle of a conversation? Losing your train of thought? Forgetting simple everyday tasks? You might be temporarily tired or stressed, or you might have depression if you find your concentration worsens over time.
Poor concentration can also become part of a negative feedback cycle in which losing focus makes depression worse. Concentration requires that you want to reach a goal that you believe is worth achieving. However, depression often interferes with that. Then; the worse your memory becomes or the more you lose focus, the harder and more pointless it all seems. You get stuck in that loop.
Physical pain and medical ailments
Depression can manifest itself as physical pain or a mild to serious illness. Common physical symptoms of depression are backache, stomachache, nausea, vomiting and headaches.
Likewise, chronic pain and illness can bring on depression in some people. People suffering from the following conditions often have co-occurring depression:
- type 2 diabetes
- autoimmune conditions
- heart disease
- HIV and AIDS
Poor hygiene and personal pride
Yes, poor hygiene is a very common depression symptom. The connection between poor hygiene and mental illness is stronger than you may think so if you or a loved one is neglecting simple hygiene tasks, it could be anything from depression to a serious mental disorder.
It’s quite common to neglect basic hygiene when you feel depressed. Either you don’t have the energy or you just can’t be bothered with the simple task of showering, brushing your teeth, washing your hands, brushing your hair or washing and ironing your clothes.
Alcohol and drug use
People with depression sometimes use alcohol or drugs to cope with their feelings of hopelessness, lethargy, sadness or loneliness. In fact, it’s quite common for substance abuse to co-occur with depression and a social anxiety disorder.
The Anxiety and Depression Association of America (ADAA) report that 1 in 5 people (20%) in America with depression, anxiety or a mental disorder use alcohol or drugs to cope with their symptoms. Likewise, 1 in 5 people who have an alcohol or drug addiction also have a mood disorder.
Postpartum depression is a debilitating condition that many women suffer from shortly after giving birth to a baby. The old fashioned term is ‘baby blues’ but this name doesn’t give enough weight to how serious postpartum depression can be.
Some of the many symptoms of postpartum depression include:
- Mood: anger, anxiety, guilt, hopelessness, loss of interest, mood swings or panic attack
- Behaviour: crying, irritable or restless
- Physical: fatigue, loss of appetite, weight gain, insomnia, trembling or racing heartbeat
- Cognitive: poor concentration or memory and unwanted thoughts of self- or baby harm
- Psychological: depression, anxiety, racing thoughts, fearfulness or hopelessness
Cutting is a form of self-injury and is a serious warning sign of depression. Cutting involves a person making small cuts on his or her body, usually the arms and legs. It’s a difficult concept for people to understand but cutters say it helps them control their emotional pain by being distracted by physical pain.
Over time, the cutting usually escalates. Cutting also usually co-occurs with mood changes such as depression, anxiety, risky behaviour and aggression.
The way you can spot if someone you love is self-harming by cutting is if they have small, straight cuts or unexplained cuts and scratches that appear regularly. They might also start wearing long sleeve shirts and pants even when the weather is warm in order to hide the cuts.
There is a strong relationship between depression and high-risk behaviour, usually because people are burdened with feelings of hopelessness and helplessness. To get temporary relief from intense emotional pain, some people are inclined to behave in a way that is a risk to themselves and others. This includes excessive drinking, drug abuse, unsafe sex, speeding, fighting or cutting.
Experts label the feeling of intense emotional pain as ‘psychache’. It’s described by Shneidman as an acute state of intense psychological pain associated with feelings of guilt, anguish, fear, panic, angst, loneliness and helplessness.
Yes, depression can worsen and lead to a person taking their own life. For this reason, even mild depression should be taken seriously because, if left unchecked, these people are at high risk of self-harm or hurting another person.
Not many of us believe that someone can ‘die from depression’, yet severe depression puts some people at high risk of self-harm or taking their own life. Depression can cause great emotional pain and leave you feeling helpless and without hope, which leads you to believe that ‘life is not worth living anymore’.
When someone you love and care about says he or she is thinking about suicide, or says things that sound as if the person is considering suicide; it can be extremely worrying and upsetting. If you don’t know what to do or how to help this person, speak to your doctor or a therapist for advice.
Are you depressed?
Only a doctor or a mental health professional such as a psychologist, social worker or psychotherapist can make an accurate diagnosis of depression and recommend the best treatment for your type of depression. It’s important that you seek medical help for depression earlier rather than later because the symptoms may worsen and leave you feeling hopeless and helpless.
Certain illnesses and certain medication can cause symptoms that mimic depression. It’s a good idea to have a complete medical examination as part of process of diagnosing and treating depression and its symptoms.
The information in this article is only meant to be used as a tool to help you recognise depression symptoms and help you talk to your doctor or loved ones. It does not substitute medical intervention for an accurate diagnosis of depression.