Signs of Depression

The signs of depression are many and varied. Depression is much more than a feeling of sadness; it is a medical condition that may cause severe, prolonged symptoms and significantly disrupt a person’s daily functioning. 1

Depression is thought to be the most common mental health condition in the world, with almost one in five Americans alone experiencing a depressive episode in their lifetime. Though the condition is widespread, it may be difficult to recognize. Symptoms of depression may be masked by physical complaints or substance abuse, or hidden because of one’s fear of being stigmatized. 1 2 3 Signs of depression may go unnoticed, and the condition is thought to be underdiagnosed, particularly in primary health care settings. 4

Symptoms of depression may vary by age and sex, but a list of some of the more common signs of a depressive episode may include: 1 5

• Persistent low mood; feelings of sadness, hopelessness, emptiness or even irritability, frustration and anger
• Loss of interest or pleasure in activities that used to be enjoyable; this can include sex
• Excessive guilt or feelings of worthlessness
• Tiredness and lack of energy
• Trouble concentrating and making decisions
• Memory problems
• Talking or moving more slowly than usual
• Restlessness or trouble sitting still
• Disrupted sleep patterns, including difficulty falling asleep, not being able to sleep through the night, waking up early or sleeping too much (excessive sleeping)
• Changes in appetite and/or weight, there may be an increase or loss of appetite and weight
• Persistent headaches, other body pains, or digestive trouble without a clear physical trigger
• Recurrent thoughts of death or suicide, or suicide attempts

Other, less obvious signs of depression may include: 1 6

• Anxiety
• Ruminative thinking: this refers to repetitive negative thoughts or brooding about distressing experiences or thoughts 7
• Self-harming, e.g. cutting oneself
• Substance abuse and addiction, including heavy drinking and smoking

Signs of depression are typically present for more than two weeks. If you think that you might have signs of depression, you can try using the Ada app to find out more about your symptoms.

Good to know: Depression varies in form and severity, and not everyone will experience all of the above symptoms. For example, a person may have several of the above signs of depression, but not sadness specifically. 8 9 10

There are many different types of depression, and the condition may occur together with a number of other health conditions – mental and otherwise. For example, depression may co-occur with an anxiety disorder, attention deficit hyperactivity disorder or a personality disorder, or diabetes, heart disease and other health conditions. The relationship between depression and other conditions is complex. 1

Sometimes, symptoms that appear to be related to depression may be indicators of another condition. For example, a person may develop apparent signs of depression due to a physical condition like hypothyroidism, which should get better with treatment, or another mental health condition like bipolar disorder. It is important to rule out other possible causes of the symptoms.

It is important not to ignore signs of depression, particularly if they seem to be getting worse. Seeing a doctor as soon as possible is recommended.

Depression is considered a treatable condition. For information on depression tests, diagnosis and treatment, including psychotherapy and antidepressant medication, see the resource on depressive episodes.

If a person shows signs of crisis – obvious indicators that they are strongly affected by depression or at risk of suicide – it is important to call a doctor, emergency services provider or suicide prevention helpline without delay.

Females seem to be more likely than males to experience depression, probably due to biological, hormonal and social factors, and some of the signs of depression may differ between the sexes. 2 For example, women with depression may be more likely than men to experience the symptoms of excessive guilt and anxiety. 11

Other signs of depression that may be more likely to be present in women include: 2 11

• Increased appetite
• Weight gain
• Sleeping too much
• Lack of energy

Some types of depression are unique to women. These include depression experienced as part of premenstrual dysphoric disorder (PMDD) and perimenopausal depression. Perinatal depression, including postpartum depression, is strongly associated with women, though new parents of any gender can experience it. Women experiencing symptoms of depression are advised to consult a medical practitioner about treatment options, including psychotherapy and medication. 12

It is estimated that between five and eight percent of women experience a severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD). Signs of PMDD may include symptoms of depression, such as low mood, ruminative thinking or obsessive thoughts, irritability and suicidal thoughts, sleep disturbances, changes in appetite, joint and muscle pain, as well as headaches, bloating and breast tenderness, among others. 11 12

Read more about PMDD »

Postpartum depression is a type of perinatal depression that may occur in the year after having a baby.

Postpartum depression goes far beyond the mild “baby blues” that many new mothers experience for four to 10 days after giving birth, and can interfere with the new mother’s ability to care for herself and her baby.

Signs of perinatal depression may include anxiety, extreme worries about the well-being of the baby, severe sadness and exhaustion, among other typical symptoms of depression. These signs may begin during the third trimester. Perinatal depression is relatively common. 11 12 13

Read more about Signs of Postpartum Depression »

During perimenopause – the transition to menopause – some women may experience depression. To an extent, mood swings, sleep difficulties and physical symptoms like hot flashes may be normal during this time, but anxiety, irritability, extreme sadness and other depressive symptoms may be signs of perimenopausal depression. 12 If you think that you might have signs of depression, try using the Ada app to find out more about your symptoms.

While men are less likely than women to experience depression, it is still a serious health problem that affects a large number of males. Men are statistically less likely to acknowledge their depression or seek help and treatment. Furthermore, men with depression are at a greater risk of suicide than women, which may be related to problematic societal norms and pressures. 2 14 15

Signs of depression in men may include: 2 14

• Irritability or anger
• Agitation
• Behavioral changes, e.g. becoming controlling or violent
• Tiredness
• Loss of interest in work, family or hobbies
• Difficulty sleeping
• Weight loss
• Physical symptoms, such as headaches, chronic pain and digestive problems
• Substance abuse; including alcohol
• Risk-taking, e.g. unsafe driving or unsafe sex

Despite a loss of interest in work or loss of concentration and attention, some men with depression may work longer hours than usual, possibly to avoid showing signs of the condition.

While the signs of depression may differ slightly between men and women, treatment is generally the same and typically includes talking to a mental health professional and taking antidepressant medication where recommended. Men experiencing symptoms of depression are advised to consult a medical practitioner. If you think that you might have signs of depression, try using the Ada app to find out more about your symptoms.

Teenagers can also experience depression, but it may be difficult for their caregivers to recognize the symptoms, and many cases go undiagnosed and untreated. 16 Signs of depression in teens and young adults may differ somewhat to those in adults, and may include the following: 17

• Seeming annoyed by everything and everyone
• Being argumentative and picking fights
• Responding to minor provocations with emotional outbursts
• A much stronger than usual need for social connection and social validation
• Promiscuity, substance abuse and risky behaviors
• Difficulties with school work
• Sleep disturbances, particularly sleeping too much 18

Other, more typical signs of depression, such as fatigue and loss of interest in activities that were once pleasurable, are very often present. It is important to distinguish normal teenage behaviors from teen depression. Significant changes in mood, together with changes in functioning, like serious social or school problems, indicate that a healthcare professional should be consulted. 17

If a teenager shows signs of suicidal thoughts or actions, it is vital to take these seriously, and it is of the utmost importance to call a healthcare professional or suicide prevention hotline without delay.

Younger children can also experience depression. However, because their behavior may change as they go through different childhood stages, and because they may exhibit different signs of depression compared to adults, it can be difficult for caregivers to recognize that a child is depressed. 19

Signs of depression in children may include: 17 19 20

• Clinging to caregivers
• Pretending to be ill and refusing to go to school
• Getting into trouble at school
• Being irritable and negative
• Being argumentative and picking fights
• Responding to minor provocations with outbursts of emotions
• Showing excessive anxiety about caregivers passing away
• Excessive sulking
• Excessive crying or tantrums
• Experimenting with alcohol or drugs
• Displaying a lack of care for things they used to value highly 21

Other more typical signs of depression in adults, such as sleep disturbances, tiredness, changes in appetite and loss of interest in activities that were once pleasurable, may be less commonly present in children with depression.

The symptoms of depression may interfere with the child’s ability to partake in social activities, complete schoolwork and enjoy family life. 20 If a caregiver notices that their child’s behavior and day-to-day functioning has changed significantly, it is recommended that they speak to a healthcare professional.

Read more about Depression in Childhood or Adolescence »

Like people of other age groups, children can show signs of suicidal thoughts or actions. If a caregiver suspects that a child is at risk of harm, they should contact a healthcare professional or suicide prevention helpline immediately.

Despite depression being more prevalent than dementia among the elderly, it remains underdiagnosed and undertreated. Some of the signs of depression in older people may be different to those considered typical, and they may be mistaken for indications of other conditions, like Alzheimer’s disease. 22 23 Depression in older adults is sometimes called geriatric depression.

In addition to manifestations like irritability, sleep disturbances and appetite changes, signs of depression in the elderly may include: 22 24

• Anxiety
• Aches, pains and other physical symptoms
• Neglecting self-care
• Confusion and agitation
• Difficulty getting up in the morning
• Behaving uncharacteristically
• Alluding to a depressed or anxious mood with vague language (e.g. talking about their “nerves”)

A senior citizen experiencing symptoms of depression is advised to consult a medical practitioner about treatment options, including psychotherapy and medication. If you think that you might have signs of depression, try using the Ada app to find out more about your symptoms.

COVID-19 can harm mental health. Social isolation and uncertainty about health caused by COVID-19 can be linked to depression.

Read more about COVID-19 and depression here.

There are a number of different types of depression and conditions that cause depressive symptoms. These include: 25 26

• Major depression. Also called clinical or unipolar depression, major depressive disorder or just depression, this is the most commonly diagnosed form
• Dysthymia (a form of persistent depressive disorder). A milder, long-lasting form of depression 27
• Adjustment disorder with depressed mood: Symptoms of depression that are triggered by a major life stressor, like moving house or becoming unemployed
• Seasonal affective disorder (SAD). Depression that affects some people seasonally, typically in the colder, darker months
• Bipolar disorder. A mental health condition characterized by periods of depression and mania

A person may experience a depressive episode as part of a chronic depressive condition, as repetitive bouts of depression, or as an isolated occurrence. For information on the causes, diagnosis and treatment of depression, see this resource on depressive episodes.

It is important to note that depressive symptoms may be a feature of other health conditions, including Parkinson’s disease and hypothyroidism, among others. Depressive symptoms may also be more likely to co-occur with certain conditions, such as diabetes, or chronic pain due to inflammatory joint conditions. 28

Previously known as manic depression, bipolar disorder is a condition that can cause extreme shifts in mood. A person may experience periods of deep depression, where they feel very low, and periods of mania, where they feel very high. When a person with bipolar disorder is experiencing a depressive phase, they may have many of the signs of depression detailed above. 29

Read more about Bipolar Disorder »

Q: What are the first signs of depression?
A: Any of the symptoms of depression listed above, including persistent low mood, loss of interest in activities that used to be enjoyable, and excessive guilt or feelings of being worthless, may serve as “warning signs” for a depressive episode coming on. Additionally, research suggests that a person might experience other early symptoms that indicate the onset of depression, known as a prodrome, in the days, weeks or months before becoming depressed. During the prodrome, the following symptoms may be present: 30 31

• A vague sense of emotional discomfort, which may be expressed as “something not being right”
• Anxiety, sadness or irritability
• Difficulty concentrating
• Loss of interest and motivation
• Fatigue
• Sleep disturbances, e.g. insomnia or sleeping a lot more than usual

These symptoms may be mistakenly attributed to external factors such as bad weather or stress. If a person thinks that they may be experiencing a depressive phase, it is recommended that they speak to a healthcare provider.

Q: Is sleeping too much a sign of depression?
A: In some cases, sleeping too much can be a sign of depression. Also known as excessive sleeping or hypersomnia, a person may experience it as part of a depressive disorder. However, sleeping too much can also be caused by a number of other conditions, including hormonal conditions like hypothyroidism, neurological conditions like Parkinson’s disease 32 or narcolepsy, as well as certain medications. If you are concerned about sleeping too much, it is recommended that you consult a doctor. 33 34

Q: What are the physical signs of depression?
A: Physical symptoms of depression may include:

• Feeling tired a lot
• Persistent aches, pains or ailments, such as headaches or indigestion, without a clear physical cause
• Slowed speech or movement
• Restlessness or difficulty keeping still
• Unplanned weight loss or gain

Q: Depression and irritability: what is the connection?
A: Persistent irritability can be a sign of depression in some people. A person might also be angry a lot and/or experience several of the other symptoms described above. 6 35 36

Q: Is there a signs of depression test?
A: There are a number of self-assessment tests, checklists and quizzes available on the internet, varying in length and complexity. While some of these tests may help a person to assess how they have been feeling, they cannot replace a consultation with a GP or other healthcare professional. If a person has any concerns or questions about signs of depression, it is important that they seek advice from a qualified medical practitioner. They can print out or take a screenshot of the quiz results and take them along to their appointment. 37 38 39

Q: What if a partner, relative or friend has signs of depression?
A: If you have recognized that your husband, wife, girlfriend, boyfriend, loved one or friend has signs of depression, you might be wondering how to help. It is important to broach the subject carefully, in a non-accusatory and tactful manner, and encourage the person to talk about how they are feeling. Listening may be helpful, and, if it seems appropriate, the person could be encouraged to speak to their GP or another medical practitioner, or join a local support group. 40 In addition, they could be encouraged to take small steps to help themselves, such as exercising, or engaging in some simple movement, like a regular walk, and eating a balanced diet. It is important to be patient when interacting with someone who is depressed. 41 If a person shows signs of crisis – obvious indicators that they are strongly affected by depression or at risk of suicide – it is important to call a doctor, emergency services provider or suicide prevention helpline without delay. 14

Q: Is it normal to develop signs of depression after the death of a loved one?
A: After the loss of a partner, friend or family member, it is normal to experience intense sadness and grief. While grief and depression can seem similar, they are not the same thing. As is the case with depression, a person experiencing bereavement-related grief may have difficulty sleeping and eating, and lose interest in activities they normally enjoy.

However, the symptoms of grief tend to fluctuate over the day and week and get better on their own over time, while the symptoms of depression are typically present almost constantly, i.e. almost every waking moment during an episode of depression. In some cases, grief can trigger or worsen a depressive episode, but it is important to remember that by far not everyone who is grieving will develop clinical depression. If a person who has lost a loved one finds that their symptoms are severe, they have difficulty functioning in daily life, or they have thoughts of suicide, it is recommended that they speak with a healthcare practitioner. 42 43 44

Q: Can preschoolers be depressed?
A: Many psychiatrists and psychologists now believe that children as young as two or three can present with preschool depression. Parents and caregivers may notice excessive and long-lasting sadness and irritability in the child, as well as excessive guilt, a negative and pessimistic self-image, and a loss of pleasure in play and everyday activities. If these signs are evident, it is recommended that you seek the advice of a pediatrician, or a child psychologist or child psychiatrist. 45 46

Q: What are the signs of high-functioning depression?
A: High-functioning depression is not a recognized medical diagnosis. However, the term is sometimes used colloquially to describe people who may experience depression, but perhaps not to the extent that it significantly or noticeably disrupts their professional and/or personal life. Sometimes, signs of depression may be subtle. Furthermore, depression may vary in severity, with some people experiencing milder forms of the condition than others. 47 48

Q: What are the signs of hidden depression?
A: Symptoms of depression vary from person to person, and sometimes they may be quite subtle or described as “hidden”. Some of the possible signs of depression that may be less obvious to a person include: 6 35 49

• Often feeling angry and/or irritable
• Difficulty concentrating or remembering things
• Deep feelings of guilt
• Persistent aches and pains

Q: I think I have signs of depression – what should I do?
A: If you think that you have symptoms of depression, it is recommended that you see a medical doctor as soon as possible. They will be able to rule out other conditions and help you decide on a treatment plan, if necessary. You can also use the Ada app to find out more about your symptoms, and consider sharing the assessment with your doctor.

Q: My signs of depression are coming back – what should I do?
A: If you think that you might be experiencing a relapse of depression, it is important to see your doctor or therapist as soon as possible. They will be able to help you manage a depressive episode, adjusting your treatment plan if necessary.

Q: Signs of anxiety disorder vs. signs of depression – what should I know?
A: While there may be some overlap between signs of anxiety disorder and signs of depression, the two differ in their symptoms and are therefore diagnosed as distinct mental health conditions. Furthermore, treatment approaches may differ, depending on the diagnosis and individual presentation in a given person. Many people have both anxiety and depression. This co-occurrence is called comorbid depression and anxiety. 25 50 51 52