Signs of Depression
What are the signs or symptoms of depression?
The signs of depression are many and varied. Depression is much more than everyday sadness; it is a medical condition that may cause severe, prolonged symptoms and disrupt a person’s daily functioning.
Depression is the most common psychiatric disorder in the world, with almost one in five Americans alone experiencing an episode in their lifetime. Though the condition is widespread, it may be difficult to recognize; depression may be masked by physical complaints or substance abuse, or hidden because of one’s fear of being stigmatized. Signs of depression may go unnoticed, and the condition is underdiagnosed, particularly in primary care settings.
- Persistent low mood (sadness, hopelessness, emptiness or even irritability, frustration and anger)
- Loss of interest or pleasure in activities that used to be enjoyable (including sex)
- Strong feelings of guilt or 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
- Changes in appetite and/or weight
- Persistent headaches, other pains, or digestive trouble without a clear physical trigger
- Recurrent thoughts of death or suicide, or suicide attempts
- Ruminative thinking
- Self-harming (e.g. cutting)
- Substance abuse and addiction (including heavy drinking and smoking)
Signs of depression are typically present for more than two weeks.
Depression varies in form and severity, and not everyone will experience all of the above symptoms. There are many different types of depression, and the condition may occur together with a number of other conditions – psychiatric and otherwise. For example, depression may co-occur with an anxiety disorder, attention hyperactivity disorder or personality disorder, or diabetes, heart disease and other medical conditions. The relationship between depression and other conditions is complex.
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 line without delay.
Signs of depression in women
Women seem to be more likely than men to experience depression (this is probably due to biological, hormonal and social factors), and some of the signs of depression may differ between the genders. For example, women with depression may be more likely than men to experience the symptoms of excessive guilt and anxiety.
- 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), perinatal depression (including postpartum depression), and perimenopausal depression. Women experiencing any symptoms of depression are advised to consult a medical practitioner about treatment options.
Signs of PMDD
It is estimated that between three and five percent of women experience a severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD). Signs of PMDD may include symptoms of depression (including anger, irritability and suicidal thoughts), sleep disturbances, changes in appetite, joint and muscle pain, bloating and breast tenderness, among others.
Signs of postpartum depression
Postpartum depression is a type of perinatal depression that may occur in the year following pregnancy (some women also experience perinatal depression while they are pregnant).
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 baby.
Signs of perinatal depression may include anxiety, extreme sadness and exhaustion – among other typical symptoms of depression. These signs tend to begin during the third trimester. Perinatal depression is relatively common.
Signs of perimenopausal depression
During perimenopause – the transition to menopause – some women may experience depression. To an extent, mood swings, sleep difficulties and physical symptoms like hot flushes may be normal during this time, but anxiety, irritability, extreme sadness and other depressive symptoms may be signs of perimenopausal depression.
Signs of depression in men
While men may be less likely than women to experience depression, it is still a serious health problem that affects a large number of them. Men with depression are at a greater risk of suicide than women, which may be related to problematic societal norms and pressures. Men are statistically less likely to acknowledge their depression or seek help and treatment for it.
- Irritability or anger
- Behavioral changes (e.g. becoming controlling or violent)
- Loss of interest in work, family or hobbies
- Difficulty sleeping
- Weight loss
- Headaches, chronic pain and digestive problems
- Substance abuse (including alcohol)
- Risk-taking (e.g. unsafe driving or sex)
Despite a loss of interest in work, some men with depression may work longer hours than usual to avoid showing signs of the condition.
While the signs of depression may differ somewhat between men and women, treatment is generally the same and typically includes talking to a mental health professional and taking antidepressant medication (where recommended).
Signs of depression in teens and young adults
Teenagers can also experience depression, but it may be difficult for their caregivers to recognize the symptoms, and many cases go undiagnosed. Signs of depression in teens may differ somewhat to those that present in adults, and may include the following:
- Seeming annoyed by everything and everyone
- Being argumentative and picking fights
- Responding to minor provocations with emotional outbursts
- A strong need for social connection
- Promiscuity, substance abuse and risky behaviors
- Difficulties with school work
Other, more typical signs of depression, such as sleep disturbances, fatigue and loss of interest in activities that were once pleasurable, may also be present. It is important to distinguish normal teenage behaviors from teen depression. Significant changes in mood, together with changes in functioning, indicate that a healthcare professional should be consulted.
If a teenager shows signs of suicidal thoughts or actions, it is important to call a healthcare professional or suicide prevention line without delay.
Signs of depression in children
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 children are experiencing depression.
- 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 emotional outbursts
- 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
Other more typical signs of depression, such as sleep disturbances, tiredness, changes in appetite and loss of interest in activities that were once pleasurable, may also be present in children.
The symptoms may interfere with the child’s ability to partake in social activities, complete schoolwork and enjoy family life. If a caregiver notices that their child’s behavior has changed significantly, it is recommended that they speak to a healthcare professional.
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 line immediately.
Signs of depression in the elderly
Despite depression being more prevalent than dementia among the elderly, it remains underdiagnosed. 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.
- 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”)
Types of depression
- Major depression: Also called clinical or unipolar depression, major depressive disorder or just depression, this is the most commonly diagnosed form
- Dysthymia (persistent depressive disorder): A milder, long-lasting form of depression
- Adjustment disorder with depressed mood: Symptoms of depression that are triggered by a major life stressor
- Seasonal affective disorder (SAD): Depression that affects some people in the cold months
Depressive symptoms may also be a feature of other health conditions, including bipolar disorder, cyclothymic disorder, hypothyroidism and diabetes, among others.
Causes and risk factors of depression
While the causes of depression are not yet fully understood, the condition is believed to result from a combination of genetic, biological, environmental and psychological factors.
- A history of depression (personal or family)
- Major life changes or stress
- Certain medical conditions and medications
- Anxiety and excess worry (neuroticism)
- Low self-esteem
- Substance abuse
- Lack of social support
- Low levels of education
However, not everyone with these factors will experience depression.
Diagnosis of depression
During a consultation, a doctor will typically take the person’s clinical history and perform an examination. They will ask about symptoms of depression, noting down when they began, their frequency and severity, and whether they have ever happened before. They will also ask a number of other questions to assess whether depression may be present, and they may request diagnostic tests (such as blood tests) to rule out any other medical conditions.
If necessary, the doctor may refer the person to a psychologist or psychiatrist to confirm the diagnosis and discuss treatment options. Some people may be diagnosed with depression directly by a mental health practitioner.
Treatment for depression typically includes psychotherapy and or antidepressant medication. The exact treatment will depend on the person’s age, preferences and circumstances, as well as the severity of the depression. There are a number of different types of antidepressants and forms of psychotherapy, and it may take some time to find out which work best for a particular person. Exercise and relaxation techniques may also be recommended to help treat depression.
These days, even severe cases of depression can usually be treated. If medication and psychotherapy do not alleviate the symptoms, the person experiencing depression may wish to consider electroconvulsive therapy or another type of brain stimulation therapy that has been shown to be effective as a treatment option.
It is important to understand that it may take a person experiencing depression a long time to get better. The support of family, friends and broader social networks is an important part of recovery.
Signs of depression FAQs
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, also known as early-onset 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 normal activities. If these signs are evident, it is advisable to seek the advice of a pediatrician, or a child psychologist or psychiatrist.
Q: Is there a signs of depression test?
A: There are a number of self-assessment tests 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 an individual 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.[^28]
Q: What if a partner, relative or friend has signs of depression?
A: It is important to broach the subject very carefully and tactfully, 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. In addition, the person could be encouraged to take small steps to help themselves, such as exercising and eating a balanced diet. It is important to be patient when interacting with someone who is depressed. 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 line without delay.
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