Depression is not just feeling blue from time to time. Instead, the warning signs of depression are characterized by overwhelming daily feelings of sadness, hopelessness, worthlessness and emptiness. A person who experiences depression often cannot see a future for themselves — they may feel like the world is closing in around them.
Not everyone who is depressed experiences every warning sign — some people will experience a few signs, while others, many. Severity of symptoms varies with individuals and also varies over time. These signs are usually pretty clear to those around the person suffering — the person doesn’t seem at all like their normal self. The changes in the person’s mood are (usually) evident to friends and family.
- Persistent sad, anxious, or empty mood
- Feelings of hopelessness, pessimism
- Feelings of guilt, worthlessness, helplessness
- Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
- Decreased energy, fatigue, being “slowed”
- Difficulty concentrating, remembering, or making decisions
- Insomnia, early-morning awakening, or oversleeping
- Appetite and/or weight loss or overeating and weight gain
- Thoughts of death or suicide; suicide attempts
- Restlessness, irritability
- Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain
In order for depression to be diagnosed, the person must experience these symptoms every day, for at least 2 weeks.
Related: Specific Diagnostic Symptoms of Depression
Depressive disorders come in many different types, and while there are many similarities to each type of depression, each has its own unique set of symptoms.
The most commonly diagnosed form of depression is Major Depressive Disorder, a condition whose primary symptom is an overwhelming depressed mood for more than two weeks. The depressed mood affects all facets of the person’s life, including work, home life, relationships and friendships. A person with this kind of depression often finds it difficult to do much of anything or get motivated, so even going to seek treatment for this condition can be challenging.
Another type of depression is called dysthymia. Dysthymia is similar to Major Depressive Disorder, but the symptoms occur over a much longer period of time – more than 2 years. This is considered a chronic form of depression (or chronic depression), and treatment can be challenging as an individual with dysthymia has often already tried all manner of treatment over the course of many, many years. Individuals diagnosed with this condition can also suffer from occasional bouts of Major Depressive Disorder. In 2013, the American Psychiatric Association renamed this disorder Persistent Depressive Disorder.
A third type of depression is referred to as Adjustment Disorder with Depressed Mood. This condition is diagnosed when a person is adjusting to some new facet or change in their lives that has caused a great deal of stress. This disorder can even be diagnosed when a person is experiencing a good event in their life – such as a new marriage or a baby being born. Because the individual usually just needs a little additional support in their lives during this stressful time, treatment is time-limited and simple.
While there are many types of depression, some kinds of this condition seem to be related to changes in the length of days or seasonality. A seasonal depression is called seasonal affective disorder (SAD). People with Seasonal Affective Disorder suffer the symptoms of a Major Depressive Disorder only during a specific time of year, usually winter. This appears to be related to the shorter days of winter, and the lack of sunlight in many parts of the country.
Depression is also a symptom of other disorders, such as Bipolar disorder. Bipolar disorder is sometimes considered a “mood disorder,” but is not a form of depression. Bipolar disorder is characterized by swings of a person’s mood from depression to mania (mania is when a person is feeling lots of energy — like they are on top of the world and can do almost anything, often trying to do just that). The cycling mood changes from severe highs (mania) and lows (depression) can sometimes be dramatic and rapid in some people, but most often they are gradual.
After pregnancy, hormonal changes in a woman’s body may trigger symptoms of depression. More than half of the women suffering from postpartum depression will experience it again with the birth of another child. It is critical to identify this danger and treat it early. During pregnancy, the amount of two female hormones, estrogen and progesterone, in a woman’s body increases greatly. In the first 24 hours after childbirth, the amount of these hormones rapidly drops back down to their normal non-pregnant levels. Researchers think the fast change in hormone levels may lead to depression, just as smaller changes in hormones can affect a woman’s moods before she gets her menstrual period.
Like any mental disorder, depression is best diagnosed by a mental health professional, such as a psychologist or psychiatrist, who has specific experience and training in making an accurate diagnosis. While a family physician or general practitioner can also make a diagnosis of depression, you should also obtain a referral to a mental health professional for follow-up care.
Related: Depression Treatment