Understanding And Recognizing The Signs Of Depression

Clinical depression is often misunderstood, partially because the term “depression” is sometimes used out of context in the English language. A consequence of these misunderstandings is that some don't even realize that they are experiencing depression. Likewise, if you suspect someone you know has depression, it may be very difficult to determine based on popular perception of what it is. 

What is depression?

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), depression is a mood disorder defined as “extreme sadness or despair that lasts more than days and interferes with the activities of daily life and can cause physical symptoms such as pain, weight loss or gain, sleeping pattern disruptions, or lack of energy.” 

There are many different types of depression, including major depression, persistent depressive disorder, and seasonal affective disorder. The most common type is major depression. According to the National Institute of Mental Health, “An estimated 21.0 million adults in the United States had at least one major depressive episode. This number represented 8.4% of all U.S. adults.” The National Center for Disease Control and Prevention notes that while the causes of depression are highly complex, brain chemistry and genetics may play a role in increasing the risk of developing depression.

Depression may also be linked to other disorders such as anxiety disorder and panic disorder, whose symptoms occur more frequently during a depressive episode. For some individuals depression symptoms may remain mild. However, for others, a major depressive episode may lead to suicidal thoughts or ideation. 

While depression is prevalent worldwide, there are also other diseases and disorders that mimic depression. Conditions like thyroid problems, vitamin deficiencies, and brain tumors can all demonstrate the same symptoms as depression. To rule out these other causes your doctor may do lab tests or advanced imaging to ensure that they are not the cause of your depressive symptoms. 

Challenges in recognizing depression symptoms

The psychological factors that influence depression vary from person to person and sometimes people’s behaviors and unique personalities make it difficult to discern whether they are experiencing depression symptoms or not. For example, some people are highly demonstrative when it comes to their emotions, while others with equally strong feelings might not show this externally. 

Sometimes changes in routine, behavior, or sudden lifestyle changes may have explanations other than depression, as well. Someone who doesn’t socialize as often as usual might be avoiding people because of depression. Or they may simply have worked longer hours or are focused on a new relationship.

In addition, some who experience depression don't want to discuss it publicly. There are many reasons this may be the case, including societal stigma or fear of being stereotyped. Some may even regard depression as a “weakness” that will affect their standing within a group dynamic, or they might not want to cause worry for those they are close to. 

There are many misconceptions about depression, but it’s vital to recognize that it is a legitimate health issue that may evolve into other conditions if left untreated.  

What are the warning signs of depression?

Understanding signs of depression or depression symptoms can be challenging because each person is unique and complex in their own way. 

The signs of depression can look very different from person to person and may depend upon variables like timing, circumstances, cultural or familial influences, past experiences, and more. There are, however, some relatively common signs of depression that may provide you with some clues about a person’s mental state: 

Decrease or increase in appetite may indicate a mental health challenge

A total lack of desire for food may be a serious symptom of either depression or other medical conditions. This points to the possibility of an unhealthy cycle of lack of appetite as a symptom of depression, leading to poor nutrition, which exacerbates the symptoms of depression. 

Paradoxically, some people with depression can feel compelled to overeat. This demonstrates that how much a person eats doesn’t necessarily signal depression; it’s the change in behaviors around eating that may be an indicator.

Risky behaviors can be one of the symptoms of depression

There are several potential motivations behind why people experiencing depression may exhibit risk-seeking behaviors, one of the most common being the use of alcohol or drugs. A recently published article by American Addiction Centers notes: “Mental health issues, including depression and anxiety, are often recognized as a driving factor behind a person’s misuse of drugs or alcohol.”

But numbing behaviors as a potential indicator of depression aren’t limited to drugs or alcohol. Distracting or numbing behaviors may include gambling, self-harm, sex, or pornography. People may also turn to binge eating or compulsive shopping – even a person’s job or career can be a source of compulsion.

Physical symptoms as signs of depression

Verbal cues that may indicate depression symptoms

If a person’s normal topics of conversation begin to change to include things like feelings of powerlessness, a poor sense of self-worth, or a lack of hope, it may be an indicator that they’re experiencing depression. It’s important to note that it’s not unusual for a person’s focus to shift to topics like these occasionally, but if you notice it’s become constant without any other context, now is a good time to gently reach out. 

The same applies to the frequent, unusual use of phrases referring to themselves negatively, such as “I am useless” or “I feel stupid.” 

Loss of interest can be an indicator of a depressive disorder

Loss of interest in sex when one existed previously is strongly associated with depression in adults. That said, a sudden loss of interest in any activity one normally enjoys could be an indicator of depression. 

Sudden improvement in mood after a positive stimulus as a sign of depression 

It may seem counterintuitive that this behavior should be an indicator of a larger problem, but sudden improvement in mood is a common symptom of a type of depression called atypical depression. It usually occurs in response to good news or positive events, but you’ll quickly notice that it’s temporary and often followed by a “crash,” resulting in worsening depression. 

Warning signs of depression in children and adolescents

A recent survey from the Annie E. Casey Foundation on state trends in child well-being states, “In 2020, 12% of children in the US aged 3 to 17 years were reported as having ever experienced anxiety or depression.” Children exhibit many of the same behaviors related to depression that adults do, but the reasons behind a child’s depression are a little more difficult to pinpoint, possibly due to differences in the ability to communicate succinctly with therapists. 

Children with a family history of depression or bipolar disorder, particularly a multi-generational history, are at a greater risk for depression. So are children with high levels of stress, including the stress associated with mental health conditions such as attention deficit and learning disabilities. Finally, anxiety, low self-esteem, and substance use disorders often occur along with depression in children as well.

The teen and adolescent years are typically also challenging for young people. The reasons for this often include physical changes in the body and brain chemicals, academic pressure, social media use, and increasing complexity in relationships. These factors, among others, may result in feelings of depression among adolescents. Many teens may turn to self-medication through recreational drugs or alcohol rather than seeking professional help. The signs indicating clinical depression in teens are much the same as those for adults, with the additional proviso that they tend to be more dynamic and prone to change with age. In many cases, primary care physicians have begun screening for depression during a routine physical exam, they may ask questions designed to identify depression and can refer their patient to a specialist if needed.

Even if they are reluctant, getting treatment is urgent for children and teens experiencing depression. Speaking to a mental health professional specializing in the care of children or adolescents is the best help for your child or teenager to cope with the symptoms of depression and potentially regain their mental well-being.

Interacting with someone who is experiencing symptoms

Depression is a serious medical condition that may require emotional support or medication to manage symptoms. If you suspect a colleague or friend may be experiencing depression, it’s essential to be mindful if you decide to approach the subject with them. Sometimes, the effort to engage in a friendly and supportive conversation can be misconstrued as a negative intention. Remember that everyone processes feelings of depression differently. Some may be open to conversation, whereas others may not. If someone is reluctant to talk about their mental health concerns, try not to coerce them individually into talking to you about their feelings if they seem reluctant to have a conversation. 

Professionals recommend gently letting the individual know you're concerned and that you are available whenever they feel like talking. If they are receptive, practice active listening and let them express their feelings. Above all, encourage them to seek treatment.

Seeking support when experiencing symptoms of depression

Reaching out to family members when you are experiencing depression may be a good first step, however, professional counseling for depression is highly recommended if you recognize symptoms in yourself. Although there are sometimes challenges involved with seeking treatment, psychotherapy is one of the most effective ways to learn the coping strategies you need to move past depression and begin the path to healing. A psychiatrist can also determine if medications are a necessary part of your treatment plan and prescribe them as needed.  You can tell them about any side effects you experience so that they can adjust your medication as needed.

If you sometimes feel overwhelmed when discussing your feelings or are reluctant to attend in-person sessions, there are helpful online counseling services available. Depression also sometimes comes with anxiety, which may present barriers to seeking help as well, including aversion to encountering others traveling to and from in-person sessions or in an office waiting room. Speaking to a therapist online is a good alternative and may contribute to overcoming some of the barriers you may experience when speaking with a counselor in person. 

Mental health support options for signs of a depressive disorder

There are many different treatments and resources for depression. Psychotherapy, medication, group therapy,  and electroconvulsive therapy are among the most common. (Electroconvulsive therapy is typically reserved for cases in which other treatments haven’t worked.) If you or someone you know exhibits signs of depression, it’s important to get help as soon as possible to work through those feelings and try to prevent any worsening of symptoms. 

If you’re ready to take control of your own depression, reaching out to a mental health professional in person or online is the first step. A therapist may assist you in uncovering the roots of your depression and the things in your life that might contribute to it currently. They will likely also provide you with strategies for coping with the symptoms and support your journey of healing. 

Online therapy for depression

As mentioned, online therapy is a popular modern treatment option. It has been proven to be as effective at treating depression with CBT (Cognitive Behavioral Therapy) as in-person sessions, and a review of recent studies from the American Psychiatric Association on CBT reports that “online CBT leads to significant decreases in symptoms of anxiety and depression.”

But online therapy has other benefits, too. Some people feel uncomfortable with speaking with an in-person therapist and prefer the option of meeting online. This is understandable, particularly for those who struggle with interacting with others. Meeting up with a therapist or support groups online eliminates the anxiety some experience over having to speak to other patients in a waiting room or along the commute to and from the visit. 

If you need assistance in between sessions, you may reach out and your therapist will contact you as soon as possible.