Symptoms and signs of depression
Symptoms and signs Major depression significantly affects a person's family and personal relationships, work or school life, sleeping and eating habits, and general health. Its impact on functioning and well-being has been equated to that of chronic medical conditions such as diabetes.
A person having a major depressive episode usually exhibits a very low mood, which pervades all aspects of life, and an inability to experience pleasure in activities that were formerly enjoyed. Depressed people may be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and self-hatred. In severe cases, depressed people may have symptoms of psychosis. These symptoms include delusions or, less commonly, hallucinations, usually unpleasant. Other symptoms of depression include poor concentration and memory (especially in those with melancholic or psychotic features), withdrawal from social situations and activities, reduced sex drive, and thoughts of death or suicide.
Insomnia is common among the depressed. In the typical pattern, a person wakes very early and cannot get back to sleep, but insomnia can also include difficulty falling asleep. Insomnia affects at least 80% of depressed people. Hypersomnia, or oversleeping, can also happen, affecting 15% of depressed people. Some antidepressants may also cause insomnia due to their stimulating effect.
A depressed person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries, according to the World Health Organization's criteria for depression. Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occur. Family and friends may notice that the person's behavior is either agitated or lethargic.
According to the DSM-IV*, a medical reference commonly used by health care professionals to aid in diagnosis, a major depressive episode consists of many of the following symptoms, occurring nearly every day for at least two weeks.
- Depressed mood most of the day; feeling sad or empty, tearful
- Significant loss of interest or pleasure in activities that used to be enjoyable
- Significant weight loss (when not dieting) or weight gain; decrease or increase in appetite
- Difficulty sleeping or sleeping too much
- Agitation; or slowing down of thoughts and reduction of physical movements
- Fatigue or loss of energy
- Feelings of worthlessness or inappropriate guilt
- Poor concentration or having difficulty making decisions
- Thinking about death or suicide
Depression symptoms include:
- Feelings of sadness or unhappiness
- Irritability or frustration, even over small matters
- Loss of interest or pleasure in normal activities
- Reduced sex drive
- Insomnia or excessive sleeping
- Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
- Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
- Slowed thinking, speaking or body movements
- Indecisiveness, distractibility and decreased concentration
- Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
- Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren't going right
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent thoughts of death, dying or suicide
- Crying spells for no apparent reason
- Unexplained physical problems, such as back pain or headaches
Depression affects each person in different ways, so depression symptoms vary from person to person. Inherited traits, age, gender and cultural background all play a role in how depression may affect you.
Depression symptoms in children and teens
Common symptoms of depression can be a little different in children and teens than they are in adults.
- In younger children, symptoms of depression may include sadness, irritability, hopelessness and worry.
- Symptoms in adolescents and teens may include anxiety, anger and avoidance of social interaction.
- Changes in thinking and sleep are common signs of depression in adolescents and adults, but are not as common in younger children.
- In children and teens, depression often occurs along with behavior problems and other mental health conditions, such as anxiety or attention-deficit/hyperactivity disorder (ADHD).
Depression is not a normal part of growing older, and most seniors feel satisfied with their lives. However, depression can and does occur in older adults. Unfortunately it often goes undiagnosed and untreated. Many adults with depression feel reluctant to seek help when they're feeling down.
- In older adults, depression may go undiagnosed because symptoms — for example, fatigue, loss of appetite, sleep problems or loss of interest in sex — may seem to be caused by other illnesses
- Older adults with depression may say they feel dissatisfied with life in general, bored, helpless or worthless. They may always want to stay at home, rather than going out to socialize or doing new things.
- Suicidal thinking or feelings in older adults is a sign of serious depression that should never be taken lightly, especially in men. Of all people with depression, older adult men are at the highest risk of suicide.
If you feel depressed, make an appointment to see your doctor as soon as you can. Depression symptoms may not get better on their own — and depression may get worse if it isn't treated. Untreated depression can lead to other mental and physical health problems or problems in other areas of your life. Feelings of depression can also lead to suicide.
If you're reluctant to seek treatment, talk to a friend or loved one, a health care professional, a faith leader, or someone else you trust.
If you have suicidal thoughts
If you or someone you know is having suicidal thoughts, get help right away. Here are some steps you can take:
- Contact a family member or friend.
- Seek help from your doctor, a mental health provider or other health care professional.
- Call a suicide hot line number — in the United States, you can reach the toll-free, 24-hour hot line of the National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor.
- Contact a minister, spiritual leader or someone in your faith community.
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately. If you have a loved one who has harmed himself or herself, or is seriously considering doing so, make sure someone stays with that person. Take him or her to the hospital or call for emergency help.