11 Warning Signs of Depression

African American Woman Looking Down

Do you (or someone you’re concerned about) really have depression, or is it a case of the blues? It's not always easy to tell the difference, especially when there’s a good reason to feel down. Grief, losing a job, or a chronic illness can all cause behaviors that might be mistaken for depression, for example.

 

"Sadness is an emotion, whereas depression is an illness," says internist and geriatric psychiatrist Ken Robbins of the University of Wisconsin-Madison.

True clinical depression differs from the blues in two key ways:

  • Severity: Symptoms are difficult enough to deal with that they interfere with everyday life.
  • Duration: Symptoms are present nearly all the time and last for more than two weeks.

The following 11 warning signs indicate that a person isn't dealing with normal, transient emotions but with the illness of depression. Note that symptoms vary by individual: A depressed person isn't likely to have all 11 symptoms at once, and their severity may shift. Depression can be mild or major; either way, if several symptoms are present and last for more than two weeks, you or someone you’re concerned about may need medical help.

1. Persistent sad, anxious, or "empty" feelings

This symptom looks like a low mood but persists even after time goes by and the cause of the bad mood has cleared up or receded.

What to look for: Blank stares, loss of interest in life, an inability to feel or express happiness or other emotions. Or the person may report just feeling "empty" or "numb."

What else to know: Often the depressed person isn't fully aware of this symptom. Try asking, "When’s the last time you were happy?"

2. Feelings of hopelessness, worthlessness, or helplessness

In an "Eeyore-like" pessimistic way, the depressed person can't help feeling that everything is wrong and it's his or her fault (rather than the fault of the situation or the illness itself). It's a hallmark sign of major depression. In mild depression, the feelings are similar but less extreme.

How to tell: The person seems unable to see any positive flip side to things or light at the end of the tunnel -- and feels little sense of control over choices or events. The person talks and acts as if he or she has no options, can't see a different path, is useless and meaningless. He or she may fixate on past mistakes, ruminating over them and expressing guilt and self blame.

What else to know: Listen for comments like these: "It's hopeless." "I can't do anything about it." "I have no choice." "Nobody cares." "I'm stuck." "I should have/could have/ if only…."

3. Frequent crying episodes

The crying may not seem to have a direct or obvious trigger; sobs often come "out of nowhere." But it's not normal to cry every day (though the depressed person may not realize this).

What to look for: In between episodes you witness, you may notice red eyes, sniffles, cracking voice, balled-up tissues, and other trails to tears.

What else to know: Not every depressed person cries; in fact, some never do. Research has shown that women are more inclined to this behavior than men. A 2001 University of California, San Francisco (UCSF) study found that crying isn't related to the severity of depression and that people who cry more may have briefer depressive episodes.

4. Increased agitation and restlessness

Some people with depression fall on the "hyper" end of a spectrum of behaviors, where others are the opposite (see symptom #5).

What to look for: The person may seem unable to relax, more irritable than usual, quicker to anger, full of restless energy, seldom calm. Look for pacing, lashing out at others, frequent standing up and sitting back down.

What else to know: For the depressed person, everything seems magnified. So small slights or irritations aren't just pebbles in the psyche, they're giant boulders that get in the way of ordinary life.

5. Fatigue and decreased energy

Typically depressed people who don't show a lot of agitation and restlessness (symptom #4) experience the flip side of those behaviors -- an increased sluggishness and slowness.

What to look for: The person may complain of having no energy, of feeling unproductive, or of "slowing down." He or she may have quit exercising, seem tired a lot, move more slowly, and have slowed reactions. "To-Do" lists never get finished the way they once did. The person may skip work.

What else to know: Fatigue is a real mind-body problem. Low mood and loss of motivation are partly at work, as well as a physiological depletion of energy -- and the two forces keep reinforcing each other.

6. Loss of interest in activities or hobbies that were once pleasurable

This is one of the single most telling symptoms of depression.

What to look for: The person no longer takes pleasure in things that once brought enjoyment, whether the lives of children or grandchildren, a hobby or craft, exercise, cooking, book club, watching sports -- or anything. The person may begin to decline invitations, refuse to go out, not want to see friends or family.

What else to know: Some depressed people lose interest in sex. For others, sex functions as a kind of escape, used the same way some depressed people turn to alcohol or drugs.

7. Difficulty concentrating, remembering details, and making decisions

"Fuzzy thinking" is often apparent both to the depressed person and his or her family, friends, and colleagues.

How to tell: Various mental slips may become obvious, such as forgetting appointments and errands, making checkbook errors, misplacing objects, forgetting names, avoiding making plans, postponing decisions or deferring them to others. The person may begin writing reminders to himself or herself or take a long time reading (because it's harder to focus). It may become harder to perform complicated tasks.

What else to know: Cognitive changes associated with depression can look like dementia; in fact, people with dementia are prone to depression, and vice-versa.

8. Sleeping too much or not enough

Disordered sleep and depression are closely related; in some people, depression manifests as insomnia (inability to fall sleep or to stay asleep), while others experience the opposite extreme: All the person feels like doing is sleeping.

What to look for: Regular sleep routines are disrupted; staying up too late or going to bed unusually early; being unable to awaken on time; complaining about a poor night's sleep; sleeping long hours but fitfully -- so the person never feels rested; excessive napping by day.

What else to know: Depression is a leading cause of sleep problems, in part because it interferes with natural biological rhythms.

9. Poor appetite or overeating

Again, the symptom tends to show up as one extreme or the other: The person loses interest in eating or falls into a pattern of constant, emotionally triggered eating.

What to look for: Missed meals, picking at food (especially if this is a change for the person), lying about food intake; loss of interest even in formerly favorite foods, mindless munching and other mindless eating, throwing up after eating; weight gain or weight loss.

What else to know: Depression is a common cause of the eating disorders anorexia, bulimia, and binge eating. It's true both that depression can lead to eating disorders and that people with eating disorders can develop depression.

10. Expressing thoughts of dying or suicide

Depression is one of the conditions most commonly associated with suicide. It begins to seem like a logical way to end the pain and suffering. As many as 90 percent of those who commit suicide are clinically depressed, have a substance abuse problem, or both, according to the National Institutes of Mental Health. (Many people with depression self-medicate with alcohol, which lowers inhibitions and increases the risk for suicide.)

What to look for: The intention may be expressed directly, such as, "I wish I were dead" or "I want to kill myself," or "I want to end it all." Or the threats may be indirect: "You'd be better off without me." "I can't go on." "I wish it were over." "Soon I won't be around any more." Also beware of a preoccupation with death or evidence of plans to follow-through, like buying a gun, hoarding pills, giving away money, or suddenly changing a will.

What else to know: If you think someone you love may be suicidal, don't leave him or her alone. Rather than leaping right to asking, "Are you thinking about suicide?" Robbins says, ask a series of questions that build on one another to assess the person’s state of mind: How are you feeling? Are you feeling depressed? Are you feeling hopeless? Are you wondering if life is worth living? Are you considering suicide? Have you made a plan? Encouraging the person to talk about the intended suicide actually lowers (but doesn't remove) the risk of following through. Keep the person safe until he or she can be brought to a doctor or therapist. Or call 911 or a suicide hotline (the National Suicide Prevention Lifeline is (800) 273-8255).

11. Persistent aches or pains, headaches, cramps, or digestive problems that don't ease with treatment.

Depression is stressful. The physical effects of chronic stress, added to poor self-care brought on by changes in energy levels, sleep, and appetite, can cause an array of health problems.

What to look for: Increased self-medication (through pain relievers, alcohol, or abuse of prescription meds), increased complaints that don't seem to fit any kind of pattern, increased doctor visits (or refusal to see a doctor despite obvious complaints).

What else to know: Obviously any of these physical signs can be clues to health problems that are unrelated to depression. The point is to notice if these behaviors are clustering with other symptoms of depression -- and to get them addressed by a health professional so that they become one (or two, or three, or five) fewer bothersome aspects of the depressed person's life.

Silver lining: Getting a loved one to a doctor on the pretext of evaluating chronic symptoms allows you to also report the worrisome depressive symptoms, and get them checked out and, if necessary, treated. This is valuable, given that so many people with depression are in denial. After all, the majority of cases of depression, even the most severe, respond to treatment, according to the National Institute of Mental Health.

 


21 days ago, said...

I need help I don't know how to tell my parents about my depression.


about 1 month ago, said...

Hi, I'm crying everyday and feeling heartbreak but nothing has happened. Why is this happening to me?


about 1 month ago, said...

Hello! So I wanted to hear an opinion before I go and chek out because I think I'm a bit of a hypochondriac and I wanna just waste time so let's get to it . So lately I've been feeling thi more and more that when I'm with people family or friends I show emotions like being happy energized and overall good but when I get alone I start feeling empty sometimes and just feeling like I'm going through the same routine all the time of not doing what I want to do and be , I feel tired and without any real goal ,once when I just started training I was really into it ,still am but in the past year or more I find myself less doing training and more like bragging maybe ,and motivating myself to excercise but eventually not doing anything, I feel like I want to change really bad but I'm stuck in this cycle of wanting to do something , saying I will do it to people around me but in the end I'm not doing it . I also feel that when I'm showing emotion to my family and friends it's fake and deep down I know it's fake but it's like I cant stop it .Another thing that when I'm studying it's also like this ,I say that I have to score high and I'm going to learn but eventually I just get distracted all the time and I feel bad because I disappoint myself .So what do you think?


9 months ago, said...

One thing I never understood is the difference in people's depression.. some say, it's because of life.. because they can't do something they would like. They are in a moment of.. sadness. But what do you call a person who's had, nothing? No love, no money, no family.. no understanding. Nothing seems to fill this gap of emptiness that sometimes turns into rage of envy. How I wish and pray, I could feel an ounce of just sadness.. so I can overcome this miserable dread. I have no ambition, no desire.. I seek not, money, love or material possession. I only seek a peace from a war ridden mind that can't seem to fathom itself.


9 months ago, said...

Hello Paula lately I've been feeling real down not wanting to go to work not wanting to go out with my wife. Feeling sad and always wanting to cry. Feeling real tired feeling like I have no strength just not wanting to do any of the things I used to love to do. I don't wanna eat and when I do eat afterwards I feel like I needa go to the restroom I can't sleep perfectly like I used to. Idk I was wondering if maybe I could be depressed alot more going on. But only telling u a bit for now thanks


10 months ago, said...

Every article about depression, suicide, grief, etc, recommends getting professional help from a therapist or councellor, but this is expensive and health insurance does not cover much of it. One visit doesn't do it, and therapists want to see a patient several times, usually once per week, making the out-of pocket fees accumulate quickly. I have been diagnosed with chronic depression, and have all of these symptoms, but no $$$$$ and so had to stop treatment.


about 1 year ago, said...

My grand daughter is severely depressed, she stays in her room in the darkness and refuses help of any kind. She will not go to Doctors nor take her meds. I am afraid for her life she is only 19 and has been diagnosed with Clinical Depression. She has all the symptoms and more. Is it possible to call 911 and get some help even if she doesn't want any?


about 1 year ago, said...

I cry every day, but I don't have depression. I am 60 years old and I still cry every day because I am an incest survivor in a world where my pain counts for nothing and I am given the message every day that I don't exist as a subjective being. It's not grief either, it's just pain because my sense of personhood was cut out and every day it grows a little only to be cut out again. So of course I cry because I am constantly being rewounded, not by myself but by others. If I had a sense of personhood their saying I'm not a person would never hurt me, but it's a Catch-22 because when you don't have a sense of personhood such words wound, while at the same time the sense of personhood can never grow because it's being cut out as soon as it starts to grow back. Living in a toxic pro-incest world, I am constantly being mutilated as the part of me that could resist the mutilation is being repeatedly cut out.


over 1 year ago, said...

My wife has been diagnosed with Alzheimers. I note that she exhibits up to 6 of the said signs of depression.


over 1 year ago, said...

I have about 10/11 of these signs. And feel completely depressed.


over 1 year ago, said...

I thought I was depressed . But I found out it was being downed by the weather as going outdoors in this brutal weather is down right craziness. Too cold for anyone. Being home bound is a not bad if you have a hobby like reading or crossword puzzles. Or even tv. Thats what kept me sane for these months of 0* weather. Now its letting up and some days are actually beautiful and sunny, Teri.


over 1 year ago, said...

That was very. Helpful. I am yonger but. Is it possible. That i am depressed?????? I do recognise. Most. Systems


over 1 year ago, said...

I suffer in silencentral while I die inside. So hard seeing life go by. it's the pain of trying so eagerly to help my partner with our kiss but it never being enough that kills me. Even as I write this I hear screaming downstairs and know that u need to intervene before she gets stressed again. I live only too see them thrive now. There is nothing else I'my life. I used to be outgoing and confident but enforced loneliness and her upbringing have destroyed who I was. My advice: don't let a partner stop you from having friends just because they don't want them.


over 1 year ago, said...

I never knew depression has a lot of the symptoms of many other health issues so no wonder people with depression can potentially be misdiagnosed with many health issues in some cases.


almost 2 years ago, said...

Yup I have all those symptoms ...


almost 2 years ago, said...

Yeah a lot of these are like me.


almost 2 years ago, said...

Please help me my son has a severe depreaaion prob. He is an adult and is.in denial. How do i get help for him


almost 2 years ago, said...

Hi, I'm certainly not brave enough to be suicidal but however, I sometimes feel like just walking away from everything and everybody, and just be on my own for a looong time. Lately I have trouble sleeping and have constant headaches, I'm a Christian but I often find myself questioning if God really does exists because I feel like He's really not there when I need Him the most. I've also been lossing appetite, I normally love watching tv but lately its not that appealing to me, I go to bed early but never really sleep. I'm moody, i cry a lot, I go to work because I feel I have to but no because I want to. Am I depressed or is it just sadness?


about 2 years ago, said...

Very helpful! Answers personal problems and helps you recognize warnings and how to deal with them.


about 2 years ago, said...

I experience all of theses. Most come and go, and I'm back to my normal happy self. My family has experienced a lot of changes through loss of life, a few funerals, job losses & income, home relocations, health issues; some celebrations, 2 weddings, a baptism, and a baby/grandchild. This happened all within 4 years. I don't think there is a household in the U.S. who has not gone through what we went through especially dealing with losses.