Depression can be difficult to recognize. Some people carry depression around like a terribly heavy backpack without knowing why they feel down all the time, and the symptoms don’t disappear as you would expect them to. For this reason it’s important to learn about the signs of depression. Depression is a treatable condition and the sooner you seek treatment, the better. This article presents the 9 signs of depression and offers you advice on where to get help.
9 signs of depression
These are the 9 symptoms of depression as defined by the DSM-V handbook* for clinicians:
- Depressed mood: Feeling blue most of the day, nearly every day.
- Loss of interest and pleasure: Markedly reduced interest/pleasure in all (or almost all) activities most of the day.
- Changed appetite or weight (eating more or less than usual).
- Sleep disturbance (too much or too little).
- Moving more slowly than usual or making meaningless movements due to anxiety (for example twisting your hands).
- Lacking energy: Feeling tired nearly every day.
- Feeling excessively guilty and/or worthless.
- Having difficulty concentrating and/or making decisions.
- Having repeated thoughts about death, suicidal thoughts, or sometimes wishing you were dead.
*The DSM-V is a psychiatric manual, frequently used by mental health professionals in the United States and all over Europe.
Are you experiencing any signs of depression?
A good way to get an indication of your own level of depression and an overall view of your mood, is to use an online depression test. The app-based treatment programme from Flow Neuroscience will regularly ask you to answer 9 different questions about your mood and give you an overall indication of your level of depression. This way, you can track your own depressive symptoms over time. To see your progress over time, all you need to do is to download the 100% free depression app and fill out the questionnaire. Your virtual therapist, Flow, will guide you through the process and the result.
Is it enough to notice the signs of depression to get a diagnosis?
Depression is a mental disorder and feeling blue or unusually tired for a few days is not the same as being depressed. To receive a diagnosis of depression, a person should experience at least 5 signs of depression (from the list above) for at least two weeks. One of the symptoms ‘Depressed mood’ or ‘Loss of interest and pleasure’ should be present. The following conditions also apply:
- The depressive symptoms cause suffering or affect the person’s ability to work, interfere with relationships or other important aspects of life.
- The symptoms can’t be explained by a physical illness or substance abuse.
- The symptoms can’t be explained by another mental disorder.
- The person has never experienced a manic or hypomanic episode.
The physical, mental and social signs of depression
As you can draw from the list with the 9 signs of depression above, depression can look quite different from person to person. Some people with depression experience mainly physical symptoms, such as changes in appetite or weight, making slower movements or speaking more slowly than usual, lacking sexual drive and sleeping too much or too little.
Others experience mainly mental symptoms, such as low mood or sadness, feeling hopeless and helpless, feeling excessively guilty, having low self-esteem, lacking motivation and interest in things that usually make the person happy, having difficulty making decisions and concentrating, feeling excessively anxious or worried and having thoughts about death or self-harm. A third group may experience mainly social symptoms, such as having trouble completing work assignments, isolating oneself and avoiding contact with friends, neglecting hobbies or interests and experiencing more conflicts at home than usual.
Most people with depression experience a combination of physical, mental and social symptoms. Below, you can read about Jake, Trevor and Elizabeth who all have their own history with depression. Reading about other people’s experience may offer you a deeper understanding of what depression can look like and how a person changes under the influence of this mental disorder.
Jake’s signs of depression
A few years ago, Jake experienced a series of difficult life events. His eight-year marriage ended in divorce and he was forced to find a new place to live. It was a big challenge for Jake to live alone after eight years of family life, especially because he could only see his two children on weekends.
A few months after moving to a new apartment, his mother passed away. Jake mourned his mother deeply, but the grief seemed to stick to him for an unusually long period of time. Several months after her funeral, he still found it difficult to feel any kind of pleasure or interest in social activities or work assignments. As time passed, Jake stopped eating proper meals and spent most of his spare time in bed, either sleeping or watching TV. Jake had three brothers and none of them reacted this strongly to their mother’s passing. He felt embarrassed to be the only one who didn’t seem to cope. That’s why he didn’t tell anyone about it.
A while later, Jake felt so exhausted that he frequently started to call in sick from work. He rarely ate and found it difficult getting out of bed in the morning. The most painful part of Jake’s depression was thinking that it would never get better. He often thought “I can’t even remember what it feels like to be happy” and “It will only get worse from here”. He started fantasizing about death and suicide. One afternoon, his brothers came to visit unannounced. This became a turning point for Jake. His brothers took one look at the messy apartment and immediately understood that something was wrong. They also noticed how much weight Jake had lost, which made them worry even more. Jake finally told them what he was going through and started seeing a psychotherapist shortly after their visit.
Reflecting on what he had been through was essential for his recovery. Jake realized that he probably had a biological vulnerability for depression. His mother struggled with recurrent episodes of feeling down for unusually long periods of time during his childhood and Jake himself had experienced depressive symptoms when he was younger, once after a break-up and one time after starting a new school. In psychotherapy, he learned to recognize the early signs of depression and how to stop them from spiraling into severe depression.
Trevor’s signs of depression
Trevor’s signs of depression were particularly difficult to recognize, especially because nothing ‘bad’ happened to him prior to the depressive episode. Instead, Trevor experienced a change in life that everyone around him thought would make him happier. He received a promotion at the law firm where he worked, which meant higher salary, higher social status and more responsibilities. Before the promotion, his family and colleagues would describe him as fair and easygoing, but soon after he’d gotten the new title, Trevor became much more ill-tempered and demanding. He would yell at colleagues for minor mistakes and overreact to everything at home.
He started arriving late for work and neglected some of his work assignments. Trevor’s colleagues started thinking that the new title revealed his ‘true’ personality and that he was actually quite a mean person. His wife noticed that Trevor seemed uninterested in sex, but he refused to talk to her about it. She started thinking that Trevor didn’t love her anymore and maybe that he had an affair. No one around him would have guessed that depression was the reason behind his behaviour. He looked like a successful lawyer on the outside, but felt completely different on the inside. Trevor started having increasingly negative thoughts about other people, such as “no one really cares about me”, “people are unreliable”, “I can’t trust anyone”. He also had negative thoughts about himself, such as “I’m not good enough”, “I’m a fraud”, “I can’t do anything right”. As time passed, his thoughts about the world in general started to become increasingly gray and hopeless, such as “life is pointless”, “we’re all alone”, “nothing will ever get better”.
A problematic thing about Trevor’s depression was that the negative thoughts and other mental symptoms made him believe that his hopeless view of the world was the actual truth and that the only reason why people around him were happy was because they hadn’t figured that out. Because Trevor still managed his work and other necessary chores, it took him several months to realize that what he was experiencing was actually a mental health disorder. One evening, he watched a documentary about depression and recognized so many of the symptoms that he considered seeking help. After many hours of watching video clips and reading articles about depression, he decided to contact a health care clinic to receive a diagnosis and treatment.
Elizabeth’s signs of depression
When she first came in contact with depression, Elizabeth was an 18 year old student living at home with her parents. Her older sister had recently left the house to live in another city and Elizabeth started feeling increasingly lonely. There was a group of students in Elizabeth’s class who used to talk behind her back and make snide comments whenever she passed them in the hallway. In the past, Elizabeth would always tell her sister about it and feel comforted by her support, but ever since her sister left the house, Elizabeth felt as if she had no one to turn to.
Elizabeth’s first sign of depression was that activities that she usually enjoyed suddenly seemed uninteresting or even boring. She didn’t understand why, only that she had no interest in basketball anymore, even though basketball practice used to be her favourite part of the week. Her teammates repeatedly asked her what was wrong, but Elizabeth would shrug her shoulders and tell them “I’m just not into basketball anymore.” She became more and more quiet at school and stopped raising her hand in class. She lost motivation for homework, even though she usually received good grades, and she secretly cried every day after school without really knowing what was wrong. Elizabeth’s parents noticed that their daughter was much more irritable than usual.
When they asked her about it, Elizabeth reacted as if they were pushing her to feel better. “Leave me alone and stop pressuring me”, was her usual response to their worries. As months passed, Elizabeth stopped seeing friends. She either felt very insecure among other people or became unreasonably irritated with them. Several months after her sister moved away, Elizabeth’s parents signed her up for a leadership conference with other young women. At first, Elizabeth was furious, but her parents eventually convinced her to go. They thought that a weekend among people her own age would do Elizabeth good.
One night at the conference, the participants gathered around a campfire and were asked to talk about themselves. Elizabeth decided to tell the others the truth about how she had been feeling for the last few months, something she hadn’t told anyone before. This was a turning point for Elizabeth. She had not expected to be met with understanding and respect, but she was. As it turned out, other participants had had similar experiences and they advised her to talk to her family. After receiving support from the group, Elizabeth decided to tell her family and her old friends what was going on with her. Engaging in more social activities, even though she didn’t feel like it at first, slowly got Elizabeth out of depression. She started spending more time with her sister, her old friends and kept in touch with the women from the conference.
Where to treat the signs of depression?
As you can see from the stories above, the signs of depression can look very different from person to person. The important thing to remember is that depression is a treatable condition and that there are several, evidence-based depression treatments available.
There are some clinics who provide remote consultations with health care professionals via video messaging through their apps. It means that you can receive the first consultation at home, without having to visit a clinic. Here are two of the most popular online clinics:
tDCS is a form of gentle brain stimulation that you can use at home to treat depression. The treatment is evidence-based and allows you to escape the side effects that usually come with antidepressant medication. First of all, tDCS is very different from electric shock therapy or electroconvulsive therapy (the current is 400 times weaker!). Secondly, Flow Neuroscience has developed a wireless tDCS headset, which is the first tDCS device approved for medical use in the UK and EU. It’s portable and available to buy online. You can get more information here.
Medication-free lifestyle changes
There are many things you can do at home to manage the signs of depression. Read more about 5 treatments for depression without medication or 4 at-home remedies for anxiety and depression. If you want to make changes right away with the help from a virtual therapist, download the free depression app from Flow Neuroscience and get over 50 free sessions with behaviour therapy.
I hope this article will help you recognize the signs of depression. Depression is a treatable condition and the sooner you seek help for your symptoms, the better.
Thank you for your attention!