Symptoms of depression can include sadness, fatigue, and poor self-esteem, but because there are various depressive disorders with varied effects, signs of depression can be more complicated. Understanding the symptoms of depression is important for identifying the condition, guiding treatment, and establishing recovery for the more than 20 million adults and adolescents with depressive symptoms in the U.S.1
What Is Depression?
Depression is a general term used to describe a combination of symptoms including low mood, low energy, and limited enjoyment from pleasurable activities. Rather than being just one thing, depression is a collection of conditions that affect nearly all aspects of a person’s life and functioning. Regardless of sex, age, and ethnicity, depression can impact all people.
Common Symptoms of Depression
Everyone’s experience with depression is unique, but there are reported symptoms of depression that a person with the condition may feel or display frequently.
The most common symptoms of depression include:2
- Low mood, sadness, or emptiness
- Hopelessness and a feeling that life will never improve
- Worthless, guilty, and helpless in making symptoms better
- Less interest and pleasure in hobbies and other favored activities
- Low energy, being fatigued, or feeling and looking slowed down
- Problems concentrating, remember, and making decisions
- Problems falling asleep, staying asleep, or waking too early in the morning
- Significant changes in weight or appetite
- Restless or irritable, especially in adolescents with depression
- Unexplained physical aches and pains
- Thoughts of death, dying, and suicide
The combination of depressive symptoms will begin to impact a person’s life at home, work, and school. Relationships may suffer as a person withdraws or self-isolates from the outside world due to worsening symptoms. People with severe depression may lose the desire to care for their well-being and struggle to complete even basic hygiene.
Because there are many symptoms of depression, two people could have vastly unique experiences, even though they have the same diagnosis. One person could feel sad and sleep all day, and another person could be extremely irritable while struggling to get much sleep at all.
Typically, a person must have five symptoms of depression that last for two weeks or longer to have a depressive disorder.2 People with even a few symptoms should consider seeking mental health treatment to ensure symptoms do not worsen in time. Some people try to hide their symptoms and smile through their depression – this can be dangerous and can keep people from getting the help they really need.
The Type of Depressive Disorder Can Impact Symptoms
When people think of depression, they commonly refer to major depressive disorder, sometimes called clinical depression. However, there are several types of depression that vary based on their symptoms and the timing of when symptoms present.
These types of depression and their symptoms include:3
- Disruptive mood dysregulation disorder: A form of depression affecting children between ages 6 and 18. This condition is marked by extreme physical and verbal outbursts and a constant level of anger and irritability.
- Persistent depressive disorder (dysthymia): A depressive disorder known to create long periods of consistently low moods, low energy, and feelings of hopelessness. Dysthymia lasts for two years or more, which makes it hard for the individual to remember feeling happy.
- Premenstrual dysphoric disorder: A specific type of depression that centers around menstruation. With this condition, intense depressive symptoms emerge about a week before a woman’s period and begin alleviating within a few days after it begins.
- Substance/medication-induced depressive disorder: Depressive symptoms triggered by the intoxication or withdrawal from a legal or illicit substance
In addition to the separate conditions creating signs of depression, the disorder may have specifiers that create an additional layer of symptoms. Depression with peripartum onset can bring intense panic, delusions, and hallucinations that only present during the final weeks of pregnancy or after the baby is born, and depression with seasonal pattern, sometimes called seasonal affective disorder (SAD), triggers depressive symptoms that change depending on the season, usually worsening during the fall and winter months and improving during the spring and summer.3
With the combination of different conditions and different specifiers, many mental health symptoms can stem from depressive disorders. For this reason, people with these symptoms and mental health professionals must take care to gather information about all symptoms and identify the actual cause.
Signs of Depression in Different Populations
Because of age, sex, and cultural differences, people may display their depression in varied ways. This further supports the idea that there is no one universal way depression symptoms present.
Signs of Depression in Women
According to the National Institute of Mental Health (NIMH), more women experience depression than men.1 The different rates of depression may be due to biological, lifestyle, hormonal, and environmental situations only women experience.
Women with depression often display these depressive symptoms:2
- Sadness
- Guilt
- Worthlessness
- Low energy
Due to differences in gender norms and stereotypes, it may be more widely acceptable for women to express their symptoms of depression in direct ways. Women may interpret being connected to their feelings as a positive trait.
Signs of Depression in Men
Where women are more likely to display sadness and guilt, depression in men might manifest as:
- Fatigue
- Loss of interest in hobbies and activities
- Difficulty sleeping
Men may be more irritable, angry, and frustrated. The same gender roles that permit women to express their depression openly often force men often to conceal and hide their symptoms.
Because a man may see their depression as a sign of weakness, they might seek negative coping skills as a way to manage their problems, which makes using alcohol and other drugs more appealing. With increased substance use, men attempt to numb or avoid unwanted feelings.2,4
Signs of Depression in Children
Children with depression are likely to experience a range of symptoms. Possible depressive symptoms in kids include:
- Physical signs or symptoms like abdominal pain
- Avoiding school
- Worrying about a parent or sibling dying
The important note here is that symptoms of depression in children usually grow, evolve, and shift over time. Some children may present with more symptoms of anxiety, like worry and tension, developing into depression as they age. Parents and teachers should be aware of these changes and communicate with each other to gather information before talking with a mental health expert.2
Signs of Depression in Teens
Teenagers face challenges on numerous fronts that can strongly influence how they’re feeling. The significant social, biological, and environmental changes of adolescence bring opportunity for new and worsening adolescent depression.
The more than three million adolescents with depressive symptoms may:1,2
- Get into more trouble at school
- Appear moody, irritable, or sad
- Report feeling misunderstood
Some of the changes are common and typical for teenagers as they adjust to their physical and emotional states, so a period of assessment and introspection is valuable. Parents, teachers, and experts should work to identify how long the symptoms have lasted, how intense they are, and how differently the teen is presenting compared to their usual self.
Signs of Depression in Older Adults
Since no age group is immune to the impacts of depression, even older adults are at risk. Rates of depression begin falling after age 25, but the condition continues to affect many older adults and seniors.
An older adult with depression could:
- Complain of feeling tired
- Have sleeping problems
- Be more irritable than usual
- Struggle with periods of confusion and limited focus
These symptoms are not a normal part of aging, so anyone recognizing these signs should seek a thorough evaluation.2 As with other groups, a mental health professional can work to distinguish typical levels of sadness, distraction, and distress from diagnosable levels.
Separating depressive symptoms from typical functioning is challenging for older adults because the effects of depression overlap with common reactions to aspects of getting older, new or chronic physical health problems, retiring or losing their job, and experiencing grief and loss.
Thoughts of Death or Suicide With Depression
Suicide is the second leading cause of death in people ages 10-34.4 Though other factors may contribute to suicide, depression is a major force behind these high numbers due to its ability to adversely influence someone’s thoughts, feelings, and behaviors.
In many ways, thinking about death is a normal part of human existence. It becomes more problematic when the thinking shifts to suicidal ideation where the person begins to see dying by suicide as a favorable decision.5 Nearly 10 million adults had serious thoughts about suicide, and more than one million adults attempted suicide in 2017 alone.5
If someone notices themselves feeling this way, it is good to take action by:
- Contacting a trusted support
- Phoning a mental health provider
- Going to the nearest emergency department
- Calling a suicide hotline like the National Suicide Prevention Lifeline at 1-800-273-8255
If someone you know has reported a specific suicide plan or a strong desire to die, you should contact emergency services by calling 9-1-1. Suicide is a serious concern and should never be ignored.
When & How to Get Help With Depression
It is never too early or too late to get help with symptoms of depression. Getting help early while symptoms are mild can resolve the problem and prevent the disorder from causing significant impairment. On the other hand, people should never give up on the idea of recovery, since even the most severe symptoms can respond well to treatment—either therapy, medication, or a combination.
Sadly, about 35% of adults and 60% of adolescents with depression do not receive treatment.1
A person can get help for depression by:2
- Contacting their primary care physician or another medical doctor for an evaluation or referral to additional treatment
- Using a convenient online directory of mental health professionals to find the right therapist
- Phoning their insurance company to learn about covered treatment providers in the area
- Speaking with friends and loved ones who have firsthand experience dealing with mental health issues
- Calling a reputable mental health agency to get an assessment appointment
- Calling a mental health hotline for suggestions about treatment options
Local, state, and federal programs may help pay for mental health services of those without insurance.
How Depression Is Treated
Most often, depression is treated successfully with a combination of therapy and medication. Depending on the situation and symptoms, a person may find relief from only therapy or only medication.1
Therapy
Sometimes called talk therapy or psychotherapy, therapy for depression typically involves meeting with a therapist in an individual, group, or family setting. Therapy may look different depending on the professional’s background and focus, but the goal of therapy will always be to build coping skills, improve relationships, and modify thoughts and behaviors connected to feelings of depression.6
Medication
A psychiatrist or other prescriber may offer medication to help the person’s brain use chemicals more effectively, leading to less stress and depression. Some commonly used types of antidepressant medications include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic depressants, and monoamine oxidase inhibitors (MAOIs).2
The effectiveness of therapy and medication will vary widely based on many factors, including:2
- When the symptoms started
- How severe the symptoms are
- If symptoms are new or returning
- The triggers of symptoms
- Recent major life changes
- Other medical or mental health issues
- Family history of depression
With effective treatment, symptoms of depression can improve, but both therapy and medication take time before seeing a reduction in symptoms. About 40% of people with major depression will begin recovery within three months, while 80% will experience symptoms lifting within a year.3
Healthy Ways to Reduce Symptoms of Depression
By modifying their thoughts and behaviors, each person has the ability to make their symptoms of depression better or worse. They may not be able to resolve symptoms completely, but a depressed person can improve their life by:2,4,7
- Learning about depression: The condition is complex and confusing, so anyone with symptoms of depression should spend some time learning about it.
- Following through with the treatment plan: Mental health professionals will offer their medication and therapy recommendations, and following through with treatment will produce the best chances of success.
- Focusing on physical health: Someone with depression can benefit from taking measures to improve their diet, increase their physical activity, and make time for restful sleep.
- Finding helpful support: Depression may pull people away from their loved ones, but as isolation only intensifies symptoms, those with depression should seek out people they trust to talk through their situation or to temporarily escape from their symptoms.
- Leaving time for pleasure: Listening to music, watching a favorite movie, reading a good book, taking a long bath, and eating a good meal are all pleasurable treats for the senses that can distract from the sadness of depression.
- Staying optimistic: Hope plays a significant role in depression. As long as optimism is present, a person can stay inspired to keep addressing their symptoms.
Strategies That Are Unhealthy When Dealing With Depression
Finding healthy coping skills is key, but avoiding unhealthy coping skills can be even more critical. Unhealthy coping skills are challenging to spot at first because they often appear helpful and effective as they offer quick relief, but in time, they lead to unwanted results.
Unhealthy coping skills to avoid include:
- Spending time with negative people: These people find a way to target your depression and make it worse by blaming, judging, and stalling progress.
- Making too many changes at once: Staying motivated is good, but when people make multiple adjustments at once, it is impossible to know what is helping and what is hurting.
- Using alcohol and other drugs: Substance use always leads to increased symptoms and new problems like poor finances, conflict in relationships, and legal troubles.
- Trying to escape from the symptoms: Everyone needs a break from depression, and watching TV, playing video games, or scrolling through social media can supply some escape. Some people take this coping skill to the extreme by wasting hours each day with these activities, which leaves little time and energy for focus on improving symptoms.
As long as a person fully engages in professional treatments, uses positive coping skills, and avoids the negative ones, they will increase the chances of reducing the symptoms of depression.
Final Thoughts on Dealing With Depression Symptoms
Depressive symptoms will frequently follow the stereotype of teary people staying in their bed all day without the energy or interest in doing most anything. Other times, the symptoms of depression are a sneaky combination of lesser-known effects. Whatever you are feeling, a mental health professional can be an essential ally in properly assessing and treating depressive symptoms, no matter how they present.
