Sadness, fatigue, poor self-esteem, and excessive guilt are the classic symptoms of depression, but because there are various depressive disorders with the power to trigger numerous effects, the signs of depression are more complicated. Understanding depression symptoms is necessary to help identify a problematic condition, guide treatment, and establish recovery for the more than 20 million adults and adolescents with depressive symptoms in the U.S. 1
Symptoms of depression can improve with effective treatment, which typically includes a blend of therapy and medication. Many people with major depression reported symptoms lifting between three months to a year after beginning their treatment regimen.
Most 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:
- 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 2
The combination of depressive symptoms will begin to impact a person’s life at home, work, and school. As symptoms progress, relationships will suffer as a desire to withdraw and isolate from the outside world grows. 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.
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 are:
- 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 3
In addition to the separate conditions creating signs of depression, the disorder may have specifiers that create an additional layer of symptoms.
Some of the frequently displayed specifiers for depressive disorders are:
- Anxious distress – feelings of strong anxiety, worry, and tension that only occur during periods of depression
- Mixed features – fleeting feelings of high energy, high self-esteem, and elevated moods that present in a depressed episode
- Psychotic features – experiencing delusional thinking or hallucinations that are only caused by significant feelings of depression
- Peripartum onset – intense panic, delusions, and hallucinations that only present during the final weeks of pregnancy or after the baby is born
- Seasonal pattern – depressive symptoms that change depending on the season, usually worsening during the fall and winter months and improving during the spring and summer3
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
Because of age, sex, and cultural differences, people may display their depression in varied ways. This notion further supports the idea that there is no one universal way depression presents.
Signs of Depression in Women
According to the National Institute of Mental Health (NIMH), more women than men have a depressive disorder.1 The different rates of depression may be due to biological, lifestyle, hormonal, and environmental situations only women experience. Of the women who do have depression, many display the common depressive symptoms of sadness, guilt, and worthlessness.2
Signs of Depression in Men
Where women are more likely to display sadness and guilt, men are more likely to feel fatigued, lose interest in hobbies and activities, and experience sleeping problems. Men may be more irritable, angry, and frustrated, which makes using alcohol and other drugs more appealing as a way to numb or avoid unwanted feelings 2,4).
Signs of Depression in Children
Children are likely to show their depression by complaining of physical sickness, avoiding school, or worrying about a parent dying. Some children may present with more symptoms of anxiety before shifting into depression as they age. Parents and teachers should be aware of these changes and communicate with each other to gather information before choosing to follow up with a mental health expert.2
Signs of Depression in Teens
The significant social, biological, and environmental changes of adolescence bring opportunity for new and worsening depressive symptoms. The more than three million adolescents with depressive symptoms may get into more trouble at school, appear moody, irritable, or sad, and report feeling misunderstood1, 2. Many teens experience shifting mental health, so parents, teachers, and experts should work to identify how long the symptoms have lasted, how intense they are, and how different it is from their expected self.
Signs of Depression in Older Adults and Seniors
Rates of depression begin falling after age 25, but the condition continues to affect many older adults and seniors. Separating depressive symptoms from typical functioning is challenging for older adults because the effects of depression overlap with common aspects of getting older, physical health problems, and grief. An older adult with depression could complain of feeling tired, having sleeping problems, or being more irritable than usual. They may also 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
Thoughts of Death or Suicide With Depression
Suicide is the second leading cause of death in people ages 10-14, 15-24, and 25-34.4 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.
Suicide occurs at high rates, and the numbers have steadily increased since 2001. According to the NIMH, there were more than 47,000 completed suicides in 2017, more than double the number of homicides.5
Women are more like than men to attempt suicide, but more men complete the act, often because they utilize more violent methods.2 More than half of men who die by suicide use a gun, while women most often complete suicide by poisoning.5
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. 5Nearly 10 million adults had serious thoughts about suicide, and more than one million adults attempted suicide in 2017 alone.5
Suicidal ideation, suicidal intent, and suicidal plans are not a typical part of life, as they indicate an increase in depression.
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 and other mental health conditions. Getting help early while symptoms are mild can resolve the problem and prevent the disorder from causing significant impairment. On the other end of the spectrum, people should never give up on the idea of recovery, since even the most severe symptoms can respond well to effective treatment. Sadly, about 35% of adults and 60% of adolescents with depression do not receive treatment.1
Delaying and avoiding treatment for depression is linked to two significant issues:
- Since depression has the ability to negatively impact thoughts, behaviors, and feelings, the person’s well-being will become more distorted as symptoms continue for extended periods.
- Symptoms of depression tend to worsen over time, so the longer symptoms have to grow, the more pervasive their impact becomes.
Luckily, accessing professional mental health treatments is simple and straightforward in many situations.
A person can access psychological services to manage depression by:
- Contacting their primary care physician or another medical doctor for an evaluation or referral to additional treatment
- 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
- Presenting to a reputable mental health agency for an assessment appointment
- Calling a mental health hotline for suggestions about treatment options2
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
Sometimes called talk therapy or psychotherapy, therapy 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
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
Antidepressants are generally safe and effective when used as prescribed, but people taking the medicines must use patience and caution. Typically, antidepressants take about a month to start working and creating the desired effect.2 Some people will note unwanted side effects caused by antidepressants such as nausea and diarrhea, weight gain, low energy, etc.2
For some people, especially teenagers and young adults, the use of prescribed antidepressants is linked to worsening depression. These people may have trouble sleeping, a lower mood, and new thoughts of suicide.2 Anyone trialing a new antidepressant medication should always communicate with their prescriber about any significant mood changes or undesirable side effects. There are many different medications and one or another might work better for someone, their prescriber will help to find the right fit.
The effectiveness of therapy and medication will vary widely based on many factors, including:
- 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 depression2
With effective treatment, symptoms of depression can improve. About 40% of people with major depression will begin recovery within three months, while 80% will experience symptoms lifting within a year.3
Do’s & Don’ts for Depression Symptoms
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:
- 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.2, 4, 7
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. 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, conflictual relationships, and legal troubles.
- Escaping 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.
Additional Resources for Depressive Disorders
For more information about depression, please refer to these organizations: