The Signs & Symptoms of Depression

By The Fix staff 01/21/15

Warning Signs & Symptoms of Depression

Symptoms of Depression

Is it just a simple case of the blues, which will go away on their own in less than two weeks at most? Or is it a real-live, honest-to-goodness case of clinical depression? What will make the situation better? Medication? Psychotherapy? Hospitalization? All three?

Depression is not a sign of weakness, nor is it a character flaw or moral failing. It is a serious condition that can invade every part of life. Depression does not respect age, socioeconomic group, social standing, gender, ethnic background, religion, or size. It often follows a period of time or series of events in which a person feels they have little or no control.

Depression looks different in different people. The stereotypical symptoms are moping around, sighing, not eating or sleeping or eating/sleeping too much, and generally exuding sadness. This is not always so. Depression symptoms can be as different as each individual dealing with the condition. Many of its indicators are covered here.

DSM-V Diagnostic Criteria for Depression

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) outlines the diagnostic criteria for depression. 

The following are adapted from the DSM-V. In order to be considered a clinically significant depressive disorder, at least five of these symptoms need to persist, without interruption, for at least two weeks.

Here is a paraphrased list of diagnostic criteria:

  1. Feeling sad for a good part of the day almost every day
  2. Diminished interest in things that used to be pleasurable
  3. Feeling worthless, or guilty without justification almost every day
  4. Concentration problems, or indecisiveness, practically every day
  5. Frequently thinking about dying or committing suicide, with or without planning or attempting it
  6. Gaining or losing at least 5% of body weight in a month without trying
  7. Restless or slowed down in physical movement
  8. Noticeable changes in sleep patterns
  9. No get-up-and-go, regardless of the amount of rest gotten
  10. Ongoing physical ailments that do not respond to treatment

To qualify for a diagnosis of Major Depressive Disorder, a person also has to be experiencing distress about having these symptoms, or these symptoms must interfere with a person's social or occupational functioning.

It is possible to have depression, but not have the psychiatric diagnosis. That's when it's part of a bigger picture that includes a physical illness. When this kind of depression is discovered, the primary doctor who is treating the illness often consults with a psychiatrist or psychologist, or adds them to the treatment team.

Other Forms of Depression

Adjustment Disorder with Depressed Mood - Mental health professionals use this diagnosis when the issue has a specific stressor and symptoms develop within three months after the onset of the stressor. By definition, Adjustment Disorder with Depressed Mood must resolve within six months of the termination of the stressor.

Persistent Depressive Disorder – the DSM-V combined Dysthymic Disorder (also called dysthymia) and Chronic Major Depressive Disorder into one diagnosis. This is a longer-term version of Adjustment Disorder with Depressed Mood.

Seasonal Affective Disorder (SAD) - a subtype of major depression that comes and goes based on seasons. Its appearance usually coincides with a shorter day, which means less sunlight. Treatment for people with SAD usually involves light therapy of one type or another, which contributes to relieving the depressive symptoms.

Depression and Suicide

No matter what kind of depression is diagnosed, all forms have the feature of suicidal thoughts, or attempted suicide. This should never be taken lightly! If a depressed person mentions hurting themselves, an intervention of some type is definitely in order. According to Mental Health America, people who talk about suicide, threaten suicide, or call suicide crisis centers are 30 times more likely than average to kill themselves.

Knowing what to do when encountering a suicidal person is knowing first aid for the mind. Here's a list of what to do – and not to do:

  1. Trust your instincts. If you have a gut feeling that the person may be in trouble, they probably are
  2. Talk with the person about your concerns for them. Listen to what the person has to say
  3. Ask the person if he or she has a specific plan to carry out the suicide. The more detailed the plan, the greater the risk
  4. Get professional help, even if the person says they're OK
  5. Do not leave the person alone, even for a second
  6. Do not allow yourself to be sworn to secrecy
  7. Do not show any shock or judgment
  8. Do not try to "talk the person down"

You may end up taking a ride to the Emergency Room with the person. Once in a doctor's care, that particular suicidal crisis is over. With luck, there won't be a next time.

Substance abuse is another reason for suicide, and may be involved in as many as half of all cases. About 20% of suicides involve people with alcohol issues, and the rate of suicide throughout their lifespan of people with substance-use problems is three or four times the average.

Medications are tools for short-term or emergency measures to stop urgent self-harming behaviors. Some of the medications used to treat depression are selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), tetracyclic antidepressants (TeCAs), and atypical antidepressants.

Where Depression Comes From

Research has demonstrated that different types of depression develop at different times in different ways in different people for different reasons, sometimes more than one at the same time. Some of the factors involved in developing depression are:

  1. Abuse of any kind
  2. Certain medications
  3. Conflict
  4. Death or a loss
  5. Genetic predisposition
  6. Major events
  7. Personal problems
  8. Serious illnesses
  9. Substance abuse

Depression Symptoms in Women

In most types of depression, women are twice as likely to be diagnosed with depression as men, beginning in adolescence. There is no satisfactory scientific explanation for this. Many mental health professionals speculate that social stereo-and gender typing have something to do with it.

Age Differences

Adult depression has been explained above. However, depression can develop in any age group. Different ages show it in different ways:

Symptoms of Depression in Children

Children are not always capable of verbally expressing their feelings, so they act out. Some expressions are the same, but in children, other behaviors show up. Childhood depression can look like this:

  1. Frequent sadness, crying
  2. Diminished interest or enjoyment in activities
  3. A what's-the-use attitude
  4. Constantly expressing boredom
  5. Having little or no energy or concentration
  6. Not communicating well
  7. Lessened self-esteem
  8. Expressing unreasonable guilt
  9. More sensitive to rejection or failure
  10. More irritable, angry, or hostile
  11. More difficulty with relationships
  12. Frequent complaints of physical illnesses such as headaches and stomachaches
  13. Frequent absences from school or poor performance in school
  14. Changes in eating and/or sleeping patterns
  15. Talking about or trying to run away from home
  16. Expressing suicide in either verbal or non-verbal ways
  17. Acting in risky or self-destructive ways

Not every daredevil or disrespectful kid is depressed, nor is every depressed child engaged in back-talking or risky behavior. If any one of these signs appears, though, especially #15, consulting with a mental health professional who specializes in children is always good to do.

Childhood depression can be successfully treated in more than 80% of cases. But if it goes untreated, it can be deadly — it is a major risk factor for suicidal behavior.

Depression Symptoms in Older Adults

This refers more to a life stage than a chronological age. Retirement, relocating to live in a different area, loss of spouse or siblings, and bona fide health issues all have the potential to disrupt emotional stability. When this happens, depression can develop. Some of the symptoms that are seen in the elderly are:

  1. Unexplained or increased intensity of aches and pains
  2. Hopeless or helpless feelings
  3. Expressions of anxiety and worry
  4. Trouble remembering things
  5. Not being able to sleep
  6. A why-bother attitude
  7. Slower movement and speech that being older, or a physical illness (like stroke residuals) doesn't explain
  8. Irritability
  9. Loss of interest in socializing and hobbies
  10. Not taking care of one's self

The meanness and nastiness of the curmudgeon in that rundown old house on the corner, or the anxious mutterings of the old lady at the nursing home, may actually be from depression.

In Conclusion

Depression comes in many forms. Although it may not look like much on the surface, it can develop into a serious, even life-threatening condition. The best way to deal with any kind of depression is to see a doctor who can help rule out any physical cause for feeling down, and make referrals for mental health follow-up, if needed.

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