Recognizing the Signs of Depression

Nearly everyone has experienced a time when it hardly seems worth the effort to get out of bed, or when the problems they face seem so overwhelming that they're not sure where to begin. Let’s face it—life can be difficult and depressing. And feeling sad, overwhelmed, guilty, or hopeless is a normal human response during those times.

In fact, just like physical pain, these feelings and thoughts are helpful warning signs that something isn’t right. They may be telling you that you’ve suffered an important loss and need to spend some time grieving; that what you’ve been doing isn’t fitting well with your real needs and desires; or that you simply need to slow down a little.

But sometimes these feelings and thoughts take on a life of their own, dominating your experience for extended periods of time. Instead of reacting to events appropriately, you're only able to see and react to the negative aspects of your experience, or you become unable to experience the pleasure, interest, or satisfaction that you normally get from daily activities and relationships. To make matters worse, this sadness, lack of interest, worthlessness, and hopelessness feels more real to you than any efforts to cheer you up. Being depressed feels like the way things “really are,” not like a medical problem.

Recognizing the Signs Depression
It isn’t always easy to tell when normal reactions to difficult situations (grief, sadness, etc.) have crossed the line towards clinical depression that needs treatment. However, the number of signs or symptoms you are experiencing, along with the duration and frequency you have them are all important. You are probably dealing with clinical depression (which warrants a visit to your doctor for evaluation) if you have experienced 5 or more of the following symptoms (and at least one of them is among the first two listed), nearly every day for two weeks or more:

1. Loss of interest in things you normally enjoy
2. Feeling down, depressed, or hopeless
3. Thoughts of death or suicide
4. Feeling worthless or guilty
5. Problems falling asleep, staying asleep, waking too early or sleeping too much
6. Unexplained decrease or increase in appetite, resulting in weight gain or loss within the last month.
7. Trouble thinking, concentrating, remembering, and making decisions
8. Extreme tiredness or lack of energy that interferes with your ability to work or take care of your daily responsibilities
9. Feeling restless, unable to sit still, or abnormally slow when moving

What Is Depression?
Clinical depression is a medical condition that is related to neurotransmitters, which are chemicals in the brain. These neurotransmitters play diverse roles, regulating mood, responsiveness to stimuli, appetite and more, which is why depression can take different forms and have different symptoms. Some people with depression tend to eat less, sleep more, and feel fatigued, while others tend to experience increases in appetite, insomnia, agitation, and anxiousness. Some individuals also experience significant, unexplained physical pain or other physical ailments.

The severity of depression can vary significantly from person to person. Some people suffer from a relatively mild but chronic form of depression called dysthymia, which is usually not disabling, but can make it extremely difficult to find pleasure in normal activities, and cause feelings of sadness and emptiness that may persist for years. Others may suffer from major depression that can be either moderate or severe, with symptoms that are more disabling and effect daily life. People with major depression may experience a single episode, or recurring episodes. In most cases, each episode will end by itself (with or without treatment), but can last up to six months.

There is also often a cognitive component to depression, which usually takes the form of a recognizable pattern of thinking characterized by pessimism, perfectionism, relentless self-criticism, helplessness, irrational guilt, and highly dichotomous (either-or, all-or-nothing) thoughts. It is often these distorted thought patterns that make it difficult for an individual to see her depression clearly or help herself effectively.

Depression is a real medical condition—not the result of weak character or a defective personality. Many people are reluctant to talk about their difficulties or seek treatment out of embarrassment or shame, but there is nothing to be ashamed about, and medical professionals should not be judgmental about the problems you are experiencing.

Suicidal Thoughts & Self-Harm
Thoughts of suicide and physical self-harm are very common among people struggling with depression. Sometimes, they are lurking in the background—you may think to yourself that, if things don’t get better, you can always kill yourself, or you may wish that you could just go to sleep at night and never wake up. But other times they become more forceful and dangerous.

If you are seriously thinking about harming yourself, please call 1-800-273-8255 right now. This is the national suicide prevention hotline, and you will be connected to a mental health professional in your area who can talk to you right now. There is no charge, and the call is completely confidential. If you want to find out more about this program before calling, you can find information at You can also call 911 (or a local crisis hotline), if you prefer.

How Is Depression Treated?
From medication to therapy to regular exercise, there are several treatment options for depression. Medications that affect specific neurotransmitters (such as serotonin, norepinephrine, and dopamine) can greatly reduce the frequency and severity of depressive episodes—or completely eliminate them. It can take four to six weeks for these medications to produce results, and sometimes it is necessary to experiment with dosage and/or medication type to get the desired results with minimal side-effects. Only your doctor can prescribe medication, if necessary, and work with you to find the proper dosage to meet your needs.

Cognitive and behavioral therapy can also help you learn to recognize the cognitive distortions mentioned above and effectively manage them. Typically, a short course of therapy with a trained doctor or therapist is all that's necessary to produce positive results.

In addition to medical help like medication and counseling, there are also many things you can do to help manage depression. Regular exercise has been shown to be just as effective as many forms of counseling in combating depression. Effective stress management and good nutrition practices can help you keep things on a more even keel, and avoid the emotional slide that often ends in a depressive episode.

If you do find yourself struggling with depression, know that things are not nearly as hopeless as they may seem to you. If you can reach out and ask for help, you can find yourself back on the road to recovery and wellness very soon.