The Hidden Signs of Depression

I’m not a psychiatrist, but if a friend came to me and said she was feeling so hopeless that she couldn’t function at work; that she was going through a box of tissues every few days because of her unexplained crying spells; and that she was no longer enjoying the things she used to dig, like her three-month-old chocolate lab, I’d heave her into my car, take her to the doctor, and see that she get evaluated for depression.

According to the National Institutes of Mental Health (NIMH), depression affects over 15 million U.S. adults every year, so you probably know someone who is (or has been) depressed.  And most of us are familiar enough with the symptoms of depression that we could easily recognize them in ourselves or loved ones.

But there are some other signs of depression that often get overlooked. 

If the same friend told me that she had been feeling lethargic, wasn’t sleeping well, felt annoyed with everyone around her, and kept getting headaches, I might assume she was drinking too much coffee or suffering from a bad case of PMS.  But these could also be symptoms of depression.  Many people suffering from these “hidden signs of depression” delay or never receive diagnosis and treatment, because they attribute them to some other cause.  Some commonly overlooked symptoms of depression may include:
  • A persistent lack of energy—feeling fatigued, lethargic, and “slowed down," even with ample sleep
  • Difficulty concentrating, remembering things, and making decisions
  • Changes in sleep patterns—insomnia, early-morning awakening with difficulty going back to sleep, or oversleeping that can make other symptoms even worse
  • Appetite changes—a decrease in appetite and subsequent weight loss OR increase in appetite and weight gain could mean you're depressed
  • Thoughts about death or dying, but not necessarily of suicide
  • Restlessness, increased irritability, anger, worry, agitation, anxiety
  • Withdrawal from friends and family
  • Chronic pain and persistent physical symptoms that do not respond to treatment, such as headaches, backaches, and digestive disorders (dry mouth, stomachaches, constipation, diarrhea)
Our moods naturally vary over time, and everyone feels sad, annoyed, worried, or withdrawn from time to time.  In order to be diagnosed with depression, five or more of the above symptoms must be present continuously for at least two weeks.  The symptoms should be serious enough to cause worry and to interfere with work, social life, and/or daily life.

Many things can trigger depression.  A traumatic event, like the death of a loved one or the loss of a job—or even the long-term stress of a chronic illness or an unhealthy relationship can trigger the biochemical changes that affect brain function and lead to symptoms of depression.  But sometimes these biochemical changes seem to be the result of nothing in particular.  In short, sometimes depression just happens.
Fortunately, depression is a treatable illness that responds extremely well to treatment programs. The most effective treatment for depression is one that includes counseling in addition to appropriate use of medication.  The first step is to talk with your doctor, explaining exactly how you’ve been feeling.  Don’t try to diagnose yourself, because depression is a complex disorder with many possible causes, symptoms, and treatments.  Together with your doctor, you can formulate a treatment plan that can help you feel like yourself again.