If these red flags last more than two weeks, see a doctor.
Depression may not be something you can physically see from the outside, but the mental health condition still leaves plenty evidence throughout a person’s life. “Depression affects the person’s entire world, whether it’s having a romantic relationship, friendships, or holding a job,” says Ben Michaelis, PhD, a psychologist in New York City.
Certain symptoms, like loss of pleasure in usual activities, are more obvious; others, like sleep problems, can be vague and trickier to ascribe to depression alone.
And what’s the difference between depression or just a bad mood or a slump? The symptoms of depression must be present every day for at least two weeks in order to be considered a depressive episode, according to psychiatrist Susan Samuels, MD, NewYork-Presbyterian Hospital and Weill Cornell Medicine. Otherwise, chock up those few lousy days as a string of bad luck (take care of yourself, but you can hold off on calling your doc). Here are the common depression symptoms patients may experience during a major depressive episode.
Persistent low mood
Difficulty with sleep (either too much or too little)
Loss of interest in the things you used to like (called anhedonia)
Overwhelming feelings of guilt or hopelessness
Lethargy, which can feel like fatigue or a lack of ambition
Changes in appetite (either increased or decreased)
Feeling “slow” or easily agitated
Thoughts of self-harm or suicide
These depression symptoms may vary depending on the person and the type of depression they have. Learn more about the eight types of depression here.
What Causes Depression Symptoms?
Experts don’t know exactly what’s going on in the brain that causes depression symptoms. “We do know that serotonin is probably the predominant neurotransmitter or neurochemical involved in depression,” says psychiatrist Gail Saltz, MD, of NewYork-Presbyterian Hospital and Weill Cornell Medicine.
Serotonin is a hormone that both allows nerves to send messages to each other and causes blood vessels to narrow, according to the National Institutes of Health. It is one, but not the only, chemical involved in the onset of depression. When people are experiencing depression, their bodies don’t regulate these hormones correctly.
“There’s also some research indicating that people [who] are depressed have differences in their brain structure,” says Dr. Michaelis. “The white matter in their brain is structured somewhat differently.”
Depression affects 16.1 million U.S. adults, or 6.7 percent of the adult population, according to the National Institute of Mental Health. Specifically, the highest rates of depression occur in people between 18 and 25, and depression is more common in women than men (8.5 and 4.7 percent of the population, respectively).
Besides age and gender, these are common risk factors for depression:
A personal history of depression
A family history of depression
A personal history of another mental health disorder, such as anxiety or addiction
A stressful life event
Certainly, major life changes like losing a parent or getting laid off can trigger depression, but it’s important to realize that depression doesn’t need to have an obvious cause. It can strike without any major event at all. In fact, some people with depression may feel guilty because they feel they have no valid reason to be unhappy with their lives. “[Depression] is a real struggle,” says Nancy Snell, a patient with depression. “It’s not logical, and it doesn’t matter what you look like on the outside. My life is really, truly in technicolor, and yet it feels black and white to me.”
“There’s a biological process going on,” says Dr. Saltz. “It’s an illness. They can’t control it, [and] they really need treatment.” That treatment may include medication, therapy, or both. Find out more about the types of psychotherapy used to treat depression here.
Although many people try to “fight through” feelings of depression, getting a diagnosis can come as a relief. Having an answer also means being closer to finding a solution, and many people with depression are able to manage symptoms and even recover to live more vibrant lives out of the fog of depression.
Dr. Michaelis is a clinical and media psychologist in New York City.Susan Samuels
Dr. Samuels is an assistant professor of clinical psychiatry and clinical pediatrics at Weill Cornell Medicine and an assistant attending psychiatrist at NewYork-Presbyterian Hospital.Gail Saltz
Dr. Saltz is a clinical associate professor of psychiatry at the NewYork-Presbyterian Hospital and Weill Cornell Medicine and a psychoanalyst with the New York Psychoanalytic Institute.
00:00:00,871 --> 00:00:02,839
00:00:02,839 --> 00:00:07,328
Depression affects the person's
entire world whether it's having
00:00:07,328 --> 00:00:11,130
a romantic relationship,
friendships or holding a job.
00:00:11,130 --> 00:00:17,856
00:00:17,856 --> 00:00:22,758
The symptoms of a major depressive
episode include having a persistent low
00:00:22,758 --> 00:00:25,160
mood for at least two weeks.
00:00:25,160 --> 00:00:27,374
And it exists almost every day.
00:00:27,374 --> 00:00:30,850
Difficulty with sleep,
whether it's too much or too little.
00:00:30,850 --> 00:00:33,919
Not being interested in things
that normally interest you,
00:00:33,919 --> 00:00:35,249
which we call anhedonia.
00:00:35,249 --> 00:00:39,445
Having an excessive sense of guilt or
hopelessness, having very,
00:00:39,445 --> 00:00:44,597
very low energy, having difficulty
focusing, having changes in your appetite,
00:00:44,597 --> 00:00:48,590
which could either mean eating more or
less than usual.
00:00:48,590 --> 00:00:52,970
Feeling incredibly slow or
what we call psychomotor retardation.
00:00:52,970 --> 00:00:57,290
Or feeling sort of keyed up,
which we call psychomotor agitation.
00:00:57,290 --> 00:01:02,200
And finally, having thoughts of wanting
to harm oneself or suicidality.
00:01:02,200 --> 00:01:06,200
To qualify for
a diagnosis of clinical depression,
00:01:06,200 --> 00:01:11,660
the symptoms have to be present for
two weeks and they go on mostly every day.
00:01:11,660 --> 00:01:15,273
We don't really always
know what chemically exactly
00:01:15,273 --> 00:01:19,617
is causing depression nor
where in the brain that is happening.
00:01:19,617 --> 00:01:24,522
But we do know that serotonin is probably
the predominant neurotransmitter or
00:01:24,522 --> 00:01:27,300
neural chemical involved in depression.
00:01:27,300 --> 00:01:29,680
We all have these brain
chemicals called neurotransmitters,
00:01:29,680 --> 00:01:31,270
which help us to function.
00:01:31,270 --> 00:01:34,552
People that are feeling
depressed have a harder time.
00:01:34,552 --> 00:01:38,160
Their systems are not regulating
those brain chemicals as easily.
00:01:38,160 --> 00:01:41,664
There's also some research indicating that
people that are depressed have differences
00:01:41,664 --> 00:01:42,744
in their brain structure.
00:01:42,744 --> 00:01:45,960
Their white matter in their brain
is structured somewhat differently.
00:01:45,960 --> 00:01:51,150
Some of the risk factors for experiencing
depression include a personal history
00:01:51,150 --> 00:01:56,200
of experiencing major depressive episode,
a family history of somebody else
00:01:56,200 --> 00:02:00,170
having a major depressive disorder or
another mental health disorder.
00:02:00,170 --> 00:02:04,820
One's own history of another mental
illness, such as anxiety disorder, or
00:02:04,820 --> 00:02:08,940
a substance use disorder, and
a particularly stressful life event
00:02:08,940 --> 00:02:12,450
which could be a move or
the loss of a loved one.
00:02:12,450 --> 00:02:14,880
Depression is really painful.
00:02:14,880 --> 00:02:15,875
It's a real struggle.
00:02:15,875 --> 00:02:18,100
It's because it's not logical.
00:02:18,100 --> 00:02:21,005
And it doesn't matter what
you look like on the outside.
00:02:21,005 --> 00:02:24,740
Cuz my life is really
truly in technicolor.
00:02:25,800 --> 00:02:29,620
And yet it feels black and white to me.
00:02:29,620 --> 00:02:33,740
It can happen with no trauma and
nothing stressful going on your life.
00:02:33,740 --> 00:02:36,820
And that's important, because some
people are like, what's going on?
00:02:36,820 --> 00:02:39,080
My life is wonderful,
why do I feel this way?
00:02:39,080 --> 00:02:39,910
I shouldn't feel this way.
00:02:39,910 --> 00:02:41,790
There was a biological process going on.
00:02:41,790 --> 00:02:45,050
It's an illness, they can't control it,
they really need treatment.
00:02:45,050 --> 00:02:49,597
00:02:49,597 --> 00:02:53,434
If you ever feel like you might want
to harm yourself or somebody else,
00:02:53,434 --> 00:02:57,970
please call 911 immediately or
proceed to your nearest emergency room.
00:02:57,970 --> 00:03:05,040
It's also good to have on hand
the National Suicide Prevention Lifeline,
00:03:05,040 --> 00:03:09,200
which is 1-800-273-8255.
Definition of serotonin. Bethesda, MD: National Cancer Institute. (Accessed on January 11, 2021 at https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=335511.)Depression. Bethesda, MD: National Institute of Mental Health. (Accessed on January 11, 2021 at https://www.nimh.nih.gov/health/topics/depression/index.shtml.) Major depression among adults. Bethesda, MD: National Institute of Mental Health. (Accessed on January 11, 2021 at https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml.) Symptoms. Silver Spring, MD: Anxiety and Depression Association of America. (Accessed on January 11, 2021 at https://adaa.org/understanding-anxiety/depression/symptoms.)