Symptoms of Depression
Symptoms vary by person and may fluctuate day to day or between episodes. They can be emotional, physical, and cognitive.
- Altered sleep: Sleeping significantly more or less than usual.
- Changes in appetite: Overeating, loss of appetite, or loss of interest in food.
- Concentration & cognition: Inability to concentrate, “fuzzy” thinking, trouble remembering, slowed thoughts or speech.
- Low energy: Persistent fatigue or sluggishness.
- Loss of interest: Reduced or absent interest in previously enjoyable activities.
- Low self-esteem: Diminished self-confidence and feelings of worthlessness.
- Heightened emotions: Hopelessness, increased agitation, or anger.
- Intrusive thoughts: Persistent negative thoughts about yourself, triggered or unprompted.
- Restlessness: Pacing, hand wringing, or inability to stay still.
- Decision-making difficulties: Trouble making simple or complex decisions.
- Physical pain: Headaches, back pain, or unexplained pain not resulting from injury.
- Suicidal thoughts: Thoughts of suicide or suicidal ideation.
Important: Suicidal ideation is a medical emergency. If you are experiencing suicidal thoughts, go to the nearest emergency room or call the National Suicide Prevention Lifeline: 800-273-8255, or call/text 988 for the Suicide and Crisis Lifeline.
How Depression Symptoms Vary by Age
- Children: Refusing school, being extra clingy to parents, or experiencing physical symptoms such as stomachaches.
- Older children & adolescents: Difficulties at school, low self-esteem, lack of motivation, and ADHD-like symptoms. Teen depression may also involve eating disorders and substance abuse.
- Adults: May occur at pivotal life moments. Young adults may experience co-occurring anxiety or eating disorders. Middle-aged adults may experience more physical symptoms and insomnia.
- Elderly adults: Grief, generalized depressive moods, and feelings of loneliness.
Causes of Depression
Depression is almost always multifactorial — feeling depressed is never someone’s fault. There are several risk factors that may raise the possibility of someone developing depression.
- Genetics: Having an immediate family member with depression gives you a 40% chance of experiencing it yourself.
- Trauma: Childhood abuse, sudden loss, war, poverty, or natural disaster can trigger depression. Early or repeated traumas affect how the brain responds to stress.
- Life circumstances: Major disruptions such as job loss, moving, or divorce can trigger depressive episodes.
- Medical conditions: Chronic pain, ADHD, sleep disorders, and other conditions increase the likelihood of depression. Some conditions (e.g., hypothyroidism) can mimic depression symptoms. Certain medications can also cause depressive symptoms.
- Substance abuse: People with substance abuse issues are more likely to experience depression. Alcohol and other substances can worsen symptoms.
- Hormonal changes: Puberty, pregnancy, postpartum, and menopause can all trigger depression.
- Brain & biological differences: Differences in pituitary/hypothalamus hormone interaction or neurotransmitter function can contribute to depression.
Risk Factors
- Being female (a third of women experience a depressive episode in their lifetime)
- History of trauma: childhood abuse or neglect, death of a loved one, financial hardship, or sudden major life change
- LGBTQ+ identity, especially without support for identity or lifestyle
- Family or personal history of mental health conditions (anxiety, eating disorders, PTSD, bipolar disorder, postpartum depression)
- Chronic illness: fibromyalgia, cancer, heart disease
- History of substance abuse
- Taking medications that may cause depressive symptoms (e.g., blood pressure or sleep medications)
According to NAMI, depression raises the risk of cardiovascular and metabolic diseases by 40%. Teens with depression are twice as likely to drop out of high school.
Types of Depression
It’s possible to experience more than one type at once.
- Major Depressive Disorder: The “classic” type: persistent symptoms, loss of interest in previously enjoyable activities, difficulty completing daily tasks, and commonly issues with sleep, eating, and weight. May include very low self-esteem and suicidal thoughts.
- Persistent Depressive Disorder (Dysthymia): Symptoms persisting for two or more years. May fluctuate in severity while maintaining consistently low mood, sleep/appetite/energy changes, and low self-esteem.
- Bipolar Disorder: Bipolar disorder is not depression, but involves cycles between depressive symptoms and mania or euphoria. Requires psychiatric care and medication.
- Seasonal Affective Disorder (SAD): Depression primarily during darker, colder months, linked to reduced sunlight, social interaction, and exercise. Treated with light therapy, psychotherapy, or medication.
- Postpartum Depression: Affects 1 in 7 new parents. Distinct from “baby blues,” involves more serious and persistent depressive symptoms beyond two weeks, including extreme sadness, guilt, anxiety about parenting, and difficulty caring for self or baby.
- Situational Depression: Similar to major depressive disorder but triggered by a specific life event and typically less long-lasting.
- Atypical Depression: Like major depressive disorder but with moments of lifted mood in response to positive events, before returning to intense depression.
- Premenstrual Dysphoric Disorder (PMDD): Severe PMS-related depression typically affecting women in the week before their period. SSRIs and lifestyle changes can relieve symptoms.
- Psychotic Depression: Severe depression with psychotic symptoms such as delusions or hallucinations. Requires treatment for both psychosis and depression.
Treatment
The APA reports 80–90% of people who seek treatment respond positively. Treatment works best when approaches are combined.
1. Therapy
Common approaches: CBT (identifies and changes negative thought patterns), DBT (builds distress tolerance and emotional regulation), Psychodynamic Therapy (explores unconscious patterns and past experiences), and Interpersonal Therapy (addresses relationship problems contributing to depression). Available in-person and virtually.
2. Medication
The most commonly prescribed antidepressants are SSRIs. Other options include SNRIs, tricyclic antidepressants, and MAOIs. Allow 2–4 weeks to take effect. Never stop abruptly — taper gradually with a doctor’s guidance.
3. Natural Remedies & Lifestyle Changes
Lifestyle changes accelerate recovery when combined with therapy and medication.
- Stay active: Exercise releases endorphins and reduces stress. Even a short walk helps.
- Build healthy routines: Adequate sleep, regular nutritious meals, reduced alcohol intake, and daily practices like meditation or journaling.
- Talk about it: Trusted people, a therapist, or a support group provide a safe space. Keeping feelings bottled up worsens depression.
- Be realistic: Healing involves possible setbacks. Be compassionate with yourself. Deciding to seek help is an enormous first step.
