Depression is surprisingly common. Nearly 8 percent of adults will struggle with depression in the coming year. That’s nearly 17 million people.
It’s even more widespread among adolescents. Thirteen percent of teenagers will have a significant depressive episode in the next 12 months (19% of female teens, and 6% of male teens).
The consequences of having a major depressive episode can be devastating, but you can lessen both the severity and duration of depression by catching it early.
And if you can identify it early on, before it has become extreme, it is easier to take some very simple and straightforward steps to get your life back to normal. This makes early detection especially important.
Frequently, however, it is difficult for the depressed person to recognize just how serious the situation is that they have gotten into. Difficult to clearly discern that this is no ‘momentary dip’ in their mood, but a much more pernicious decline.
Perhaps that’s because a lack of energy, diminished focus, and a dull or even saddened outlook is something that everyone experiences from time to time. It’s not that hard to pass this off as the mental equivalent of catching a cold.
Only in this instance it is your psychological system that has been temporarily overwhelmed by the contagions of life.
These could include conflicts with family or friends, professional setbacks, health concerns, financial worries, or you’ve been paying too much attention to the news and have concluded that the political elite are out of their minds.
No matter the reasons, these setbacks usually are short lived and it usually does not take long to bounce back.
Sometimes, however, these symptoms persist, become rooted, and create the ideal conditions for a serious depressive episode to occur.
Although you may find it strange, I’ve often worked with severely depressed men and women who did not realize they were suffering from a major psychiatric challenge. Sure, they recognized that they were unhappy, that they didn’t sleep well, lacked energy and seldom found life interesting… but they had come to think of this as normal.
As one fellow, let’s call him Jack, protested to me “Hell, yes, I feel like crap, but don’t most people? I mean, I don’t know too many guys that are whistling on their way to work every day.”
He had a point. About the whistling and work that is. But regarding most people feeling as he did, well, that was way off the mark. Jack was committing a common error of explaining other people’s behavior by assuming his own mental state was shared by everyone.
It’s a form of confirmation bias: he was feeling miserable, and rather than consider that this had something to do with his life specifically, he looked for instances wherein others expressed unhappiness. He then assumed that these small signs of unhappiness reflected a deeper misery similar to his own.
Had Jack realized earlier that the symptoms he was experiencing were actually signs of serious depression, he might have sought out help at a time when he could have avoided much of the heartache that followed instead.
Knowing the symptoms of depression (called Major Depressive Disorder, or MDD) can help anyone get a jump on changing the course of their life when things begin to head south.
In the following section we’ll look at the criteria used to diagnose depression. Knowing these symptoms gives you a chance to make immediate course corrections.
Think of it as the equivalent of a colonoscopy for the mind, a preventative that can alert you to problems needing your attention (or, on second thought, don’t think of it as a mental colonoscopy because that gets weird… just think of it as helpful).
PRIMARY SYMPTOMS
Look at the list of symptoms below and put a check mark next to any that describe you. When considering whether the description fits your experience, only consider things you’ve experienced in the past two weeks.
1. Depressed mood
This is one of the most common symptoms. It refers to feeling hopeless, sad, ‘empty’, etc. and occurs nearly every day. In teens and children these feelings are sometimes expressed in an irritable or oppositional response to parents and others (of course, there are many other reasons that teens and children act out, so don’t use this one symptom to come to any conclusions about your son or daughter).
2. Loss of interest or pleasure in that which had created interest or pleasure in the past
This is termed ‘anhedonia.’ An example would be someone who had enjoyed engaging in a hobby but now has no interest in it at all. Or someone who had enthusiastically followed a sports team but no longer cares (unless they were a Chicago Bears fan last year, in which case their change of heart makes perfect sense).
When anhedonia is present, it is not limited to one specific interest or hobby but extends more generally to a lack of interest in most things in life.
3. Changes in Body Weight
Significant weight loss (without dieting) or weight gain (change of >5% body weight in a month), or significant decrease or increase in daily appetite. In children this may show itself simply by a failure to gain weight as expected
4. Insomnia or hypersomnia
Nearly every day. This may show up as extreme difficulty falling asleep or staying asleep, as well as the opposite problem of needing many extra hours of sleep each night (as compared to past sleep patterns).
5. Psychomotor agitation or retardation
Like some of the previous symptoms, this involves opposites. Agitation does not refer to your mood, but instead is focused on behavior that is restless or fidgety.
Psychomotor retardation refers to slow movement, slow speech patterns and impaired cognitive functioning (often showing up as poor attention, confusion and lapses in memory).
Whether the symptom is agitation or retardation, in a major depression they are likely to occur nearly every day and be obvious enough to be observed by others (that is, the experience is not just subjective)
6. Fatigue
Although this symptom is likely to be observable to others, it is first and foremost a subjective experience. This sort of fatigue leaves one feeling an extreme lack of energy. Performing simple tasks can feel difficult, and a desire to spend the day sitting mindlessly is not uncommon.
7. Decreased concentration
Not surprisingly, depression also affect someone’s ability to think clearly. This is seen in diminished attention. Depressed individuals find it challenging to maintain their concentration, and consequently take longer to complete tasks.
This in turn creates more stress as unfinished tasks pile up and the consequences of leaving so much undone leaves one feeling much worse about themselves.
8. Thoughts of death/suicide
When someone is in the grips of a major depression they will often feel that there is no hope that they will ever feel better. Recovery seems like a farfetched idea. Some folks I’ve worked with describe this experience as being at the bottom of a hole so dark and deep that there is no light.
Unsurprisingly, this perspective often leads to thoughts of death as a means of escaping intense suffering. Sometimes these thoughts are simply wistful thinking. That is, the person dwells on death only because of the vicarious comfort such thoughts provide.
But very often these ruminations are of a more active nature. The person contemplates how they might facilitate their own death.
In the worst case, a depressed person will map out a plan to take their life and then proceed to act on that plan.
A common misperception is that by asking someone who is depressed if he/she has considered suicide the idea is then ‘implanted in their mind’ and increases the chance that they subsequently take their life.
This is not true. Far from it. In nearly all cases the depressed individual will either wonder why you worry about them taking such extreme actions, or they will feel relief that someone has broached a topic that the were afraid to bring up.
9. Feeling worthless or having excessive/inappropriate guilt
One of the most common symptoms people describe having when seriously depressed is feeling worthless, and/or guilty. These thoughts about oneself are not in reference to the impact their depression is having on others. Instead, they nearly always point to a more global sense of having little to offer the world, and a general sense of guilt.
What’s more, these feelings are chronic, occurring nearly every day.
As you can imagine, this symptom reinforces other symptoms. When someone feels guilty and worthless it becomes much easier to entertain thoughts of suicide, it becomes more difficult to feel energized to complete household tasks or go to work, and it certainly will lead to a diminished mood.
Am I Depressed?
The above list of symptoms covers the major diagnostic aspects of a severe depression. The more symptoms that you checked the more likely it is that you are struggling with a significant depression. If you checked five or more symptoms it is even more likely you are ‘clinically depressed.’
But let’s be clear. This list does not provide a formal diagnostic screening for depression. For that you would want to consult with a therapist, or with your primary care physician.
What the above list of symptoms does do is provide markers to help you judge whether depression may be playing a role in your life. Regardless of whether you meet a formal diagnosis.
If you checked one or more symptoms above then consider what you can do to improve in that area of your life. For example, if your sleep patterns have dramatically changed then you will want to consider why this might be, and what practical steps you can take to return your sleep to a healthy state.
If you have lost interest in activities, relationships, and life in general, take some time to consider why this has occurred. Perhaps you’ve been exhausted from a hectic work schedule; discouraged by repeated relationship failures; pre-occupied by health concerns, or some other worry.
The solution would then be two-fold. Determine the best way to resolve whatever problem(s) underlie the symptom, and to also force yourself to engage in those interests/activities that you’ve let drop by the wayside.
Don’t wait for an emotional ‘rekindling’ of interests in past hobbies, relationships, etc. Waiting does not help. Instead, take the initiative and force yourself to get involved with those things that in the past brought you joy.
Conclusion
Depression can slowly creep into your life in such a way that once it has taken root you fail to recognize it as being a significant change from your previous happier and healthier state of mind. Use the checklist above to get a reality check.
If doing so leads you to identify aspects of your life that are problematic, then its time to take action. You may want to arrange for a consultation with your primary care provider or a therapist. Or you may just want to tackle a specific problem using what you think would be best.
Either way, the longer you wait to respond the harder it becomes to get your psychological health back where it belongs. Don’t be complacent. Don’t settle for a less fulfilling life by responding with “I can live with this, it’s not that bad.”
Take action. Push back against those things that are holding you down, persist in these efforts, get the support you need, and look forward to enjoying a happier life.
