Top 10 Signs and Symptoms of Depression
Table of Contents
Dr. Marco M. Zahedi
Medical Director, Compassion Recovery Center
Dr. Michael Majeski
Licensed Psychologist (LP), Compassion Recovery Center
Depression is a general term for a series of mental health disorders as well as for symptoms of mental health disorders. For most of us, depression comes and goes. For others, with chronic depression, it can be ongoing and may never fully go away. Most of us also think of depression as a disorder where you feel sad all the time. At the same time, that isn’t necessarily true, because clinical depression can come with symptoms of anxiety, simply feeling down, or feeling out of place.
Understanding the symptoms of depression will help you to recognize when you might quality for a depression diagnosis. However, it’s important to keep in mind that if you feel things are not right or things are off, it’s a good idea to talk to your doctor or a mental health professional anyway. You don’t have to qualify for “depression” to need help and there are many things that can go wrong with your mental health.
Top 10 Signs and Symptoms of Depression
The following 10 signs and symptoms of depression are based on the DSM-5 diagnostics. For the DSM-5, you need 5 or more of the following symptoms with depressed mood and loss of interest/pleasure in activities to qualify for a diagnosis. In addition, you’ll need symptoms to cause significant distress or impairment to get a diagnosis. However, you can get treatment and help without that qualification.
1. Depressed Mood
A depressed mood means that you feel down, sad, empty, hopeless, or wrong. In some cases, you might not have the vocabulary to put words to these feelings. From the outside this can look like not doing things, it can look like irritability, it can look like tearfulness. It can also look like being lazy or staying in bed, refusing to do things, preferring to do nothing, etc.
Most people will suffer depressive episodes, and these qualify as “depression”. Even if your depressive episodes only last a few weeks, getting treatment can help you to get in control and recover more quickly – meaning you have minimal impacts to your quality of life. In fact, in 2023, an estimated 13.5 percent of adolescents (aged 12-17) and 8.5% of adults or almost 1 in 10, suffered from severe depressive episodes, meaning that depression prevented them from living or enjoying life as usual.
2. Loss of Interest/Pleasure
Depression is majorly characterized by a loss of interest or pleasure in things you’re doing, even if you previously enjoyed them. That can be eating, relationships, TV, work, hobbies, friends. Depression means your brain stops producing the needed quantities of serotonin (pleasure at doing things) and dopamine (motivation to do things) meaning that for many of us, motivation and feeling good after doing things simply drops. That can result in not cleaning, not investing in personal hygiene, dropping hobbies, dropping classes, slacking at work, not talking to friends, not feeling good about things like hugs, losing interest in sex or food … or in binging on high reward things like alcohol, sex, food, or gambling, because other things aren’t making you feel good anymore.
This loss of pleasure and interest is called anhedonia and it’s the most common symptom of depression.
3. Weight Changes
If you lose or gain weight rapidly, it’s usually a bad sign for your mental health. Here, most doctors will pay attention to weight changes of +/- 5% within a month, especially if you are not deliberately dieting or do not have an eating disorder. Here, weight changes can be caused by binge eating because nothing else causes pleasure or by loss of interest in food. Both are very common and both can be symptoms of depression.
4. Sleeping Problems
Depression can cause major problems with falling asleep, staying asleep, quality of sleep, and with waking up. Most people either end up sleeping not enough or too much as a side-effect of depression. In other cases, it means restless sleep, not feeling rested after sleep, or vivid nightmares. If you have sleep problems more nights than not, it may be a symptom of depression but you should talk to your doctor either way.
5. Agitation or Lethargy
Depression causes psychomotor side-effects, meaning that people will either be restless or they will be delayed in reaction. That can mean they can’t stop moving, they pace, they shake their legs, their fidget, they get impatient. It can also mean they have delayed reactions and for example, might be unable to catch things, might be slow at reacting in traffic, or might respond very slowly to seemingly normal physical interaction. Both are signs that the serotonin balance in the brain is off, resulting in difficulties processing motor reactions.
6. Fatigue
It’s normal to be tired after work or to have a dip in the middle of the day. But, if you’re always tired, you’re struggling to have energy to do anything, you don’t feel like you’re getting enough sleep, or you always feel out of energy, it’s a sign you should be talking to your doctor. Here, fatigue can have a lot of overlaps with loss of interest in things. It may be impossible to tell what you’re not doing because you don’t have interest and what you’re not doing because you’re tired and have no energy. That’s okay and things don’t have to be clear. However, you should be able to assess energy levels over the day and recognize when they are too low.
7. Feelings of Worthlessness or Guilt
Most people will feel some guilt or feelings of not being good enough from time to time. If those feelings start to dominate your thoughts and who you are as a person, it’s likely a sign that something is wrong. Feelings of worthlessness and guilt can be based on something, they can be based on low self-esteem rather than something that happened, and they can be pathological, meaning that they become most of what you think about. This is often made worse by the fact that depression is literally being sick, which means you can’t uphold responsibilities, take care of people, or be there for people. That can be a lot to deal with and can mean you have trouble facing yourself.
8. Concentration Problems
Many people describe depression as “living in a fog”. Usually depression results in difficulty concentrating, making decisions, or forming opinions quickly. From the outside, it often looks like indecisiveness, but it can feel like your mind moves sluggishly and takes a long time to sharpen to an idea or decision.
9. Suicidal Ideation
Suicidal ideation means having thoughts about death, making plans to die, having intrusive thoughts about killing yourself. It’s more than being afraid of death, it’s actively wanting to die, even if those feelings don’t stick around. For some people, it can manifest as fleeting urges to do things like step in front of a bus. For others, it’s a more pressing and ongoing feeling of not wanting to live anymore that can result in making suicide plans or attempts. These feelings should always be taken seriously, even if you don’t think you qualify for depression, because mental health help can help you overcome these thoughts.
10. Feeling Things are Off
Not everyone has the emotional literacy to describe how they feel. That’s okay. Feeling things aren’t right, feeling you aren’t right, or feeling that things are “off” is more than enough reason to go to the doctor. Your doctor can help you talk about things and can work with you to get you the mental health help you need, even if you don’t know what you need.
Getting Help
It doesn’t matter if what you’re experiencing is depression or not, if you’re struggling with mental health, it’s important to get help. That’s also true if someone you love is struggling with things like personal hygiene, doing things they love, or enjoying life. Depression is extremely common and most of us will experience some form of depression during our lifetime. However, if it lasts for more than two weeks, you can and should look for mental health help, counseling, and therapy, because it will help you to get symptoms under control and get your life back.
