Depression Symptoms and Signs

Depression is a mood disorder characterized by persistent symptoms that may include hopelessness, sadness, suicidal thoughts, sleep problems, and tiredness.

The various types of depression include

• atypical depression,
• clinical depression (which includes major depression, persistent depressive disorder [dysthymia], seasonal affective disorder, psychotic depression, and bipolar disorder),
• disruptive mood dysregulation disorder,
• postpartum depression,
• premenstrual dysphoric disorder, and
• situational depression.

This article will focus on the signs and symptoms of clinical depression, postpartum depression, and premenstrual dysphoric disorder.

Clinical depression is not something you feel for a day or two before feeling better. In true depressive illnesses, the symptoms last weeks, months, or sometimes years if you don't seek treatment. If you are depressed, you are often unable to perform daily activities. You may not care enough to get out of bed or get dressed, much less work, do errands, or socialize.

• Adults: You may be said to be suffering from a major depressive episode if you have a depressed mood for at least two weeks and have at least five of the following clinical symptoms:
  • Feeling sad or blue
  • Crying spells
  • Loss of interest or pleasure in usual activities
  • Significant increase or decrease in appetite
  • Significant weight loss or weight gain
  • Change in sleep pattern: inability to sleep or excessive sleeping
  • Agitation or irritability
  • Fatigue or loss of energy
  • A tendency to isolate from friends and family
  • Trouble concentrating
  • Feelings of worthlessness or excessive guilt
  • Thoughts of death or suicide

Men and women sometimes show depression differently. Specifically, men are more likely to experience irritability, sleep problems, fatigue, and loss of interest in activities they liked previously as a result of depression, whereas women tend to have overt sadness and feelings of worthlessness and guilt when depressed. For people who tend to suffer from an increase in appetite, tiredness, and the tendency to sleep (atypical depression), carbohydrate craving, sometimes specifically for chocolate, may occur. This has been found to sometimes be an indication that the person tends to suffer from irritability and anxiety in addition to depression.

• Children with depression may also experience the classic symptoms but may exhibit other symptoms as well, including the following:
  • Poor school performance
  • Persistent boredom
  • Frequent complaints of physical symptoms, such as headaches and stomachaches
  • Some of the classic adult symptoms of depression may also be more obvious in children, such as changes in eating or sleeping patterns (Has the child lost or gained weight in recent weeks or months? Does he or she seem more tired than usual?)
  • Symptoms and signs of depression in teens may include more risk-taking behaviors and/or showing less concern for their own safety. Examples of risk-taking behaviors include driving recklessly/at excessive speed, becoming intoxicated with alcohol or other drugs, especially in situations in which they are driving, being in the presence of others who engage in risky behaviors, and engaging in promiscuous or unprotected sex.
• Parents of children with depression report noticing the following behavior changes. If you notice any of these, discuss this with your health-care provider.
  • The child cries more often or more easily.
  • The child's eating habits, sleeping habits, or weight change significantly.
  • The child has unexplained physical complaints (for example, headaches or abdominal pain).
  • The child spends more time alone, away from friends and family.
  • The child actually becomes more "clingy" and may become more dependent on certain relationships, but this is less common than social withdrawal.
  • The child seems to be overly pessimistic or exhibits excessive guilt or feelings of worthlessness.
  • The child expresses thoughts about hurting him or herself or exhibits reckless or other harmful behavior.
• Elderly: While any of the classic symptoms and signs of depression may occur in elderly men and women, other symptoms also may be noted:
  • Diminished ability to think or concentrate
  • Unexplained physical complaints (for example, abdominal pain, changes in bowel habits, or muscle aches)
  • Memory impairment (occurs in about 10% of those with severe depression)

Since elderly individuals tend to show more physical symptoms of depression compared to younger individuals, this puts these individuals at risk for having their depressive symptoms erroneously attributed to medical problems.

For more information, please read our Clinical Depression article.

Signs and symptoms usually appear any time from 24 hours to a few months after delivery.

• If you have these, it is important to see a health care professional, who will look for other conditions that can cause similar symptoms.
  • Sad mood, frequent crying
  • Lack of pleasure or interest in activities that once gave pleasure
  • Sleep disturbance
  • Weight loss
  • Loss of energy
  • Agitation or anxiety
  • Feelings of worthlessness or guilt
  • Trouble concentrating or making decisions
  • Thoughts of death, suicide or homicide of the baby
  • Decreased interest in sex
  • Feelings of rejection
• Physical symptoms such as frequent headaches, chest pain, rapid heartbeat, numbness, shakiness or dizziness, and mild shortness of breath suggest anxiety. Postpartum anxiety disorder is a separate disorder from postpartum depression, but the two often occur together.

For more information, read our Postpartum Depression article.

Symptoms of PMDD can vary significantly among women, but have in common the fact that they occur in relation to the menstrual cycle. The following symptoms have been reported by women suffering from PMDD:

• fatigue,
• mood changes,
• abdominal bloating,
• breast tenderness,
• appetite changes,
• hot flashes,
• palpitations,
• crying spells,
• headache,
• difficulty concentrating or forgetfulness,
• feeling irritable, tense, or overly sensitive to stimuli,
• depression,
• acne, and
• gastrointestinal (stomach and intestine) upset.

For more information, please read our Premenstrual Dysphoric Disorder (PMDD) article.