Symptoms of Clinical Depression

The two "core" depression symptoms are low mood and loss of interest in activities. In addition to those, people may also experience changes in appetite, trouble sleeping, tiredness, feelings of guilt, trouble concentrating, or thoughts of death.

While only a qualified medical or mental health provider can diagnose depression, there are certain warning signs that can help you identify whether you or someone you care about may be depressed.

And sometimes, what you think are depression symptoms aren't really caused by depression. Substance use issues, medical problems, medication side effects, or other mental health conditions may produce symptoms that look similar to depression. 

Depression Symptoms and Signs

The DSM-5 recognizes several different types of depressive disorders. The two most common types include clinical depression, also referred to as major depressive disorder (MDD), and persistent depressive disorder (PDD). People with PDD often experience the same type of symptoms as those with MDD, but they are typically less severe and last longer.

There are over 1,000 different combinations of symptoms that could lead to an MDD diagnosis. If you recognize signs that you or someone you may know be depressed, professional help may be warranted. Depression is very treatable with medication, talk therapy, or a combination of the two.

Depressed Mood

Depressed mood is consistent with both major depression and persistent depressive disorder. In major depression, a person feels depressed most of the day. Children or adolescents, on the other hand, may appear more irritable than sad.

People with PDD experience a depressed mood more days than not for at least two years. As with MDD, children with PDD may appear more irritable than depressed. However, for a PDD diagnosis, they must experience this for at least one year.

Decreased Interest

The second core symptom of major depressive disorder is a decreased interest or pleasure in things that you once enjoyed, also known as anhedonia. (Sidenote: The DSM-5 does not explicitly use the term anhedonia, but it is captured in the main criteria as “decreased interest and pleasure in most activities most of the day.")

Symptoms of anhedonia can be divided into the following two categories:

• Physical anhedonia: Those with physical anhedonia are less able to experience sensory pleasures. For example, foods you once enjoyed now taste bland. Sex may not feel pleasurable or you may lose interest in it.
• Social anhedonia: People with social anhedonia tend to experience decreased pleasure from social situations. For example, someone who used to love meeting up with their friends for brunch is now indifferent to attending these get-togethers or returning phone calls.

Changes in Appetite

Another common sign of depression is a change in how much you eat. For some people, this means a loss of appetite. You may have to force yourself to eat because eating has completely lost its appeal. Or maybe you simply don't have the energy to prepare meals.

Feelings of sadness or worthlessness can also lead to overeating. In these instances, food is typically being used as a coping mechanism. You may find that food elevates your mood, but when the temporary pleasure of eating is gone, you reach for more food to suppress your feelings.

One study followed thousands of men and women for a period of 11 years. Those who reported feelings of depression and/or anxiety during that time had larger changes in their weight and a greater chance of being diagnosed as obese.

Sleep Disturbances

Sleep disturbance is present in as many as 90% of people with depression. It can take the form of either difficulty sleeping (insomnia) or sleeping excessively (hypersomnia).

Insomnia is the most common and is estimated to occur in approximately 80% of people with depression. With insomnia, people may have trouble falling asleep or staying asleep. Less frequently, in about 15% to 25% of cases, people with depression find themselves sleeping too much. This is more likely in younger people.

Sleep issues can be both a cause of depression and a symptom of depression. Thus, improving your ability to sleep is important for making you feel better now and reducing your likelihood of a future depression relapse.

Psychomotor Disturbances

Psychomotor skills are skills where movement and thinking are combined. This includes things like balance and coordination, such as when picking a coin up off the floor or threading a needle.

Psychomotor disturbance is typically classified as either psychomotor agitation or psychomotor retardation.

• Psychomotor agitation: This involves excessive motor activity associated with a feeling of inner restlessness or tension. The activity is usually purposeless and repetitive and consists of behaviors such as pacing, fidgeting, hand-wringing, and an inability to sit still.
• Psychomotor retardation: The opposite of psychomotor agitation, this involves slowed speech, thinking, and body movements. This can hamper everyday life in many ways, from signing your name to getting out of bed to even keeping up in conversation.

Fatigue

Chronic feelings of fatigue can be a symptom of both persistent depressive disorder and major depressive disorder. This loss of energy, which can equate to feeling tired most if not all of the time, can interfere with your ability to function normally. 

Maybe you don't feel well enough to take care of your children or tend to your housework. Perhaps the fatigue is enough that you need to call in sick at work a lot because you can't get out of bed. The fatigue that comes with clinical depression can sometimes feel overwhelming.

Feelings of Worthlessness or Guilt

Depression can put a negative spin on everything, including the way you see yourself. You may think of yourself in unappealing and unrealistic ways, such as feeling as if you are worthless.

You may also find that have trouble letting a past mistake go, resulting in feelings of guilt. You might become preoccupied with these "failures," personalize trivial events, or believe that minor mistakes are proof of your inadequacy.

An example of this would be a relationship that ended after you had a fight with your partner and said some not-so-pleasant things. This could lead you to consider yourself the cause of the breakup while potentially ignoring other issues in your relationship, such as a partner who is abusive or a poor communicator.

Excessive, inappropriate guilt and feelings of worthlessness are common symptoms of major depressive disorder. In some cases, the feeling of guilt may be so severe that it leads to delusion, which is an inability to see things for what they really are, therefore holding onto false beliefs.

Difficulty Concentrating

Both major depressive disorder and persistent depressive disorder involve difficulty concentrating and making decisions. People with depression may recognize this in themselves, or others around them may notice that they're struggling to think clearly. 

This effect has been found especially in older adults. They may notice that they're having trouble processing thoughts quickly and attribute their symptoms to cognitive decline.

Recurrent Thoughts of Death

Recurrent thoughts of death that go beyond the fear of dying are associated with major depressive disorder. An individual with major depression may think about suicide, make a suicide attempt, or create a specific plan to kill themselves. 

The Centers for Disease Control and Prevention reports that more than nine million adult Americans have suicidal thoughts annually. Additionally, these thoughts are highest for those between the ages of 18 and 25.

Depression Symptoms by Age

While low mood and loss of interest are common in people with depression across the board, there are other depression symptoms that are often specific to a certain age group.

Depression Symptoms in Children

Depression in children will likely manifest as a loss of interest in activities and socializing with family and friends. Anxiety often co-occurs with depression in children. For instance, your child might show signs of fear or panic during an everyday situation (one that perhaps hasn't worried them before).

Many times, depression symptoms in children are confused as a normal part of growing up, or "hormonal changes." However, it's best to speak to a healthcare provider if your child shows any signs of depression.

Depression Symptoms in Teens

Depression in teens often manifests as self-blame, anger, hopelessness, and a negative outlook on their future.

You will likely notice changes in their academic performance—they may even skip school altogether. Teens also may start self-harming, using drugs or alcohol, changing their appearance, and/or neglecting their personal hygiene.

While it's true that teens go through many transitions and, oftentimes, emotional ups and downs, it's important to speak to your teen if you feel they're depressed. Depression symptoms will be persistent and your teen will feel overwhelmed or unable to handle life.

Depression Symptoms in Older Adults

Sadness may not be the primary symptom of depression in older adults. Older adults may experience emotional numbness instead. It can also be difficult to know whether an older adult is depressed, as they may be less likely to talk about their feelings.

In other cases, loved ones or healthcare providers may mistake an older adult's depression symptoms for a reaction to life's changes. Unfortunately, however, older adults are at an increased risk of developing depression—their symptoms should be taken seriously so they can receive proper treatment.

Depression Complications and Comorbidities

Clinical depression is one of the most common complications reported by people with chronic diseases and conditions, including heart disease, cancer, diabetes, obesity, and arthritis. Often, the illness triggers depression, especially in people who are biologically vulnerable to the disorder. 

It's not uncommon for people with depression to live with two disorders or illnesses at once. This is known as a comorbidity. For instance, someone with chronic pain may become depressed (and vice versa).

Similarly, substance use disorders and depression often coexist. Someone with depression may turn to alcohol to self-medicate, and alcohol use disorder can also cause someone to experience symptoms of depression.

The following are some common co-occurring conditions in people with clinical depression:

• Anxiety disorders
• Attention deficient and hyperactivity disorder (ADHD)
• Autism spectrum disorders
• Chronic pain
• Eating disorders and body dysmorphia
• Fibromyalgia 
• Migraines
• Multiple sclerosis (MS)
• Irritable bowel syndrome (IBS)
• Obsessive-compulsive disorder (OCD)
• Phobias
• Post-traumatic stress disorder (PTSD)
• Sleep disorders
• Substance use disorders

The Truth About Depression Misconceptions

Despite ongoing efforts by researchers, medical professionals, and patients to raise awareness, stigma continues to be a reality for people living with depression. This is partly because of the many damaging misconceptions that exist, which can prevent someone from recognizing depression symptoms and signs, and from getting the help they need.

Here, we debunk these misconceptions.

You Can't Just "Get Over It"

Being diagnosed with depression does not mean that you are being "crazy" or weak. Nor is it your fault or something you can simply snap out of on your own.

Depression is caused by a complex mix of factors, including an imbalance of neurotransmitters (mood-regulating chemicals) in your brain.

Just like people diagnosed with diabetes can’t will their pancreas to produce more insulin, you can’t “try harder” to overcome depression. It’s a real disease that requires proper treatment. 

Depression Doesn't Only Cause Mental Symptoms

Depression certainly includes mental symptoms like sadness, anxiety, irritability, and hopelessness. But physical symptoms are also a reality for many people living with depression.

This can include fatigue, body aches, headaches, and digestive troubles. People with depression can also have a weaker immune system, potentially putting them at greater risk of catching the latest bug or virus.

Anyone Can Become Depressed

Depression can occur in people of any race, ethnic, or economic group, and at any age. Women are almost twice as likely as men to be diagnosed with depression, but the jury is still out on how much of this is due to women reporting and seeking treatment more often than men.

One study notes that depression symptoms in women may be more obvious than depression symptoms in men. For instance, women may be more likely to show typical signs of depression such as crying, whereas men may not cry as openly.

Children and adolescents can also be at risk for depression. Unfortunately, many children with depression go untreated because adults don't recognize the warning signs, which are often different when compared to adults.

Depression Is Treatable

Although depression can make you feel hopeless, there is hope for those who seek a diagnosis and comply with treatment. In fact, depression is one of the most treatable types of mental illness, with 80% to 90% percent of people responding to treatment.

Treatment doesn't just involve taking medication for the rest of your life. Therapy and lifestyle modifications also play a key role in managing symptoms and preventing relapse.

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A Word From Verywell

One of the dangers of depression is that its symptoms can keep people from seeking help. But if you notice these symptoms in yourself or someone you love, don't hesitate to talk to a mental health provider. Depression can make it hard to enjoy life fully, but you don't have to suffer needlessly. Effective help is available.