After months of incredible stress and isolation from the pandemic, it is not surprising that there is an increase in diagnoses of clinical depression. Furthermore, the world has changed drastically over the past few decades, with technology increasingly creating a different social environment and countless new stressors. Fortunately, awareness around mental health is growing, and there is more support and help for depression available -- including this insight into how to tell if you are experiencing depression.
Some people with depression may experience appetite changes and sleep problems. Other aspects of depression may bring on painful physical symptoms, such as headaches.
The National Institute of Mental Health (NIMH) reports that, in 2020, 8.4% of all adults in the United States experienced a major depressive episode at least once in the past year. However, despite its prevalence, depression is not always easy to identify.
Symptoms and causes of depression can vary widely from person to person. Gender may also play an important role in why depression affects a person and what it feels like to them.
How depression feels
One of the common misunderstandings about depression is that it is similar to feeling sad or down.
Although many people with depression feel sadness, it feels much more severe than emotions that come and go in response to life events.
The symptoms of depression can last for months or years and can make it difficult or impossible to carry on with daily life.
It can disrupt careers, relationships, and daily tasks, such as self-care and housework.
Doctors will usually look for symptoms that last for at least 2 weeks as a possible sign of depression.
Depression may feel like:
There is no pleasure or joy in life: A person with depression may not enjoy things they once loved and feel like nothing can make them happy.
Concentration or focus becomes harder: Making decisions, reading, or watching television can seem taxing with depression because people cannot think clearly or follow what is happening.
Everything feels hopeless: Depression may make people feel that there is no way to feel good or happy again.
Self-esteem is often absent: People with depression may feel like they are worthless or a failure at everything. They may dwell on negative events and experiences and cannot see positive qualities in themselves.
Sleeping may be difficult: Falling asleep at night or staying asleep all night can feel nearly impossible for some with depression. A person may wake up early and not be able to go back to sleep. Others may sleep excessively but still wake up feeling tired or unrefreshed, despite the extra hours of sleep.
Energy levels are low to nonexistent: Some people have difficulty getting out of bed or feel exhausted all of the time, even when they are getting enough sleep. They may feel that they are too tired to do simple, daily tasks.
Food may not seem appetizing: Some people with depression feel like they do not want to eat anything and have to force themselves to eat. This can result in weight loss.
Cravings for comfort foods: Although some with depression do not want to eat, others find solace in food. They can overeat and crave comfort foods, leading to weight gain.
Aches and pains may be present: Some people experience headaches, nausea, body aches, and other pains with depression.
Many people mistakenly believe that being depressed is a choice or that they need to have a positive attitude.
Friends and loved ones often get frustrated or do not understand why a person cannot “snap out of it.” They may even say that the person has nothing to be depressed about.
Depression is a real mental illness. Those who live with depression cannot simply decide to stop feeling depressed. Unlike typical sadness or worry, depression can feel all-consuming and hopeless.
Common causes and risk factors
Several factors can cause depression. Though depression may not have one single cause, experts recognize the following as possible risk factors:
Genetics: Depression and other mood disorders can run in families, though family history alone does not mean a person will get depression.
Life events: Major life changes and stressful events may trigger depression. These events include divorce, the death of a loved one, job loss, or financial problems.
Hormonal changes: Research suggests that there is an association between depression with menopause, pregnancy, and premenstrual disorders. However, hormone changes likely act with other factors.
Certain illnesses: Physical illnesses may increase the risk of developing severe depressive illnesses.
Drug and alcohol abuse: Heavy substance use may result from and correlate with depression.
Some medications: Certain prescription medicines may increase the risk of depression. These include some high blood pressure medications, steroids, and some cancer drugs.
Types of depression
This section looks at the different types of depression.
Although it may sound daunting, major or clinical depression is the “standard” type that doctors diagnose. NIMH reports that major depression is among the most common mental health conditions in the US.
People with this condition have experienced five or more symptoms of depression for at least 2 weeks.
Some people experience recurrent bouts of major depression, which can happen monthly, yearly, or a few times in their lives.
Seasonal affective disorder (SAD)
Seasonal affective disorder, or SAD, is a condition in which there is a link between mood changes and the seasons. It is a subcategory of major depressive disorder (MDD).
It is a type of recurring major depression with a seasonal pattern. It is most common during the colder, darker winter months and affects up to 9% of the US population. The prevalence of people with SAD tends to increase the further people live from the equator.
The symptoms of this condition are depression, sleep disturbance, weight gain or loss, and increased alcohol consumption. SAD occurs four times more often in women than in men.
One potential cause of the seasonal affective disorder is believed to be a lack of exposure to natural light in the winter months, although scientists are not completely sure of the cause. This lack of exposure may cause disrupted levels of serotonin and melatonin in the body.
Persistent depressive disorder (PDD)
Formerly known as dysthymia. PDD can last at least 2 years, and some symptoms may be less severe than those of major depressive disorder, but other symptoms can be just as debilitating.
Persistent depressive disorder is less common than major depression, with between 3–6% of the population experiencing it.
Postpartum, or perinatal, depression, is a type of depression that happens during or after a pregnancy.
The “baby blues” describes the typical stress and worry of caring for a newborn in the first 2 weeks after giving birth while postpartum depression interferes with daily life and can persist for weeks or months.
As well as experiencing the common symptoms of depression, a person may:
feel numb or disconnected from the baby
worry about harming the baby
feel guilt about not being a good parent
withdraw from loved ones
cry more often than usual
Research from the Centers for Disease Control and Prevention (CDC) shows that around 1 in 8 women with a recent live birth experience symptoms of postpartum depression.
This type of depression includes episodes of psychosis or delusions in addition to major depression.
Examples include paranoia, difficulty understanding what is real or not, and hallucinations, including seeing, hearing, or smelling things that others cannot perceive because the affected person’s mind is fooling their own senses.
Premenstrual Dysphoric Disorder (PMDD)
PMDD is not a type of depression but a condition that can cause severe depression.
It is a depression distinct from MDD as it links to the menstrual cycle, resulting in significant emotional lability. It also has unique physical symptoms, like breast tenderness and bloating.
It is similar to premenstrual syndrome (PMS) but with more serious effects.
PMDD can cause severe irritability, depression, and anxiety in the week or two leading up to a person’s period. Symptoms usually go away 2–3 days after a person’s period begins.
Depression and women
Research suggests that the pathways to depression may be different for women than for men.
Scientists suggest this may be due to:
differences in experience
A review of studies also found that women’s symptoms of depression were different. The women studied were more likely to have symptoms of fatigue, irritability, and sleep disturbances in addition to their depression.
Other studies indicate that women may be more likely to gain weight than men. This is due to a higher incidence of emotional eating.
Women’s hormonal changes may also influence how and when depression affects them.
Research on this hormonal link has found the following:
Girls with a family history of depression may be more likely to experience the onset of depression at puberty.
Women with depression have more severe symptoms during the premenstrual phase of their cycle, even if they are already taking antidepressants.
Postpartum depression occurs after giving birth and affects 1 in 8 women.
During the menopause transition, a woman’s risk of depression increases.
Depression and men
A study suggests that a high mental strain at work is much more likely to cause psychological distress in men than women. Loneliness and dissatisfaction with work are very strongly associated with psychological distress in both men and women.
Symptoms of depression in men may also be different. A review in Frontiers in Psychiatry found that men were more likely than women to experience anger attacks, aggression, and risk-taking behavior as depression symptoms.
Though it is commonly thought that women suffer from depression more frequently than men, the study suggests that men and women may both equally suffer from depression.
The differences in symptoms and what men report to their doctors may make depression harder to diagnose in men.
Men may more frequently hide or not report traditional symptoms of depression, such as sadness and crying. Some may feel that these symptoms go against society’s idea of what it means to be a man.
When to see a doctor
Those experiencing symptoms of depression should seek assistance from a healthcare provider. Depression can worsen without treatment and affect a person’s quality of life.
A doctor or mental health professional will discuss treatment options to help the person manage their depression and carry on with their daily life.
In severe cases, depression can lead to thoughts of suicide or physically harming oneself.
Any suicidal thoughts or statements about not wanting to live should be taken seriously. In times of crisis, a person should seek help from a hospital emergency department.
Help is also available 24/7 from the 988 Suicide & Crisis Lifeline by calling 988 or 1-800-273-TALK (1-800-273-8255), or by visiting the Lifeline’s website.
Treatments for depression
It is possible to treat depression. Treatments for depression include antidepressants and psychotherapy, of which there are many different types.
However, different people may respond better to different treatment methods. As such, people may wish to speak with a doctor about trying different methods until they find the one most suitable for them.
It may be helpful to remember that many treatments may take some time to reach their full effects, so people may not experience results immediately.
Someone on the road to recovery after receiving a proper diagnosis may find it helps to speak out to loved ones and make healthy changes to their diet and lifestyle.
If this article resonates with you and you feel you are experiencing depression, we can help. MorMindful has licensed and expert providers and professionals who genuinely care and can help you obtain skills and tools to manage depression or other mental health conditions. We are here for you, with therapy that fits you. Visit us at www.MorMindful.com or call us at 561-460-1885 to schedule an appointment.