Signs of Depression

Have you ever been worried that a friend or family member may be struggling with depression?

Were you left wondering about the signs of depression and when to be concerned?

Undoubtedly, knowing something about the signs of depression makes it easier to recognize when someone in your life may need help.

Firstly, let’s get the vocabulary down pat. “Signs” refer to what others observe. “Symptoms” is what the person with the condition experiences. Symptoms may be entirely hidden from other people, while signs are detectable (although they too can be subtle).

Signs of depression can be physical, mental, or functional.

Physical Signs of Depression

One physical sign of depression is unintentional weight loss. This is different from weight loss due to deliberate efforts via dieting or lifestyle change. You might notice that the person is picking at their food or uncharacteristically tells you that they are “not hungry” despite being presented with their favorite foods.

Other physical signs of depression include very slow movements (think of someone slowly shuffling through the house) and reduced speed of talking. The official term for those types of behaviour is “psychomotor retardation.”

In contrast, some people with depression are more fidgety and have a hard time sitting down and settling. This type of restlessness is called “psychomotor agitation” which can be a very uncomfortable experience for the person struggling with depression. It can even be difficult for the person watching from the outside.

Lack of energy is a classic complaint from people who have depression. Again, this may or may not be observable. Some people do their best to “push through” the fatigue and hide their profound lack of energy. But, in other cases, you may be able to notice a lack of “get up and go” in the person struggling with low mood.

Sleep can be a rare event for some people with depression. Others find themselves sleeping their day away. If you live with someone in either of those situations, you may be able to observe a change to their baseline sleeping pattern.

Perhaps it’s your partner who is suddenly tossing and turning all night or doesn’t even bother coming to bed until the wee hours of the morning because “there’s no point. I know I won’t fall asleep.” Alternatively, maybe your roommate is suddenly spending the day on the couch rather than being out in the world.

Observable changes in sleep patterns can definitely be among the signs of depression.

mental-signs-of-depression

Mental Signs of Depression

Mental changes due to depression, may or may not be obvious others.

For example, depression can interfere with concentration and the ability to make decisions. If your friend or family member suddenly seems to be struggling with their focus, their memory, or their ability to plan and follow-through, this would be consistent with depression (although it is also consistent with a host of other problems).

Signs of depression can include changes to facial expression.

In certain types of depression, the person may present as emotionally very flat. What used to bring a smile to their face, doesn’t elicit much of a response. The range of emotions that you notice in your friend or family can shrink. They may be primarily sad, irritable, or blank – the smiles and laughter you are used to, have disappeared.

However, there is a variant of depression, called atypical depression, in which the mood is still reactive. What this means is that positive events can still bring a smile to the person’s face. The range of responsiveness to happy events underscores how differently depression can present from person to person. Further, for people who attempt to “smile through the tears”, there can sometimes be very little evidence of depression as they do their best to hide it from those in their life.

The thought content of people with depression can be dominated by negative self-judgments, preoccupation with death, dying, and suicide and a selective focus on all that is wrong with their life. Again, for those who keep their cards close to their chest, you may have no idea what thoughts are running through their heads. In some cases, people do share their thoughts, and the bleakness and despair that they disclose is another sign of depression.

If your loved one is comfortable enough to share their experience with you, you may come to understand their distress, from which it feels like there is no escape.

functional-signs-of-depression

Functional Signs of Depression

A common finding in depression is “functional impairment.”

This term refers to changes in how the person performs in their job or at school, how they behave in their relationships, and how they manage their personal care such as showering, making meals, exercising, etc.  You may notice that your friend or family member is missing work more than usual – perhaps they have even lost their job. If the person you care about has been a consistent presence at the gym, family dinners, or nights out with friends, you may notice that all these activities come to an end.

signs-of-depression-school

Functional impairment can result in signs of depression, such as disheveled appearance, social withdrawal, and dropping out of school.

An upsurge in habits that provide short-term relief, but at a considerable cost, can be a sign of depression. In an effort to cope with their distress, you may notice that the person you care for is suddenly eating more, drinking more alcohol, smoking more, or using drugs – prescription, over-the-counter, or street drugs. Self-medicating is a relatively common sign of depression. Sometimes the self-medicating doesn’t involve a substance but a maladaptive coping mechanism like gambling away their money or spending much of their time glued to their video game console.

Reach Out if you are Worried

Unfortunately, depression and other mental health conditions can sometimes interfere with insight. In other words, it may be obvious to you that your friend or family member is struggling with depression, but they can’t see it themselves. It can be hard as the “outsider” to watch as someone demonstrate clear signs of depression and yet rejects help because “there’s nothing wrong.”

Depression can be a chameleon. It can hide itself behind an “everything is fine” mask. However, in many cases, signs of depression are more obvious. By being aware of some of these signs, you have the opportunity to intervene sooner rather than later, when you realize a friend or family member is struggling.

Even If it isn’t depression, the act of reaching out to the person you care about is valuable in and of itself. It opens the door to further dialogue about what is behind the changes you have noticed. That dialogue may be the first step towards seeking life-changing treatment and support.

Resources:

  • Corfield EC, Martin NG, Nyholt DR. Co-occurrence and symptomatology of fatigue and depression. Compr Psychiatry. 2016;71:1-10. doi:10.1016/j.comppsych.2016.08.004
  • Culpepper L. Functional impairment and improvement in depression. J Clin Psychiatry. 2016;77(1):e35. doi:10.4088/JCP.13097tx2c
  • Łojko D, Buzuk G, Owecki M, Ruchała M, Rybakowski JK. Atypical features in depression: Association with obesity and bipolar disorder. J Affect Disord. 2015;185:76-80. doi:10.1016/j.jad.2015.06.020
  • Lopez R, Barateau L, Evangelista E, Dauvilliers Y. Depression and Hypersomnia: A Complex Association. Sleep Med Clin. 2017;12(3):395-405. doi:10.1016/j.jsmc.2017.03.016
  • McHugh RK, Weiss RD. Alcohol Use Disorder and Depressive Disorders. Alcohol Res. 2019;40(1):arcr.v40.1.01. Published 2019 Jan 1. doi:10.35946/arcr.v40.1.01