According to the National Alliance on Mental Illness, approximately 18.5% of adults in the United States experience mental illness every year. That's a significant portion of our population—one in five people—yet the stigma and misunderstanding that surround mental health remain. If you are feeling symptoms of depression, talk to your doctor to learn more about treatment options.
We throw around the phrase "I'm depressed" to describe a stressful situation at work or the end of a relationship. But just like the word "crazy," for which the etymology has shifted over time, depression can often be mistaken for a way to characterise an emotion rather than a mental health issue. It trivialises those who suffer from the disorder, a real chemical imbalance that creates negative and difficult circumstances beyond our control.
Because it all can seem convoluted, the definitions melting into each other, it's often challenging to know when to seek help. "Treatment should be sought for depression when the symptoms are interfering with the quality of your life," says therapist and mental health expert Scott Dehorty, LCSW-C. "Depression is treatable, and there is no reason to suffer in silence."
To get a better understanding of the hallmark symptoms of depression, I reached out to two experts for their opinions and advice. Below, they detail 10 different, common warning signs to look out for. Keep reading for their thoughts.
1. Disturbed Sleep
"This is due to depression's sidekick: anxiety," explains Sanam Hafeez Psy.D., an NYC-based licensed clinical psychologist. "Some people when depressed are also anxious. This is when you start to struggle with falling or staying asleep. You may wake up in the night crying or panicked. If this persists and you find lack of sleep interfering with your ability to function during the day, seek help."
"Sleep is often disrupted during a depressive episode," adds Dehorty. "It can come in the form of insomnia or hypersomnia. Both increase the symptoms of depression because they leave one to feel fatigued and lethargic. It would be a big misstep to treat this as a sleep disorder and miss the depression diagnosis."
"About 80% of those experiencing depression have feelings of anxiety," notes Dehorty. "Anxiety can manifest in several ways: It can be an inner restlessness, increased concerns or worries about issues which are outside of your control, or difficulty being around groups of people. This can be treated as different forms of anxiety disorders when, in fact, they are symptoms of a major depressive disorder."
"You don't want to get out of bed. Your thoughts are of hopelessness and you even feel sick. Toxic, defeating thoughts that are chronic won't lead to a jump-out-of-bed, ready-to-take-on-the-day kind of attitude," says Hafeez. "When you prefer to stay in bed and can't seem to feel energised, seek help."
4. Loss of Concentration and Cognition
"When depressed, the brain just doesn't fire on all cylinders," explains Dehorty. "Memory, retention, and word-finding can be difficult. This presents several difficulties and frustrations. It can lead to decreased work performance, which can bring about feels of lower self-worth, and it can decrease pleasure in activities you used to find joy in."
5. You're Alone, a Lot
"You prefer to withdraw and be by yourself so you can ruminate," says Hafeez. "Some who struggle with depression tend to alienate themselves. If you notice the last time you interacted with someone was more than a few days ago and you feel like you're on your own little island unable to talk to anyone, seek help."
6. A Change in Appetite
"A change in appetite is a common symptom of depression," notes Dehorty. "This can take the form of overeating or under-eating. Both are problematic, as overeating can bring feelings of shame and physical discomfort, and under-eating starves the brain—which is already struggling."
7. You're Looking to Escape
"People who struggle with depression often try to play chemist and use alcohol or drugs to manipulate how they feel," notes Hafeez. "You think going out with friends will lift your spirits. However, alcohol is a depressant. This is why when you drink excessively, you may start crying and recalling painful memories. Those who use stimulants to improve their mood crash hard when they come down and then need the drug to soothe them again. Painkillers are numbing, so if you're looking to escape pain, it's easy to become addicted. If you're noticing you're turning to drugs to soothe depression, seek help."
8. Loss of Pleasure
"A lack of pleasure in activities once found pleasurable is a hallmark of depression," notes Dehorty. "This is typically one of the first and most distinguishable symptoms. If there was an activity that once added joy and value to your life and now just doesn't do anything for you—that very well may be due to depression."
"Another hallmark of depression is the feeling that you shouldn't be feeling this way; you should be better. This differs from most other diagnoses and is a good differentiator for depression. You feel like you can't get out of bed to face the day, and you feel guilty for feeling that way."
10. Pain and Discomfort
"Depression manifests physically as well," explains Dehorty. "During a depressive episode, you tend to feel your physical body differently. Pain sensations increase, leading to more discomfort, aches, and new onset physical pains. The physical issues need to be examined, but it could be an ongoing problem that was once filtered out by the brain. We are consistently feeling aches and pains, but the brain filters them, and we don't even notice most. With depression, we feel everything, and it becomes bothersome."
"Any of these symptoms can occur with any of us at any given time, and that can be completely normal," notes Lindsay Henderson, Psy.D., a psychologist who treats patients virtually via the telehealth app LiveHealth Online. "But if you are experiencing more and more of these symptoms, or they are growing in severity, start paying a bit more attention to how you are feeling overall. If you notice that these symptoms are impacting your overall functioning, it may be time to seek professional help. The good news is that help can come in many forms and individuals have options for how they address their mental health."
We know that things like social activity, healthy eating, good sleep, and regular exercise all directly contribute to a healthier mood. If you notice yourself experiencing symptoms of depression, take a look at your daily routines and overall physical health to identify areas that can improve. "It can be beneficial to engage in therapy and talk with a mental health professional about what you are experiencing," says Henderson. "Not only can a therapist help assess and diagnose the experiences you may be having, but they can also offer tips and tools to better understand, manage, and cope with the many complex emotions you feel."
Here's the thing: We know the idea of finding a therapist and getting to appointments can be overwhelming. Online therapy can be a wonderful way to break down many of the barriers that can get in the way of accessing therapy, as the appointment can take place wherever you feel most comfortable. Talk to your doctor to make the best plan for you and seek out an appointment with a psychiatrist. Your doctor may talk with you about the pros and cons of taking medication, which can be particularly helpful with depression and anxiety, but not for everyone. It's best to talk first with a professional about your options before making any decisions.