Depression

Symptoms

If you have depression, you may feel hopeless and sad or stop feeling pleasure from almost everything you do. You may feel down in the dumps, tearful, or discouraged. You may also be irritable or anxious or have low energy levels. The symptoms of depression are often subtle at first. It can be hard to recognize that symptoms may be connected and that you might have depression.

The two most significant symptoms of depression are:³

• Sadness or hopelessness.
• Loss of interest in or pleasure from most daily activities.

Other symptoms include:³

• Losing or gaining weight because of changes in appetite.
• Sleeping too much or not enough.
• Feeling restless and unable to sit still, or feeling that moving takes a great effort.
• Feeling tired all the time.
• Feeling unworthy or guilty without an obvious reason.
• Having problems concentrating, remembering, or making decisions.
• Thinking often about death or suicide.

If you have at least five of these symptoms for 2 weeks or longer, and one of the symptoms is either sadness or loss of interest, you are diagnosed with major depression. But if you have fewer than five symptoms, you may still be depressed and need treatment.

If you have 2 to 4 symptoms for a period of at least 2 years (1 year for a child), you may have a long-term form of depression called dysthymic disorder (dysthymia).³

Many women experience mood changes before menstruation. Physical and emotional premenstrual symptoms that interfere with relationships or responsibilities are known as premenstrual syndrome (PMS). However, women who have emotional and physical premenstrual symptoms that seriously interfere with daily life may have a type of depression known as premenstrual dysphoric disorder (PMDD). For more information see the topic Premenstrual Syndrome (PMS).

Many health professionals see people with general symptoms that may be difficult to link to depression. These symptoms, which commonly occur with depression, include:

• Having headaches and other body aches and pains.
• Having digestive problems, including constipation or diarrhea.
• Losing interest in sex or being unable to perform sexually.
• Feeling anxious or worried without an obvious reason.
• Blaming yourself or others for your depression.
• Not moving or talking for hours.

Other symptoms of depression may include:^{4, 3}

• Overeating and weight gain (rather than loss of appetite).
• Oversleeping (rather than insomnia).
• Increased tearfulness, anger, and generally not feeling well, along with anxiety and tension.
• Sometimes, a feeling of heaviness in the arms and legs.
• Sensitivity to rejection.

Depression is a serious problem for people of any age, and older adults with symptoms of depression should seek treatment right away. Depression in older adults can cause confusion or forgetfulness (although some medications can cause these symptoms as well). Depression has also been identified as a significant risk factor for death in older adults with heart problems.⁵

It is important to recognize the early warning signs of depression so that you can get treatment. If you think you may have depression, take a short quiz to evaluate your symptoms:

Interactive Tool: Are You Depressed?

The symptoms of depression are often hard to notice at first. It can be hard to recognize that symptoms may be connected and that you might have depression. Symptoms of depression in children and teens are sometimes different from adult symptoms, which can make their depression more difficult to diagnose and treat. For more information, see the topic Depression in Children and Teens.

Depression can lead to suicide. The warning signs of suicide change with age.

• Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.
• Warning signs of suicide in adults may include alcohol or substance abuse, recent job loss, or divorce.
• Warning signs of suicide in older adults may include the recent death of a partner or diagnosis of a life-limiting illness.

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Author:	Jeannette Curtis Douglas Dana Ralph Poore	Last Updated: May 14, 2007
Medical Review:	Martin Gabica, MD - Family Medicine Andrew Swan, MD, CCFP, FCFP - Family Medicine Lisa S. Weinstock, MD - Psychiatry
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