Depression Symptoms: Signs to Notice and When to Get Help

Depression does not always look like sadness. It can show up in your thoughts, your body and your behaviour, and it often builds slowly. This article lists the symptoms described by the UK's National Health Service (NHS), MedlinePlus and the World Health Organization (WHO), and explains when to ask for help.

Feelings and thoughts

According to the NHS, psychological symptoms can include:

• a low mood or sadness that does not lift
• feeling hopeless or helpless
• low self-esteem and frequent tearfulness
• guilt
• irritability and impatience with others
• little motivation or interest in things
• difficulty making decisions
• little or no enjoyment of life
• anxiety or worry
• thoughts of harming yourself or ending your life

Changes in the body

The NHS says physical symptoms can include moving or speaking more slowly than usual, changes in appetite or weight, constipation, unexplained aches and pains, low energy, reduced sex drive and sleep problems such as trouble falling asleep or waking very early. MedlinePlus adds headaches and digestive problems to the list.

Changes in behaviour

Social symptoms described by the NHS include avoiding friends, taking part in fewer activities, neglecting hobbies and having difficulties at home, at work or in family life. MedlinePlus also mentions increased alcohol or drug use and withdrawing from family and friends.

Things worth knowing

• Few people have every symptom, according to the NHS.
• Depression often develops gradually, and many people do not realise they are unwell. A friend or family member may notice first.
• Doctors describe depression as mild, moderate or severe, depending on how often and how strongly symptoms occur, how long they last and how much they affect daily life.
• Some people with severe depression also have psychosis, which can include hallucinations or false beliefs.
• Teenagers may act out or seem unusually sleepy rather than look sad, according to MedlinePlus. Symptoms in older adults may be less obvious.
• Grief is a normal response to loss and usually eases over time. The NHS says suicidal thoughts, psychosis and constant hopelessness or guilt are less typical of grief.

How doctors recognise depression

MedlinePlus says diagnosis generally requires symptoms most of the day, nearly every day, for at least two weeks, including low mood or loss of interest. A health professional may take a medical history, do a physical exam and a mental health evaluation, and may run tests to rule out other causes such as thyroid problems or the effects of medicines. The WHO notes that depression can be mild, moderate or severe and can come back after a first episode.

When to see a doctor

The NHS advises seeing a doctor if you have symptoms of depression most of the day, every day, for more than two weeks. Low mood can improve after a short time, but if it does not, please do not wait. Early help can make symptoms easier to manage.

Go to a doctor sooner if:

• your low mood is making it hard to work, study or look after yourself
• you are using alcohol or drugs to cope
• you are worried about a friend or family member who seems to be struggling

If you are thinking about harming yourself

Thoughts of ending your life are a sign that you need support now, not a sign of weakness. Tell someone you trust, contact a doctor or counsellor, or call a crisis help line in your area. Help lines exist in both India and the United States, and a doctor or local health service can tell you which are available. Do not stay alone with these thoughts.

This article is for general education and is not a diagnosis.

In an emergency, call your local emergency number (112 in India, 911 in the United States).