Signs and Symptoms of Depression: Not Just Sadness

by: Danling Chen 

It is a common misassumption that being depressed is simply “feeling sad all of the time.” This misconception, in turn, often spurs the question: Everyone feels unhappy once in a while, won’t depressed people “snap out of it” eventually?  

Major Depressive Disorder (MDD) is different. Depression is a mood disorder featuring a variety of symptoms, and it is a vast oversimplification to equate it to mere sadness. There are two major classes of depression: unipolar depression, which is identified by continuous low mood, and manic depression or bipolar disorder, which is characterized by dramatic lows and highs in mood.

Normally, life is characterized by a range of emotions cycling through at a steady pace. But for clinically depressed individuals, life does not smoothly transition from one emotional state to another, as it does for most people.

In unipolar depression, there are no blissful highs to counterbalance sad lows, no periods of euphoria followed by episodes of melancholy. This type of depression, is, to say, a “one-sided coin”: one low mood, one depressed emotion, almost all of the time.

In manic depression or bipolar disorder, states of mania and depression alternate. Individuals will experience periods of manic mood (signaled by elevated energy, intense elation, delusions of grandiosity, and racing speech and thinking), followed by periods of depression and low mood.

In both types of depression, the perpetual “sadness” of the depressed individual is patently distinct from regular sadness. The sadness of depression is more aptly illustrated as an unyielding funk of demotivation, listlessness, and lethargy.

This is the main distinguishing symptom of depression: a perpetual or prolonged period of negative mood. People with depression will often describe themselves as feeling “empty,” as if they are devoid of passion, purpose, and motivation. This state of “hopelessness” will manifest in their speech and behavior, and inevitably go on to interfere with their daily living.

Other symptoms of depression will vary according to the individual. Due to the social stigma surrounding the illness, many people will feel guilt or self-loathing for their self-perceived weakness or for their unrealized potential of achievement in life. They may feel overwhelmingly pessimistic at their chances for recovery, or they may become largely indifferent to their health. They may feel consistently numb and display no exterior emotion, or they may experience occasional bouts of unhappiness, accompanied by crying spells.

In general, individuals with depression will exhibit some common social behaviors. They may lose interest in hobbies which previously brought them pleasure, and stop taking the initiative in their career or family life. They may cease to maintain their appearance or cleanliness. They may withdraw from social settings, and grow increasingly isolated. They may have trouble concentrating at school or at work, and their grades or job performance may suffer as a result.

Depression and anxiety, furthermore, go hand in hand. According to Cameron (2002), the prevalence of comorbid, or simultaneous, anxiety disorder and major depressive disorder may be as high as 60%. This may explain why in addition to sad mood, some depressed individuals will also display irritability, agitation, shortened temper, and persistent worry.

While depression is regarded as a mental illness, it is often accompanied by physical symptoms. Individuals with depression may experience changes in appetite and body weight, and changes in sleep (such as insomnia or excessive sleeping). Loss of energy and chronic fatigue is extremely common. In non-Western nations particularly, depressed patients may also report somatic symptoms like back pain, headache, and constipation, which have no discernible physical root.

The most critical and dangerous symptom of clinical depression is recurrent suicidal thinking. Sometimes, individuals with severe depression will contemplate taking their own life to end their pain. They are often conflicted about suicide, and do not seek death, but rather a means of relieving their overwhelming suffering. These individuals require immediate support from their loved ones and treatment from medical professionals.

It is important to note that there are different intensities and durations of depression, and that there is no “one size fits all” set of symptoms. The internal turmoil of the depressed mind may not always manifest in external behavior, which only emphasizes the necessity for approaching all people with compassion and sensitivity. While the symptoms of depression are not lethal in and of themselves, if left untreated, they may have devastating consequences.

References:

Cameron, O. G. (n.d.). Understanding Comorbid Depression and Anxiety | Psychiatric Times. Psychiatric Times | Psychiatric Times. Retrieved October 18, 2013, from http://www.psychiatrictimes.com/articles/understanding-comorbid-depression-and-anxiety

Major depression - National Library of Medicine - PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved October 18, 2013, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001941/

Clinic Staff. (n.d.). Depression (major depression): Symptoms - MayoClinic.com. Mayo Clinic. Retrieved October 18, 2013, from http://www.mayoclinic.com/health/depression/DS00175/DSECTION=symptoms

NIMH · Signs and Symptoms of Depression. (n.d.). NIMH. Retrieved October 18, 2013, from http://www.nimh.nih.gov/health/topics/depression/men-and-depression/signs-and-symptoms-of-depression/index.shtml

Simon, G. E., VonKorff, M., Piccinelli, M., Fullerton, C., & Ormel, J. (1999). An International Study Of The Relation Between Somatic Symptoms And Depression. New England Journal of Medicine, 341(18), 1329-1335. Retrieved October 18, 2013, from http://dx.doi.org/10.1056/NEJM199910283

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