How does depression manifest itself?
Most people experience symptoms of depression at some time and this is perfectly normal, especially in adolescence. Each symptom alone can be explained by all sorts of factors and does not have to be due to depression. For depression to be present, many symptoms need to be present almost all day, almost every day. Many people think that depression symptoms need to be present for a long period of time for a depressive episode to be present, but it is enough to have experienced the symptoms for 2 weeks. Depression can appear in very different ways, so two people can both have enough and serious symptoms to be diagnosed with depression, even if they have only one symptom in common. There is always a need for a professional to diagnose depression and symptoms may be a sign that something else is going on psychologically. The number of symptoms and how long they last indicate whether or not depression is present.
The biggest characteristics of depression are the following two symptoms, one or both of these symptoms are always present in depression:
- Sadness: being in a depressed mood most of the day, often hard to find joy. Sadness is a symptom most people associate with depression, but it is not always present. Some people do not feel a great deal of sadness and still others experience emotional flatness where there is little emotion, neither positive nor negative.
- Lack of hobbies or pleasure: to be less interested in things that were previously exciting or to receive less joy and satisfaction from things that previously gave pleasure. It can be normal to lose interest, especially in adolescence when hobbies change, but it can be a sign of depression if nothing else takes over as a hobby or if very few things interest people. What is interesting and satisfying gives us life satisfaction and if little or nothing interests/satisfies, depression can be present.
Other depressive symptoms and manifestations that can be good to monitor both in yourself and others:
- Disturbed appetite: appetite is commonly reduced and eating little or rarely can be part of a reduced activity in depression. In some people, appetite in depression increases and they then eat increasingly more foods high in calories than usual.
- Disturbed sleep: having difficulty sleeping, for example, difficulty falling asleep, waking up often in the middle of the night, waking up and having difficulty falling asleep again, waking up early or sleeping too much.
- Fatigue or lack of energy are often associated with depression and is one of the reasons why it often reduces activity.
- Restlessness or moving more slowly than usual.
- Feeling guilty or worthless: many depressed people experience a bad conscience that can be caused from all sorts of things, often related to the situation and its consequences. Then, there are also thoughts that the person is worthless.
- Difficulties with concentration: often associated with depression and it can also manifest as forgetfulness. For example, when people forget what they were going to do during the day, they put something down and do not remember where, etc.
- Hopelessness: Depression is often accompanied by a great deal of disbelief that the situation, conditions and well-being can ever improve. Then, people have a hard time believing that the future could be brighter than the current situation.
- Reduced participation in school, work and/or social life: functional impairment is common in this way, when people reduce participation in what they usually do.
- Inactivity, lack of initiative: can occur in school, work, social life or in any area of life.
- Difficulty thinking clearly or making decisions
- Sensitivity: In depression, emotional reactivity often changes, which can result in sensitivity. Crying can occur easily or people may get upset or feel bad for little reason or for reasons that would not have triggered that response before.
- Repeated thoughts of death, suicidal thoughts or suicide attempts: when people feel bad it is common for such thoughts to follow. Despite them being common, they are always something to take seriously and it is very important to tell someone when such thoughts arise. You can read more about suicidal thoughts here.
This video was released in collaboration with the World Health Organisation and it is considered by many to provide a good metaphor for depression. In the video, depression is compared to a black dog that follows you.