How to know if you have depression

How to know if you have depression

How to know if you have depression

Authored by Gillian Harvey
Reviewed by Dr Sarah Jarvis MBE

If you’re worried you might be suffering from depression, it’s important to seek appropriate help. This quiz will help you to establish whether you’re experiencing some of the tell-tale signs of a mental health condition.

Are you depressed?

A series of questions designed to assess your emotional, physical, and intellectual symptoms.

We all feel a little down from time to time. Whether we’re going through a difficult time with work, have fallen out with friends or are just physically run-down, most of us feel sad or a little depressed once in a while.

So how do we know if our feelings are a normal emotional reaction to stressful times, or whether we’re suffering from the symptoms of depression?

Who this depression quiz is for?

This depression test is for people who are worried they might be suffering from the symptoms of depression or are concerned that a loved-one might be depressed.

What does the “am i depressed” test consist of?

This depression test consists of a series of 10 questions designed to help you see whether your symptoms are consistent with depression.

What will the results tell me?

The results will give you an indication as to whether you might be depressed; however, if you are feeling down, it is important that you speak to your GP even if your score is low.

How accurate is it?

The depression test will give you an idea as to whether you are suffering from depressive symptoms; however, as depression is a complex mental health problem, you should not rely on this test to diagnose your condition. Always talk to your GP about your symptoms.

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Feeling depressed or suffering from depression?

“We often get mixed up between low mood and unhappiness and depression. The two things are very different. Depression isn’t about feeling unhappy, it’s feeling you’ll never be happy again,” explains Colin Grange, Psychologist and Clinical Director of Lifeworks.

“If you’re feeling low, is it starting to interfere with your day to day life? Are you not doing things that you used to do? Are you losing motivation in and enjoyment of life? Are you starting to not enjoy your hobbies? Is everything becoming an effort?”

People suffering from clinical depression often experience a range of symptoms – both physical and emotional – which can interfere with day to day life. Discovering whether you are suffering from one or more of these symptoms could be an important step towards getting the help you need.

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Help for depression

For those experiencing depression, the future may feel hopeless. However, there are many ways in which this mental health disorder can be treated, from talking therapies such as cognitive behavioural therapy or counselling, to medications such as SSRIs (antidepressants) which help to increase serotonin in the brain to counter feelings of low-mood.

“One of the challenges is that patients can feel that nothing will help them. Sometimes it can be difficult to get sufferers to seek help. However, there are some very good medications and a range of different therapeutic interventions, so the prognosis is good,” explains Grange.

The important thing is that sufferers seek help and support as soon as possible, which may help to prevent the depression from worsening.

Talking about depression

“If you feel you might be depressed, it’s important to seek help, talk to friends and family, your GP and even your manager at work. Seeking help is the first step towards recovery,” explains Grange.

A self-test can help you decide what to do

Having a low mood or feeling on edge are common experiences for us all. When these moods persist, it may be that you are experiencing depression or anxiety – or both. These self tests ask some important questions that can help you take stock of where you are at so you can make a plan for feeling better sooner.

Depression test

Feeling sad or miserable most of the time?

When you’re going through a tough time it’s normal to feel down for a while, emotions like sadness and grief help make us human. But if you’re feeling sad or miserable most of the time over a long period of time, you might have depression.

Take this self-test to help figure out whether you’re showing any of the warning signs of depression. This won’t give you a diagnosis but it will help you decide the next step.

Anxiety test

Been feeling nervous, anxious or on edge?

Take this self-test to get an indication of your anxiety levels. This tool isn’t a diagnosis but it will help you figure out what your next steps might be.

Think about the last two weeks, rather than just today or yesterday. This test is just one part of an assessment of whether anxiety might be a problem for you. There’s more to it, like getting feedback from people who know you well, and looking at how long anxiety has been a problem for you and how it impacts on your life.

Need to talk?

0800 111 757

Talk to a trained counsellor at the Depression Helpline about how you are feeling or to ask a question.

Worried about
how you feel?

Wondering where to turn for help? Doing a self test can help you decide.

How do you know if you’re sad or going through depression? When do common feelings develop into a serious mental disorder and how do you recognise it?

How do I know if I’m depressed?

People often say things like ‘ I feel so depressed’ or ‘that’s depressing’, but the truth is that depression is a well defined mental disorder, including nine different symptoms. Worth noting is that it’s not enough to experience the symptoms to be diagnosed with depression. There are several depression criteria to consider.

We’ll start with the symptoms of depression . The DSM-5 is a handbook, frequently used by mental health professionals in the US and all over Europe. It contains lots of facts about depression, including the symptoms:

  • Depressed mood: Feeling blue most of the day, nearly every day.
  • Loss of interest and pleasure: Markedly reduced interest/pleasure in all (or almost all) activities most of the day .
  • Changed appetite or weight (eating more or less than usual).
  • Sleep disturbance (too much or too little).
  • Moving more slowly than usual or making meaningless movements due to anxiety (for example twisting your hands).
  • Lacking energy: Feeling tired nearly every day.
  • Feeling excessively guilty and/or worthless.
  • Having difficulty concentrating and/or making decisions.
  • Having suicidal thoughts or sometimes wishing you were dead.

Let’s continue with the depression criteria. It’s not enough to experience some of the symptoms to receive a diagnosis of depression. The following conditions also apply:

  • The person experiences at least five depressive symptoms.
  • One of the symptoms ‘depressed mood’ or ‘loss of interest and pleasure’ is present.
  • The depressive symptoms have been present for at least two weeks.
  • The depressive symptoms cause suffering or affect the person’s ability to work, interfere with relationships or other important aspects of life.
  • The symptoms can’t be explained by a physical illness or substance abuse.
  • The symptoms can’t be explained by another mental disorder.
  • The person has never experienced a manic or hypomanic episode.

Depression can be tricky to recognise and diagnose because there are so many symptoms and criteria to consider. The next paragraph includes a commonly used online depression test, which gives you an indication of the severity of your depressive symptoms.

Take a depression test

The depression symptoms test, MADRS-S (Montgomery-Åsberg Depression Rating Scale), can give you an overall view of your mood. Remember, questionnaires can’t provide you with a complete diagnosis. In clinical practice, the results are used as general guidelines.

The test usually takes 5–10 minutes to complete. Download the Flow depression app to take the test for free. In addition, the app will offer you over 50 virtual therapy sessions (also 100% free).

Are there different kinds of depression?

Being depressed can mean many things. Sometimes, depression is not visible to other people. The depressed person carries symptoms around like a terribly heavy backpack but still manages work and relationships. Sometimes, depression is apparent for others and the symptoms make it impossible to manage life in the usual way. Depressive symptoms can be divided into three categories: mild, moderate and severe depression.

  • Mild depression. All criteria for depression are met, but the depressed person can still keep up with everyday chores, work, and social relationships. The depressive symptoms are not always apparent to other people, but mild depression is much more than just feeling blue temporarily. The symptoms don’t disappear like you would expect them to if you were just experiencing ordinary sadness or fatigue. Psychotherapy is recommended for this type of depression. Also, making a few lifestyle changes can have a significant impact on your depressive symptoms.
  • Moderate depression. There are more symptoms present and they tend to be more severe than in the case of mild depression. The depressed person experiences difficulty keeping up with work and everyday life. The symptoms are usually severe enough to cause problems in the person’s social life too. If you recognise this level of depression, it’s highly recommended that you seek treatment as soon as possible. Psychotherapy and antidepressant medication are common treatment options. At-home brain stimulation is another way to treat moderate symptoms.
  • Severe depression. This is typically a level of depression that makes it a challenge to get out of bed in the morning and very difficult to perform common household chores. The quality of life is greatly reduced and the depressed person can’t keep up with everyday life. It probably affects all social relationships. Usually, it’s associated with an intense experience of hopelessness and suicidal thoughts or plans. If you recognise these depressive symptoms, please, contact a healthcare professional as soon as possible. The next paragraph provides you with links and numbers that you can call. Remember, depression is a treatable condition and there are many different treatment options available.

How do I know if I have depression or not?

An online depression test is not enough to get a diagnosis. The only way to receive a diagnosis of depression is to contact a healthcare professional. A psychologist or physician can make sure all of the criteria for depression are met.

There are some clinics that provide remote consultations through their apps. You can receive the first consultation at home, without having to visit a clinic. Here are two of the most popular online clinics:

  • For people living in the UK, contact Babylon.
  • For people living in Sweden, contact Kry.


Depression is more than just feeling sad. It’s a well-defined mental disorder with nine different symptoms. Luckily, depression is a treatable condition and there are many evidence-based treatment options available.

Hanna Silva is a psychologist at Flow.

Psychreg is mainly for information purposes only; materials on this website are not intended to be a substitute for professional advice. Don’t disregard professional advice or delay in seeking treatment because of what you have read on this website. Read our full disclaimer.

In this Article

  • Symptoms
  • Diagnosis
  • Treatment
  • Are There Warning Signs of Suicide With Depression?
  • Are There Other Therapies to Treat Symptoms of Depression?
  • When Should I Seek Help?

Most of us feel sad, lonely, or depressed at times. It’s a normal reaction to loss, life’s struggles, or injured self-esteem. But when these feelings become overwhelming, cause physical symptoms, and last for long periods of time, they can keep you from leading a normal, active life.

That’s when it’s time to seek medical help.

Your regular doctor is a good place to start. They can test you for depression and help manage your symptoms. If your depression goes untreated, it may get worse and last for months, even years. It can cause pain and possibly lead to suicide, as it does for about 1 of every 10 people with depression.

Recognizing the symptoms is key. Unfortunately, about half the people who have depression never get it diagnosed or treated.


They can include:

  • Trouble concentrating, remembering details, and making decisions
  • Fatigue
  • Feelings of guilt, worthlessness, and helplessness
  • Pessimism and hopelessness
  • Insomnia, early-morning wakefulness, or sleeping too much
  • Crankiness or irritability
  • Restlessness
  • Loss of interest in things once pleasurable, including sex
  • Overeating, or appetite loss
  • Aches, pains, headaches, or cramps that won’t go away
  • Digestive problems that don’t get better, even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Suicidal thoughts or suicide attempts


There isn’t a “depression test” a doctor can use to see if you have it, so figuring that out often starts with a thorough history and physical exam.

Your doctor will want to know:

  • When your symptoms started
  • How long they’ve lasted
  • How severe they are
  • If depression or other mental illnesses run in your family
  • If you have a history of drug or alcohol abuse

You’ll also be asked if you’ve had similar symptoms of depression before, and if so, how they wereВ treated.


If your doctor rules out a physical cause for your symptoms, they may start you on a treatment or refer you to a mental health professional. This specialist will figure out the best course of treatment. That may include medicines (such as antidepressants), a type of therapy called psychotherapy, or both.

Be prepared for the process to take some time. You may need to try different treatments. And it may take more than a month for drugs to take their full effect.

Are There Warning Signs of Suicide With Depression?

Depression carries a high risk of suicide. Suicidal thoughts or intentions are serious. Warning signs include:

  • A sudden switch from sadness to extreme calmness, or appearing to be happy
  • Always talking or thinking about death
  • Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse
  • Taking risks that could lead to death, such as driving through red lights
  • Making comments about being hopeless, helpless, or worthless
  • Putting affairs in order, like tying up loose ends or changing a will
  • Saying things like “It would be better if I weren’t here” or “I want out”
  • Talking about suicide
  • Visiting or calling close friends and loved ones

If you or someone you know shows any of the above warning signs, call your local suicide hotline, contact a mental health professional right away, or go to the emergency room.

Are There Other Therapies to Treat Symptoms of Depression?

There are other treatments your doctor may consider. Electroconvulsive therapy, or ECT, is a treatment option for people whose symptoms don’t get better with medicine or who have severe depression and need treatment right away.

Transcranial magnetic stimulation, or TMS, involves usingВ a noninvasive device that is held above the head to induce the magnetic field. ItВ targets a specific part of the brain that can trigger depression.

With vagus nerve stimulation, or VMS, a pacemaker-like device is surgically implanted under the collarbone to deliver regular impulses to the brain.

When Should I Seek Help?

If your symptoms of depression are causing problems with relationships, work, or your family — and there isn’t a clear solution — you should see a professional.

Talking with a mental health counselor or doctor can help prevent things from getting worse, especially if your symptoms stay for any length of time.

If you or someone you know is having suicidal thoughts or feelings, get help right away.

It’s important to understand that feeling depressed doesn’t mean you have depression. That condition involves not only changes in mood, but also changes in sleep, energy, appetite, concentration, and motivation.

If you have physical symptoms like these and find yourself feeling depressed much of the time for days or weeks, see your doctor.

Show Sources

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5.

National Institute of Mental Health: “What are the symptoms of depression?”

American Academy of Family Physicians: “Depression.”

The National Women’s Health Information Center: “Depression.”

American Academy of Family Physicians: “Depression in Older Adults: What it is and how to get help.”

The Journal of the American Medical Association. “Recommendations for Screening Depression in Adults.”

If left unmanaged, stress can lead to depression.

Posted January 8, 2016


  • What Is Stress?
  • Find a therapist to overcome stress

How to know if you have depression

Feeling stressed out? You’re not alone. Seventy-two percent of adults surveyed by the American Psychological Association reported feeling stressed out at least some of the time during the past month.

Regardless of what you’re stressing about, stress can quickly turn into a problem when it builds and starts to cause wear and tear on your body—and your overall mental state. In fact, if left unmanaged stress can actually lead to depression.

Chronic stress leads to physical changes in your brain and body, changes in the way you’re thinking, and ultimately to changes in the way you’re behaving.

Stressed out people are more likely to engage in unhelpful and unhealthy behaviors like overeating, smoking, drinking, and dropping out of important activities like exercising and socializing. And all of this can increase the likelihood that your stress turns into depression.

So how can you tell if you’re just stressed out or are suffering from depression? Essentially the answer lies in the severity and the duration of your symptoms.

Feeling stressed out is usually associated with feeling overwhelmed or under pressure. As you know, I believe the term “stressed out” is a generalization we use to really just say that we’re having a hard time coping with distressing emotions such as fear or sadness.

These feelings can last for a couple of days (read about how to take charge of your emotions to manage stress here). However, when you don’t manage these emotions effectively they can transform from a single episode of feeling overwhelmed into a chronic mood that feels more severe and lasts longer. That’s when stress turns into depression.

Depression is more than just a passing bad mood. If you’ve been feeling some of the following symptoms for two weeks or more, you might be suffering from depression:

• Feeling sad and hopeless

• Lack of energy, enthusiasm and motivation

• Withdrawing from other people

• Trouble making decisions

• Feeling restless, agitated and irritable

• Eating more or less than usual

• Sleeping more or less than usual

• Feeling bad about yourself or feeling guilty

• Feeling anger and rage

• Feeling that you can’t overcome difficulties in your life

• Trouble functioning in your personal life

• Chronic physical symptoms (such as pain or stomach issues)

• Thoughts of death or suicide

Although depression is the most common mental health disorder in the US, it is treatable. However, most people can’t manage it alone.

If you or a loved one is suffering from depression, it’s important that you seek professional help. Ask your primary care physician for help finding a mental health professional in your area or look here for more resources.


  • What Is Stress?
  • Find a therapist to overcome stress

if you’re depressed it can feel incredibly hard to take action and do anything to help you get better. The key is to start by taking small steps.

I’ve helped hundreds of patients overcome depression and the key to feeling less depressed is to get help. For more information on how to cope with depression, read this post.

To stay updated on Wise Mind Living visit

Sign up for the WML newsletter here & receive a free guided meditation to reduce your stress in 3 minutes.

Is it depression or just a bad day?

If you’ve been feeling really miserable for more than two weeks you’re not just going through a phase. You could have depression. Fortunately there are some things that can help.

What is depression?

Feeling down when something upsetting or stressful happens, like a relationship break-up, or losing a job, is pretty normal, and usually the feelings fade over time and you get on with life. But if it’s depression the feelings don’t go away, even when things improve.

The way you feel when you’re depressed is connected to:

  • your thoughts (whakaaro)
  • the way you behave
  • what happened to you in the past
  • what’s going on around you now
  • the way stress hormones affect your brain.

All depression will be helped by better self care. For mild depression, self-help techniques (like physical activity) can make a big difference. It can be really helpful to see someone who knows about depression. There are people whose jobs are all about helping others who are having a hard time coping.

Depression can often lead to thoughts that it’s not worth going on, or that everyone would be better off without you. If you’re feeling this way, and especially if these thoughts are getting stronger then you need to get help right now.

What are the signs and symptoms?

The signs and symptoms of depression should be taken seriously if they last for more than two weeks or if they leave you feeling unsafe at any point in time. If you’re in any doubt, call the Depression Helpline 0800 111 757 or talk to your doctor.

key signs

  • constantly feeling down or hopeless
  • having little interest or pleasure in doing things you used to enjoy.

other possible signs and symptoms

  • irritability or restlessness
  • feeling tired all the time, or a general loss of energy
  • feeling empty, lonely, mokemoke
  • sleeping problems – too much, or too little
  • losing or gaining weight
  • feeling bad about yourself or things you have done
  • problems with concentration
  • reduced sex drive
  • thinking about death a lot
  • thoughts of harming yourself.

It is common for people who have depression to also feel anxious. The symptoms of anxiety and depression can overlap. You might want to take a look at the anxiety information too.

Types of depression

There are a number of different kinds of depression, and when you see your doctor, psychologist or counsellor you might hear them use these names.

One we hear quite a lot about is p ost-natal depression , which is more than just what some people call ‘baby blues.’

Some other names you might hear include: major depression, bipolar disorder, anxious depression, and psychotic depression. To read more, visit the Health Navigator site .

What next

All sorts of things affect mental health. Understanding what’s going on in your life could help you get to a better place.

How to know if you have depression

Summer depression is a real phenomenon, although uncommon. Only about 10% of people with seasonal depression have the summer type. Some unique characteristics of summer depression include increased agitation and irritability, decreased sleep, insomnia, and weight loss. This type of depression can be tough to recognize because most people don’t associate summer with feeling sad. It’s important to recognize the signs and to get professional help to alleviate symptoms.

Quick Links

  • What Is Seasonal Depression?
  • Signs of Summer Depression
  • What Are the Risk Factors for Summer Depression?
  • Summer Depression With Bipolar Disorder
  • Getting a Diagnosis
  • Tips for Living With Summer SAD

While the winter blues are more common, summer depression is a real phenomenon. First described in the literature in 1987, summer depression is a mental health condition triggered by the warmer months of the year.

No one knows for sure why summer triggers this mental health issue in some people, but it is a unique type of depression with characteristic symptoms.

If you have always dreaded the coming of summer, hate the hot weather, and have a hard time functioning normally, you could have summer depression.

What Is Seasonal Depression?

Seasonal Affective Disorder (SAD) is depression that comes and goes with the seasons. The onset and end of an episode are the same from year to year for each person. Most people with SAD experience symptoms in the fall and winter.

Only a small amount of people have what is called spring and summer SAD. It’s also known as summer depression or summer-onset SAD. The winter-onset variation is more common because of the colder weather, less sunlight, and more time spent indoors, which can be isolating.

Any version of SAD is more than seasonal or weather-related blues. Some shifts in mood as the seasons change is to be expected, but SAD is a real mental illness. It requires a professional diagnosis and care to overcome.

Signs of Summer Depression

Summer depression causes much of the same symptoms as other types, including winter depression:

  • A feeling of sadness, hopelessness, and generally being down most of the time on most days
  • Losing interest in activities and pursuits you used to enjoy
  • Changes in eating and sleeping habits, potentially with changes in weight
  • Difficulty thinking or concentrating and completing tasks
  • Feeling worthless, guilty, or ashamed
  • Having suicidal thoughts

There are some important differences between summer and winter depression. The winter type tends to make a person eat more, sleep more, and feel more lethargic and drained. If you have the summer type, the opposite is true. Summer depression makes people more agitated and irritable. They tend to eat less and sleep less, even struggling with insomnia.

What Are the Risk Factors for Summer Depression?

Exactly what causes any type of depression isn’t always clear. There are likely genetic components, but environmental triggers and experiences also play a role. Summer depression is uncommon and not as well understood as other types, but some factors that put you at a greater risk for it include:

  • Changes to routines and schedules that often accompany summer, such as being out of school
  • Isolation from friends when school ends, triggering loneliness
  • Feeling uncomfortable in hot, humid weather
  • Living somewhere with very hot and sunny summer conditions
  • Having pollen and other spring and summer allergies
  • Circumstances, such as health or money that don’t allow you to participate in typical summer activities or travel
  • Anxiety and stress over body image issues and summer activities that require wearing less clothing or a bathing suit

The pressure to enjoy summer and its activities only add to this type of SAD. It’s challenging for other people to understand why you don’t like this time of year. They might put pressure on you to be happy or participate in activities, which isn’t helpful.

Summer Depression With Bipolar Disorder

If you have bipolar disorder, you have an increased risk for SAD, including the spring and summer types. While the winter version of SAD can increase depressive cycles, summer SAD might trigger more manic episodes.

Summer depression with bipolar disorder can cause or worsen mania, trigger hypomania—a less intense variety of mania—and make you feel more irritable, agitated, angry, or anxious.

Call for a Free Confidential Assessment.

Getting a Diagnosis

The only way to know for certain that you have summer depression is to get a diagnosis from a mental health professional. Don’t hesitate to speak up about it and share your symptoms. Few doctors will immediately make the connection to summer depression because it isn’t that common. Emphasize the seasonal nature of your symptoms and ask about SAD as a possible diagnosis.

Tips for Living With Summer SAD

Professional support will help you learn to manage your seasonal depression, but you can also make some lifestyle changes and use healthy habits to boost your summer mood:

  • Keep a journal. A journal of your moods and activities can help you identify triggers for depression. Once you know what sets back your mood, you can avoid it or find healthy ways to cope with what you can’t avoid.
  • Cool off. Do what you can to stay cool in the summer. Keep the air conditioning on, for instance, or go to a local pool or take a cold shower to get relief from the heat.
  • Go dark. Make your bedroom both cool and dark so you can sleep better. Use blackout curtains to keep sunlight at bay early in the morning. This should help you sleep in longer. Wear dark sunglasses when outside in the summer.
  • Live by a schedule. If your summer is less routine than the rest of the year, it can throw off your mood. Creating and using a schedule will help you feel more in control.
  • Avoid isolating. All kinds of depression are isolating. You may want to stay in and avoid social contact, but this only makes depression worse. The obligations of summer activities might also be a trigger for your depression, so don’t overdo it but do get out there and spend time with friends.
  • Say no. While it’s important to stay social, you don’t have to be obligated to say yes to every invitation. Set healthy boundaries and avoid those events or activities you just don’t want to do or can’t afford.
  • Maintain healthy habits. It’s easy to partake in unhealthy habits when you’re not feeling well. But eating poorly, being sedentary, and drinking too much will only worsen your depression. Exercise early in the morning so that you can avoid the heat. Cook with fresh, seasonal produce and limit your drinking.

If you or a loved one show signs of being depressed in the summer season, talk to your doctor or mental health professional. They can recommend recovery plans and lifestyle changes to help you cope and enjoy the season more.

Experts explain how to know when being kind of blue has crossed over into full-blown depression.

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Feeling down in the dumps every so often is a normal part of life. But when you’re gripped by an unrelenting sadness or hopelessness that keeps you from going about your usual routine, it’s time to pay attention as this is the hallmark sign of clinical depression. An estimated 8.4% of adults will experience a major depressive episode, according to the National Institute of Mental Health. Even with this telltale sign in place, it’s tough to know if you’re depressed. “Almost all of the symptoms of depression on their own are experienced by everyone at one time or another,” said Jennifer Payne, MD, director of the Women’s Mood Disorders Center at Johns Hopkins University in Baltimore. If you’ve been dealing with four or more of the following symptoms every day for two weeks, and they’ve impaired the way you usually function (for example, preventing you from working, being a responsible parent, or seeing friends), it’s time to check in with your healthcare provider.

You’re Eating More (Or Less) Than Usual

Depression leaves you withdrawn and checked out, and that can manifest as a loss of appetite. “If your brain is preoccupied with negative thoughts, you may forget to eat or lose interest in cooking or preparing meals,” said Yvonne Thomas, PhD, Los Angeles-based psychologist specializing in depression and self-esteem. On the other hand, sometimes the disease kicks in the opposite effect, making you hungry and driving you to overeat. “The mix of emotions that tend to accompany depression—sadness, pessimism about the future, and low self-esteem—can compel you to try to soothe your feelings with food binges,” said Thomas.

You’re Sleeping Too Much or Too Little

Some people with depression find themselves snoozing under the covers more; the disengagement and dip in energy make you tired all the time, said Thomas. “Sleeping more is also a way depressed people escape from their sadness; it becomes a refuge,” said Thomas. Others with depression experience restless or interrupted sleep or even insomnia—they’re too wired by obsessive thoughts or ruminations to wind down and score the seven to eight hours per night most adults need. Thing is, not only can sleep changes help you know if you’re depressed, but they also make it worse. When you’re not getting the proper amount of shuteye, your body’s internal clock gets out of sync, and you’re even more tired and unfocused. and less able to cope.

Small Things Agitate You

It’s a sneaky sign few people recognize: depression can show up as heightened irritability, said Jennifer Wolkin, PhD, a New York-based a health psychologist. You might feel cranky and grumpy; little things that normally wouldn’t register set you off and leave you snapping at friends and coworkers. Part of the prickliness may be the way depression exacerbates normal hormonal swings. But it could also be triggered by the weight of so many heavy emotions. “When people are in physical pain, they often get angry and irritated easily, and it’s the same with psychological pain—you don’t feel good or like your usual self, and that saps your patience and puts you more on edge,” said Thomas.

You Can’t Concentrate or Focus

Forgetting work deadlines or when to pick up your kids from a playdate? Feeling like your mind resembles an out-of-focus photo, and the fuzziness has made a dent in the way you weigh choices and make decisions? That’s your brain on depression. Being preoccupied with thoughts of sadness and emptiness can plunge you into a head fog that affects your job, memory, and decision-making skills, said Wolkin. In turn, that unfocused thinking can lead you to make poor choices or take on unhealthy, risky behavior.

You Don’t Enjoy the Things That Once Made You Happy

You used to hit happy hour with your favorite group of coworkers, but for the last few weeks, you’ve been ducking out. Or you always looked forward to your nightly run, but these days, you can’t muster the interest. Not taking part in things you once enjoyed because they no longer give you pleasure is a telltale sign of depression. “A person who is simply blue might skip a few outings, then get back in the swing of things,” said Wolkin. “But depression makes you apathetic about activities and hobbies that once gave you joy, and that makes you isolate yourself.” It sets up that vicious cycle: depression robs you of your ability to derive pleasure from experiences, so you stop doing the very things that could brighten your mood.

You Feel Down on Yourself and Worthless

If you’re constantly putting yourself down, or you feel worthless or inconsequential, something is up. “Repetitive thoughts along the lines of ‘I’m not good enough’ or ‘I don’t matter’ are dangerous because they can fuel self-harming behavior,” said Wolkin. When you think this way, you tend to find ways to verify the negativity, and that in turn makes you more depressed and more at risk. Extreme guilt for things you aren’t solely responsible for—for example, a bad breakup or sudden job loss—also bashes your self-esteem and is a tip-off that you’re depressed, said Dr. Payne.

You’re Preoccupied With Thoughts of Death

Persistent thoughts about ending your life, wondering how friends and family would feel if you went and did it, pondering different ways to carry out the act, and even general thoughts about death are all strong indicators that it’s time to reach out for professional help, said Wolkin. “Because these thoughts pose such a direct threat to your life, it’s important to seek help if you experience them daily or almost every day for two weeks, even if you don’t recognize any other symptoms of depression in yourself,” said Wolkin.

You’re Panicky and Anxious

Overwhelming feelings of fear are usually thought to signify an anxiety disorder. And while that’s often true, they can also be a clue to depression. “Anxious feelings often coincide with depression, and some depressed people have panic attacks,” said Dr. Payne. Anxiety is more than just the normal apprehension most of us feel when we’re challenged; it’s a constant feeling of panic and obsessive thoughts that often show up in physical symptoms such as rapid heartbeat, excessive perspiration, and sleep problems. The tricky thing is, even though anxiety can signal depression, it’s possible that a person with depression also has an anxiety disorder as well. If you feel overwhelming anxiety, consider it another crucial reason to seek help from your provider.

Your Energy Level Has Hit the Wall

Depression-related lethargy may be simply the consequence of not eating enough or sleeping too much. But it’s also the result of having a black cloud of sadness or hopelessness over you all the time. Dealing with chronic emotional pain is an energy suck, and it makes you too dragged and tired to tackle routine tasks, not to mention work and family responsibilities. “You feel overwhelmed by day to day life; even getting out of bed and taking a shower becomes exhausting,” said Wolkin. When you’re always tired and that fatigue impairs your life, it’s time to seek help.

You’re Dealing With Unexplained Aches and Pains

“Emotional pain from depression that you aren’t getting help for can be channeled throughout your body and show up as physical ailments, like headaches, stomach problems, neck and back pain, even nausea,” said Thomas. “I see this with many of my patients; they’re holding so much sadness and distress inside, these feelings end up playing out in other ways.” Not every cramp or twinge is a sign that you are depressed, of course. But if you’re suffering from a chronic ailment you can’t attribute to another cause that isn’t clearing up on its own,” see a healthcare provider to get it checked out, but also consider it a possible sign of depression too,” said Thomas.

Are you worried that your husband / boyfriend or wife / girlfriend may be depressed? Take this short quiz to see if your spouse is experiencing symptoms common among people with depression.

Who Is This Partner Depression Quiz For?

Answer the questions below to see if your partner may have depression. This quiz is for anyone who is worried their partner may be suffering from depression, and wants to take the first step toward seeking help.

How Accurate Is It?

This quiz is NOT a diagnostic tool. Mental health disorders can only be diagnosed by qualified mental health professionals.

Psycom believes assessments can be a valuable first step toward getting treatment. All too often people stop short of seeking help out of fear their concerns aren’t legitimate or severe enough to warrant professional intervention.

Your privacy is important to us. All results are completely anonymous.

How to know if you have depression

If you think you or someone you care about may be suffering from depression or any other mental health condition, Psycom strongly recommends that you seek help from a mental health professional in order to receive a proper diagnosis and support. We have compiled a list of resources (some even offer free or low-cost support) where you may be able to find additional help at:​

Partner Depression FAQs

How do you support a partner with depression?

Having a partner with depression is more common than you might think. According to the National Institute of Mental Health, almost 20 million adults experience at least one depressive episode in a year.

An important first step in supporting your partner is to educate yourself about the symptoms and risks of depression. Knowing the facts can help you feel less frustrated or hostile when a partner is struggling. Also, try to keep communication honest and open. Ask your partner what they need, instead of making assumptions. Don’t shy away from asking hard questions, like whether they are experiencing suicidal thoughts.

People with depression benefit from having partners who are warm, empathetic, and willing to celebrate even small improvements. By staying curious about what makes a difference, you can help each other and the relationship grow.

How do you deal with a partner who has depression?

When you’re focused on helping a partner with depression, it’s easy to neglect your own mental and physical health. Make a plan for self-care that addresses your physical, emotional, and social needs. A person who is exercising, getting enough rest, and doing activities they enjoy is in a better position to support their partner with depression.

Also, don’t be afraid to tap into your social network. Let friends and family members step up to help care for you and your partner. Depression is nothing to be ashamed about, and the more connected you are to others, the less pressure there is on your relationship with your partner.

It can also be useful to talk with a therapist about your life and challenges. Mental health professionals understand the facets of depression as well as the strain it can put on romantic relationships.

How do you reconnect with a partner who has depression?

People with depression experience a number of symptoms that impact their relationships. Anger, tiredness, decreased sexual interest, and trouble concentrating can make it difficult for a person to connect with their partner, who might begin to feel lonely and neglected.

When trying to reconnect, it’s important to start small. Set aside a few minutes a day to share joys, hopes, and challenges with each other. When planning an activity, choose options that don’t place unrealistic expectations on your partner. When rebuilding physical intimacy, be curious about what works, instead of critical about what doesn’t.

Don’t hesitate to reach out to a therapist to help you work on your relationship if connection proves difficult. Therapy can be a safe, calm space to think about relationship challenges and get excited about new ways to connect.

How do you help a partner with depression?

The best way to help your partner with depression is to educate yourself. You can’t cure your partner’s depression, but you can better understand their challenges and root for their improvement. Researchers have found that loving relationships can moderate the impact of depression in an individual, while hostile relationships can increase an individual’s vulnerability.

Another way you can help your partner is to refrain from telling them what to do or what they need. Instead, ask them how you can support them. Be willing to let them express their frustrations or fears about living with depression.

The best way to help a partner with depression is to take care of yourself. Focusing on your own mental and physical health, rather than anxiously focusing on “fixing” your partner, gives you the energy you need to be present and patient when a partner experiences a depressive episode. You aren’t neglecting the relationship by taking care of yourself; you’re setting it up to be resilient for the long haul.

National Institute of Mental Health. Major Depression [Updated 2021 October]. Available at Accessed January 28, 2022.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.5th ed. Washington DC: American Psychiatric Publishing; 2013.

Proulx, CM, Buehler, C, Helms, H. Moderators of the link between marital hostility and change in spouses’ depressive symptoms. Journal of Family Psychology. 2009;23(4): 540–550.

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Major depression isn’t always easy to spot in yourself or someone you love. Use these clues to determine when treatment may be needed.

How to know if you have depression

How to know if you have depression

If you or someone you know is struggling with depression, you’re far from alone. In 2017 over 7 percent of U.S. adults — approximately 17.3 million people — had at least one major depressive episode, according to the National Institute of Mental Health. What’s more, a study published in September 2020 in the journal JAMA Network Open found that the prevalence of depression symptoms tripled in the United States during the COVID-19 pandemic.

Depression symptoms aren’t always as obvious as frequent crying and overwhelming despair. “Oftentimes the changes are subtle, and the person may not notice, but their friends and loved ones may,” says Boadie W. Dunlop, MD, director of the mood and anxiety disorders program in the psychiatry department at Emory University School of Medicine in Atlanta.

There’s no one pattern to depression, and the condition can vary in progression from person to person. Symptoms may gradually go from mild, such as choosing to stay home to watch TV instead of going out for a walk with a friend, to more severe, such as not even getting out of bed to shower or persistent thoughts of suicide. Others may quickly progress from their usual state to a severe depressive episode.

“Depression symptoms are particularly troubling if someone displays more than one or if they persist for more than two weeks,” says Simon Rego, PsyD, an associate professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine and the chief psychologist at Montefiore Medical Center in the Bronx, New York.

To help you recognize depression that warrants concern, whether in yourself or a loved one, here are eight depression symptoms — some of which you might even find surprising — that you shouldn’t ignore.

  1. Trouble sleeping Although depression can sap energy and motivation during the day, a person may often lie awake at night, unable to sleep, says Sarah Altman, PhD, a clinical psychologist in the department of psychiatry and behavioral health at The Ohio State University Wexner Medical Center in Columbus. On the other hand, some people with depression may find it difficult to get out of bed and may sleep for long periods during the day.
  2. Loss of interest in favorite activities Some people turn to hobbies they enjoy when they feel blue, but those with major depression tend to avoid them, according to the American Psychiatric Association (APA). If you or someone you know usually loves to garden but can’t muster the energy to go outside, let alone work in the yard, that can be a red flag.
  3. Increase in energy Ironically, when depressed people have made a decision to do something drastic, such as killing themselves, they may go from slowed down to far more energetic. That’s because they feel a sense of relief in having come to a resolution, so if you notice a drastic change like this in someone you love, it’s a big cause for concern. This can also manifest as reckless behavior — particularly in men — such as indulging in risky sexual behavior, overspending, or abusing substances, such as alcohol or drugs, according to the Anxiety and Depression Association of America (ADAA).
  4. Change in appetite Some people overeat when they’re depressed or anxious, but in people with severe depression, the opposite is usually true. “A depressed person may stop eating because he or she is no longer concerned with physical well-being,” says John Whyte, MD, MPH, a board-certified internist in Washington, DC, and the author of Is This Normal?: The Essential Guide to Middle Age and Beyond. “Disregard for personal hygiene is also cause for concern,” Dr. Whyte adds.
  5. Feeling or seeming on edge “In many people, depression can manifest with irritability, impatience, or anxiety and worry. Women are especially prone to anxiety symptoms along with depression,” says Diane Solomon, PhD, CNM, a psychiatric nurse practitioner in Portland, Oregon. Trouble concentrating is another related symptom.
  6. Expressions of guilt Feeling excessive guilt or worthlessness can also be a hallmark of depression, according to the APA. People might feel guilty because they are depressed or aren’t doing enough at home or at work.
  7. Unexplained physical symptoms Since the body and mind are connected, depression can also start to manifest in physical ways that are resistant to treatment, such as persistent headaches, digestive issues, or unexplained pain, according to the ADAA.
  8. An emerging dark side A person who is severely depressed may become preoccupied with death and other morose topics, the APA notes. For example, they may talk about what things will be like “after I am gone” and may also become more likely to take uncalculated risks.

The Next Step: Getting Help

If you notice any of these serious depression symptoms in yourself or someone you love, reach out and get help. In most people, even major depression is a very treatable disorder, with a wide range of medications and therapies that have been proven to work, according to the APA.

If Your Loved One Has Symptoms

  • Encourage your loved one to seek professional help. If your loved one is considering harming themselves or having other dark thoughts, immediate treatment is critical. Go to the nearest emergency room or contact a local mental health provider. You can also call the National Suicide Prevention Lifeline at 800-273-8255 (TALK).
  • Create a safe environment. “If the person expresses suicidal thoughts, remove any potentially lethal items from the home, such as guns,” Dr. Dunlop says.
  • Be kind. “Blaming or chastising depressed people for feeling low or unmotivated is not helpful and typically serves to reinforce negative feelings they already have,” Dunlop says. “Instead, open the discussion in a nonjudgmental way and encourage the person to seek help.”
  • Be willing to support treatment. Offer to help your loved one prepare a list of questions for a provider about depression or drive them to appointments.

If You’re Experiencing Symptoms

  • Recognize if you’re starting to slip. If you are struggling with new or worsening symptoms, don’t hesitate to seek help. If you already have a therapist, reach out to them right away. If you do not have one, call the Substance Abuse and Mental Health Services Administration (SAMHSA)’s National Helpline at 1-800-662-HELP (4357) for a free, confidential referral for treatment. If you’re considering harming yourself, contact the National Suicide Prevention Lifeline at 800-273-8255 (TALK).
  • Ignore incorrect attitudes. The old idea of “pulling yourself up by your own bootstraps” is not only outdated, but also not based in science. “If you feel depressed, there is no cause for guilt,” says Dr. Solomon.

Depression Resources

Many organizations also have online resources for depression. These include:

Additional Reporting by Erica Patino

In honor of World Mental Health Day, let’s talk mental health solutions.

How to know if you have depression

October 10th was World Mental Health Day. I didn’t write about it yesterday because I was traveling, but I don’t want to skip over such an important day. 18.5 percent of American Adults suffer from some type of mental illness every year. That’s 43.8 million people or almost 1 in five. Take a look around your office. There’s a good chance that there are several people in your office who have some sort of mental illness right now and you’re not even aware. Of those, over 6 million are suffering from depression.

I’m one of those people. I have anxiety and depression which is (thankfully) well managed by medication. The downside? Medication makes me fat. But, since my choices are to be fat and happy or thin and an anxious depressed mess, I’ll take the plus size clothing, thanks. You wouldn’t know that I suffer from depression if you met me, by the way, even before I was on medication because I’m good at putting on a happy face. And chances are, there is someone at your office, or maybe you, who is also good at getting through life when she feels rotten.

If you’re depressed, you still have to go to work and earn money. It’s how it is. Plus, you need that health insurance more than ever! Some of the best tips I’ve ever read on functioning with depression come from Jennifer P, also known as, Captain Awkward in her 2013 article, “How to Tighten Your Game When You’re Depressed.” I strongly recommend reading the whole thing, but here are some of her ideas:

I don’t know how to tell you how to feel normal again or get back to ‘normal.’ I don’t know what normal is for you. I don’t know what you do next, or what you want to do.

But I do speak “corporate boss” and I can help you (and maybe others who are in your same shoes) keep your job until you decide you don’t want it anymore, and if you can’t keep this one maybe this will help you keep the next one.

A lot of this stuff is literally THE hardest stuff to do when you’re feeling down. Because the principle behind this is antithetical to who we probably are as people, seeking genuine connections and genuine expressions of ourselves. The operating principle is: Appearances count at work. Sometimes more than the actual work does.

Captain Awkward is 100 percent right on all of this. Everything is harder to do when you’re depressed and appearances do count. You know how I talk about how managers should judge you based on achievements rather than butt-in-seat time? They should. But, they don’t. If you’re on time and appear to be working, that may be more helpful to your career than slouching in late and doing a fantastic job. Seriously. Responding to an email with, “I’ll look into that and get back to you,” makes you look better than not responding at all, even though you’ve done the same amount of work both ways.

Jennifer described a situation where she had to fire an employee who suffered from depression. It was horrible for Jennifer and much worse for the employee, but businesses need to function and if you’re not functioning at all, they have to fire you. She tells the experience like this:

The kicker was, *I* had to let her go.

I will never forget it, because when I fired her she got up without a word and turned and walked out of the office, slamming the door behind her.

Unfortunately, outside it had started pouring, and she had left her umbrella in my office, so 5 minutes later, there she was, drenched to the skin, coming back from her umbrella. Which I handed to her, and then she slammed the door again.

I don’t tell you this because I want you to feel bad for me. Things were definitely, obviously, MUCH worse for her that day.

But I can tell you what would have made a difference in keeping her employed that doesn’t have to do with her intelligence or capability or qualifications:

  • Showing up on time every day.
  • Being showered and wearing clean clothes.
  • Being honest and up front if she couldn’t complete things, updating us as to the status of tasks.
  • Leaving her work environment (desk, computer files) in a state where if she couldn’t make it we could easily figure out where she was in a project.
  • Being present and paying attention during conversations.
  • Not bursting into tears every time her work needed critique or adjustment. Hard to control sometimes, I know! But “Can you use consistent naming conventions when you save files to the servers” doesn’t mean “EVERYONE HATES YOU.”

We could have worked up to actual quality work output from there. This would have communicated “I am trying as hard as I can, and things will get better if you hang in with me a little longer.” But without those basic things, the theoretical quality of work didn’t matter – work had stopped.

Jennifer acknowledges, and I agree with her, that these things that would have helped this employee are hard. So very hard. But, if you want to save your job, you have to do these things.

Ask for Help

If the company you work for has 15 or more employees, then you’re covered by the Americans with Disabilities Act (ADA) from day one. (Well, actually, from your interview.) This means that if your depression or other mental illness qualifies as a disability, your company is required to provide a “reasonable accommodation” for you–but only if you ask. (Yes, there have been some court cases where the employee didn’t ask, and the court determined the employer should have known, but be smart and ask.)

The company isn’t required to give you whatever accommodation you ask for, but they are required to engage in an “interactive processes” to determine a reasonable accommodation that will work. So you may say, “I need to work part-time,” and they may say, “that isn’t reasonable. How about you work from home 50 percent instead?” Going back and forth isn’t bad. It’s part of the process.

If you haven’t seen your doctor, go to the doctor. Depression screenings are free under the Affordable Care Act, so get screened. If you don’t have a therapist, call your Employee Assistance Program and ask for a referral or ask your doctor for a referral. Often, the first visit is free under your company’s EAP. If you don’t have time to go to therapy, look into one of the new online therapy services. You can often find a counselor that can meet with you via video or phone conference at a time convenient to you–even if that is 10:00 at night.

Whatever you do, don’t just assume it will get better. And don’t assume you’re a failure. You’re not. Getting help can also be one of the most difficult things you’ll ever do, and if you can’t bring yourself to make a doctor’s or therapy appointment, ask a friend or family member to make the call for you. You’re not alone. Ever.

How to know if you have depression

How to know if you have depression

How to know if you have depression

How to know if you have depression

How to know if you have depressionWhile most Americans will experience some level of depression in their lives, some will experience an intense and serious depression that requires the help of friends, family, and often a mental health professional.

The severity of a depressive state will fluctuate based on a variety of factors, including the availability of a support system, treatment options such as a therapist or psychiatrist, emotional coping skills, and a history of successfully navigating previous mental health episodes. However, when depression worsens, suicidal ideations (or thoughts) may develop, and are therefore often seen together. The focus of this article is to help identify common signs and symptoms of suicidal thoughts related to severe depression and how to recognize when to seek help.

Common depressive symptoms include a loss of interest in previously enjoyed activities, low energy, changes in sleep and appetite, concentration and focus problems, and changes in libido. When depression worsens, often people will experience hopelessness, a desire to isolate and withdraw, and may begin to have thoughts about how to make the pain (depression) stop. These are symptoms most commonly associated with the onset of suicidal ideations. This is where outside help is needed. The vulnerability experienced with hopelessness and a desire to make the pain stop sometimes leads to irrational actions and decisions. Once this hopelessness manifests as a desire to “go to sleep,” “make the pain go away,” or identifying ways to die and how to obtain the means (guns, pills, etc.), the suicide risk is dramatically heightened.

Find a Therapist

Other factors must be considered when determining how soon help should be acquired during a worsening depression. First, if a firearm is in a person’s possession or at least accessible to the person, help should be sought as soon as the depression is apparent. The firearm should be secured by a third party or by law enforcement. Next, any use of recreational drugs or alcohol limits a person’s insight and judgment, making them more impulsive and less likely to consider available resources. If a person is likely to use drugs, help needs to be called before a person becomes intoxicated and possibly makes a dangerous mistake. A previous history of suicide attempts increases a person’s suicide risk; thus, help should be attained immediately if a suicide survivor begins to experience suicidal thoughts.

Risk Factors

Numerous risk factors need to be evaluated to determine suicide risk level. Below is a listing of the more serious factors warranting immediate intervention. If any of the following become present in a person’s thoughts or behavior, help should be sought immediately (note this is not a comprehensive list but rather an overview of the more common risk factors):

  • Decreased or no sleep. Without adequate restorative sleep, a person’s insight and judgment become significantly affected.
  • Developing a suicide plan. A person moves thoughts into an action plan.
  • Identifying ways to access suicide means or storing means (pills, guns, etc.).
  • Giving away personal items of value and/or getting one’s affairs in order with the anticipation of dying.
  • Any psychotic symptom such as auditory or visual hallucinations.
  • Hopelessness, seeing no hope for the future.
  • Intent to die.
  • History of mental health treatment in the past, especially a history of suicide attempts.
  • Family history of a completed suicide.
  • Limited or absent support system (few or no friends or family to call for help)
  • Serious/chronic medical condition(s).
  • Withdrawing from sources of support, such as family, work, or friends.
  • Happiness immediately after feeling severely depressed: This may suggest a person has resolved to die and is now hopeful for their plan.
  • Impulsive and/or high risk taking or careless behavior, different from the person’s normal functioning.

Treatment Options

Depression and thoughts of suicide are serious, but they are also highly treatable. The sooner a person elicits help from friends, family, or a compassionate mental health professional, the sooner they may be able to gain healthier perspectives and insight into ways they can work to handle their current state. Help may be able to instill hope and help a person begin the process of returning to a happier and stable state.

It is important to know some available resources for those experiencing suicidal ideation. First, call 911 immediately if a person is expressing they may no longer be able to remain safe on their own. Second, if safety permits, a person can be taken by friends or family to any hospital emergency department, where the person will receive a comprehensive evaluation and possible placement inside a mental health facility. Third, many therapists have after-hours support available, but this should be used only if there is not an imminent threat to personal safety. Fourth, the National Suicide Prevention Lifeline (24 hours, seven days a week) can be reached at 1-800-273-8255, where a trained person will listen and help a person decide the best route for help. And lastly, many communities have local-based suicide-prevention crisis lines and clinics. Check with your local mental health department to see what resources are available.

How to know if you have depression

While not an official term or diagnosis, the term “depression attack” is an apt way to describe an episode of depression, usually a depression relapse or recurrence. It can be triggered by an upsetting event or appear to strike out of nowhere. Often, depression sneaks up on people insidiously, with depression symptoms slowly appearing and gradually worsening. In those cases, you might not realize right away that you’re experiencing depression. You might think that you’re just “off” or down or stressed or tired and that the feelings will pass—until they don’t. When people talk about a depression attack, they’re referring to depression symptoms that barge in and bring healthy functioning to a screeching halt.

Let’s look at what a depression attack is like. Then, you’ll learn how you can fight back.

What’s a Depression Attack Like?

A depression attack is different in nature from a panic attack or a heart attack. Heart- and panic attacks are short-lived (the consequences and effects do last, but the actual attack happens in a distinct amount of time). The symptoms of a depression attack can be just as gripping and intense, but their duration is more prolonged. In fact, to be considered an episode of major depression, symptoms must last at least two weeks.

In addition to lasting at least two weeks, to be considered a depressive episode, at least five of these depression symptoms must be present nearly every day (American Psychiatric Association, 2013):

  • Low mood
  • Hopelessness
  • Unintended weight loss or weight gain
  • Sleeping too much (hypersomnia) or difficulty sleeping (insomnia)
  • Fatigue
  • Difficulty thinking and concentrating
  • Restlessness or lethargy
  • Thoughts of death

That list of symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is accurate but doesn’t capture the essence of an attack of depression. Such episodes are forceful and can feel crushing. In a 2004 Psychiatric Times article, pediatrician Elizabeth Griffin describes her own depression attacks and echoes the experiences of countless others. Depression attacks, Griffin explains, can:

  • Shut you down completely so that you miss work, separate from family and friends, and even withdraw from yourself, neglecting self-care and the activities of your life
  • Cause frequent crying spells
  • Create or intensify strong self-hatred
  • Throw you into deep despair
  • Overwhelm you with your own crushing thoughts
  • Make you want to die

(Note: If you are experiencing suicidal thoughts, please contact the National Suicide Prevention Lifeline online or call 1-800-273-8255. They exist to help.)

“Attack” is a good word for these experiences because it feels like you are under siege, held captive by depression. Even though it might feel impossible, you can fight back against depression any time it attacks.

How to Fight Back When Depression Attacks

When something assaults us, our fight, flight, or freeze response automatically kicks in. Fighting involves changes throughout the brain and body, with stress hormones flooding our system so we can tense up and strike back. Our flight response creates the urge to run and hide from the problem, withdrawing from our lives in an attempt to escape. And when we freeze, we stop in our tracks, figuratively paralyzed and unable to take action at all. These are our natural survival instincts, and following them doesn’t make you weak or bad. Yet neither fighting, fleeing, nor freezing works to stop a depression attack.

The following actions are effective ways to move yourself out of the way of depression’s advances and keep moving in the direction you want to go.

  • Use deep breathing exercises to remain calm and counter physical symptoms of depression like aches and pains.
  • Understand your depression and its attacks, and accept that they’re there. This will allow you to stop ruminating about your symptoms while you develop your character strengths, roles (parent, coworker, group member, etc.), and interests.
  • Practice self-care even if you don’t want to. Nutrition, hygiene, and exercise all combat depression attacks.
  • If your doctor has prescribed medication, take it as directed to keep a steady supply in your system.
  • Enlist the help of a mental health professional. Therapy can help thoughts, feelings, and behaviors.
  • Reach out to others for support. Talk to a family member or a friend, and consider joining a depression support group.

You can also counter a depression attack by being positive and shifting your perspective away from what’s wrong and onto the good in your life. While depression tries to hide the good from you, you can seek and find it. Practice mindfulness to be fully present in your moment rather than trapped in negative thoughts. Express gratitude, writing it down in a journal, saying it out loud to someone, or both. This also shrinks depression by growing your awareness of the good in your life.

A depression attack can be miserable. Fighting back isn’t easy. That said, moving yourself out of a depressive episode is absolutely possible.


Professor of Affective Neuroscience, University of East London

Disclosure statement

Cynthia Fu has received funding from the MRC, Wellcome Trust, Brain and Behavior (NARSAD) Foundation, HEFCE, GlaxoSmithKline and Eli Lilly.


University of East London provides funding as a member of The Conversation UK.

We currently diagnose depression based on what individuals tell us about their feelings – or those of their loved ones. People with depression usually describe feeling sad or say they are unable to enjoy the things they used to. But in many cases they don’t actually realise that they are clinically depressed – or feel uncomfortable talking to a health professional about it.

Such cases pose an important problem as untreated depression can hugely interfere with someone’s life, significantly increasing the risk of suicide. Currently, it is difficult to help people who are not able or willing to communicate how they feel, as there are no biological markers for the condition. But we have managed to identify a network of brain regions that is affected in people with depression – raising hope that brain scans could soon be used to diagnose it.

Depression has been recognised as an illness for centuries and was initially called melancholia – then believed to be caused by an excess of “black bile”. We now recognise that there are genetic as well as environmental factors that increase the risk of depression. For example, it occurs more frequently in certain families and in children who have suffered from abuse. We are also beginning to identify genes that are associated with the development of depression.

There are several physical symptoms of depression, including a reduction in appetite and weight loss. But the trouble is that these could be caused by a variety of conditions. Also, people can be affected in different ways – some may notice an increase rather than a decrease in appetite, for example.

Problems with sleep are also common. Many people wake up in the middle of the night and then have trouble getting back to sleep. Others may be sleeping more than they usually do. Further symptoms include losing interest in doing things, a reduction in libido, a lack of energy and finding it difficult to concentrate. Some people start over-thinking things, feeling guilty or even begin to wish they were dead.

While we have all experienced feeling low at some point in our lives, a distinct feature of depression is how long these symptoms continue for and how bad they can become. They are often experienced as unremitting.

The depressed brain

We have been studying the brain regions affected by depression for some time. For example, we have already identified widespread reductions in brain tissue known as grey matter in the limbic lobe (supporting functions including emotion, behaviour and motivation) and prefrontal regions (involved in planning complex cognitive behaviour and decision making) in depressed people.

Most previous research has looked at overall differences between groups of people with depression and groups of healthy volunteers. We did something different. We identified the pattern of brain regions that is most commonly found in our group of patients with depression. We then asked whether the same pattern could be found in another person and whether it would indicate that they were also suffering from depression.

How to know if you have depression

To do this, we applied a form of analysis called machine learning, using algorithms developed from statistical learning theory and artificial intelligence. It works by recognising patterns in data and learning from these patterns to make predictions about new data sets. The data came from structural magnetic resonance imaging (MRI) scans (which use strong magnetic fields map the location of water and fat in the body) in 23 adults with major depressive disorder and 20 matched healthy individuals.

How to know if you have depression

We found that there is a widespread network of brain regions which includes specific density variations in both grey and white matter in patients with depression. These extend from the prefrontal areas of the brain to the parietal lobes (which integrate sensory information), and include occipital (involved in visual processing) and cerebellar (centre for motor control) regions. We were able to match the exact same pattern of brain regions in other people who were also experiencing depression.

The study, published in the British Journal of Psychiatry, tells us that there is an underlying brain structure in depression and that we may be able to use this information to help us to make a diagnosis.

We also looked at whether we could use the same pattern of regions in individuals with different ethnicity. This is because there is some evidence that people with different ethnicity can demonstrate distinct neural responses in particular situations. But we found that the same pattern of regions appears to underlie depression in individuals with different ethnic backgrounds – adding further hope that we have indeed found a true biological marker for depression.

We also looked at whether we could predict if someone’s depression would respond to an antidepressant medication or to a talking therapy. Although we have guidelines about how to start particular therapies, we are not able to say, for a specific patient, how likely it is that the therapy will help their depression. But we found that there are specific patterns of brain regions which distinguish how well someone’s depression will improve when treated with antidepressant medication or with a talking therapy.

The pattern of regions that indicated whether a patient would experience a good response to pharmacological treatment included a greater density of grey matter in the areas that, among other things, help link behavioural outcomes to motivation. However, participants who were at risk of having symptoms that resisted treatment with medication instead would have a greater grey matter density in areas of the brain involved in evaluating reward. Based on this pattern, we were able to say that there was at least an 80% likelihood that a certain patient would respond to antidepressant medication, and in some cases even higher.

The scan itself took about ten minutes. Although promising, MRI scanners are currently not widely available, and not everyone can have an MRI scan – for example, those fitted with a pacemaker. In order for this to be used in day-to-day clinical care, we would also need to distinguish the pattern of brain regions that is specific for depression from other disorders, such as bipolar disorder and schizophrenia, which could show distinct networks of brain regions.

But the good news is that the study is supported by other research which has similarly found that structural MRI scans could be diagnostic for depression. The next step is to replicate and generalise these specific findings.

Though a bad mood might feel like depression, they’re really two different things.

How to know if you have depression

Everyday Health Archive

How to know if you have depression

Most everyone goes through bad moods. But when the blues don’t go away, you might wonder if, in fact, you are truly depressed. Because depression has clearly defined symptoms, however, there’s a way to figure out whether you need to seek treatment.

Depression is diagnosed when a person experiences five or more specific symptoms for more than two weeks, according to the American Psychiatric Association. Those symptoms include feelings of sadness and loss of pleasure in activities you once enjoyed, changes in appetite that cause weight loss or gain, sleeping too little or too much, feeling tired all the time, having difficulty concentrating and making decisions, and feeling angry and irritable. People with depression might also have feelings of worthlessness or guilt, unexplained physical pain like headaches or backaches, and frequent thoughts of death or suicide.

“Everyone has bad days, the normal ups and downs of life where you feel better the next day, but depression is ongoing,” says David Hellerstein, MD, a psychiatry professor at Columbia University Medical Center in New York City. It’s also common, affecting more than 23 million adult Americans every year, according to the Depression and Bipolar Support Alliance.

“People who have major depression have it for a lot more than two weeks; usually months or years,” Dr. Hellerstein says. They find it extremely difficult to function. Those with a milder form, known as dysthymic disorder, feel chronically lousy but are typically able to push through their days.

A bad mood shares many of the same characteristics as depression but moves like a subway ride though the city: Before you know it, it’s over. With depression, however, you’re on a road trip that never seems to end.

Candy McCarley, 62, of Cincinnati, was one such traveler.

“I got to the point where I couldn’t even go out of the house,” McCarley says of her depression. She compares the feeling to trying to climb out of a jar of peanut butter. “I couldn’t make any headway, I just kept getting stuck,” she says. “I slept a lot. I cried a lot. I was really not aware of what was going on around me.” A friend who had been treated for depression told McCarley she needed help.

Is It Depression, or Not?

Not everyone experiences depression in the same way.

Women suffering from depression often report feeling sad, while men with depression may be more likely to be irritable and aggressive, according to the Mayo Clinic. Depression in children can include clinginess, worry, and a desire to stay home from school. Teens may get angry, engage in self-harm, and withdraw socially. Older adults may experience memory problems and personality changes.

Common symptoms across all groups include physical problems like chronic pain and digestive disorders that don’t respond to treatment, according to Mental Health America.

Depression also can sometimes go from enduring feelings of sadness to a situation that is potentially deadly. Common suicide warning signs include feeling worthless, a lack of interest in previously enjoyed activities, withdrawal, reckless behaviors, giving away possessions, talking about death, and searching for ways to die by suicide, according to the National Alliance on Mental Illness. Suicidal people can sometimes appear to be feeling better just before they take their lives.

If you feel you might be depressed, says Hellerstein, start by making an appointment with your family doctor. “The primary care physicians are the gatekeepers; the first source for seeking treatment,” Hellerstein says.

For starters, your doctor will want to rule out other conditions with symptoms that can mimic depression.

“Generally a person for whom a medical condition is the cause of the depression will have some abnormalities on those tests — for instance, abnormal thyroid hormone levels,” says Hellerstein. “At times, there is a hidden medical cause of depression, such as cancer, but that is pretty rare.”

In addition to checking you physically, your doctor may do a psychological evaluation in which you’re asked about your thoughts and feelings. Although it shouldn’t replace a doctor’s visit, you can also do a test online to help determine if what you’re feeling and experiencing is truly depression.

If you are depressed, your practitioner may start treatment by prescribing medication, referring you to a therapist or psychiatrist, or both. Though antidepressants generally provide relief in two to four weeks, “if there is no benefit after one month, that medication is probably not going to work,” Hellerstein says. Then, your doctor might try a higher dose or a different medication.

Today, McCarley is no longer taking an antidepressant but recognizes that feeling good requires getting enough sleep, eating a well-balanced diet, exercising, and reaching out to others, particularly when she’s feeling down. She encourages those suffering with depression to seek help and be patient in finding the right course of action.

“If a medication or treatment doesn’t work, try a different one,” she says. “Don’t give up — there is help out there that works.”

Everyone feels down from time to time. Work is busy. Your kids’ schedules are overwhelming. You’re not getting enough sleep, and you’d rather spend the day at home in your sweats in front of the TV. You can’t muster the energy to do the things you need to do or the things you want to do. We’ve all been there. How do you know if you’re just burned out — or if you’re actually depressed?

It can be hard to distinguish between a bad mood or exhaustion and actual depression because the symptoms can be similar. While the word “depression” often brings to mind images of extreme sadness or inactivity, the mood changes related to depression are often more subtle than that, especially for women. Plus, it tends to affect more women than men.

You don’t need to have extreme emotions to have depression or another mood disorder, says Karen Swartz, M.D., director of the clinical and education programs at the Johns Hopkins Mood Disorders Center . “People think of depression as sadness or crying. They think of bipolar disorder as the Hollywood version of ‘mania,’ which is fun, outrageous happiness,” she says.

But in reality, mood disorders aren’t that dramatic — fewer than 50 percent of depressed women even describe themselves as sad. And not knowing the signs of a mood disorder can lead women to go untreated for longer than they should.

So how do you decide if it’s time to get help? First, it’s important to know that there are several types of mood disorders.

Types of Mood Disorders

There are several common types of mood disorders, including:

  • Major depression : Characterized as having less than normal interest in regular activities and lacking energy and focus for at least two weeks. “This is an illness mainly of women,” Swartz says. Premenopausal women are the group most affected by major depression. Their risk is twice as high as it is for men — roughly 20 percent of women will have a depressive incident at some point in their lives, compared to 10 percent of men. Research also suggests that in some women, reproductive-related hormonal changes can raise the risk of having depression.
  • Dysthymia (chronic depression) : A chronic, low-grade depressed or irritable mood lasting for at least two years.
  • Bipolar disorder : Fewer than 1 percent of adults have bipolar disorder. This mood disorder is marked by periods of depression alternating with periods of mania or elevated mood.

All mood disorders tend to run in families, so your risk is higher if you have relatives with depression or bipolar disorder.

Symptoms of Mood Disorders

Because the effects of mood disorders can be easy to ignore, it’s important to be tuned in to small changes in how you feel. Common symptoms of mood disorders include:

  • Irritability, aggression or hostility
  • An ongoing sad, empty or anxious mood
  • Changes in appetite or weight
  • Changes in sleep patterns
  • Difficulty concentrating

These symptoms may be more intense and last longer than what you normally experience every now and then. For instance, they might interfere with your ability to work or to enjoy being with friends and family.

How to Get Help for a Mood Disorder

If you think you might have a mood disorder, Swartz recommends first bringing your concerns to your primary care provider. If you feel your doctor is not taking your symptoms seriously, ask to be referred to a psychiatric provider.

“It’s OK to ask your physician, ‘Are you comfortable with treating these illnesses, or would it be better to refer me to a specialist?’” Swartz suggests.

Typical treatments include antidepressants and cognitive behavioral therapy, a type of talk therapy that focuses on developing coping strategies and changing unhealthy thoughts and behaviors. Of the antidepressants, selective serotonin reuptake inhibitors (SSRIs) like escitalopram are most commonly prescribed. Many studies show that a mix of medication and therapy is the most effective way to treat mood disorders.

Proper sleep is also critical while being treated for a mood disorder, Swartz says. “Interrupted sleep can be a trigger for bipolar disorder and depression. Normalizing and protecting sleep is very important,” she says.

If you don’t notice mood improvement on medication right away, remember that it does get better. Most people need to be on a full dose of medication for up to eight weeks before seeing benefits.

#TomorrowsDiscoveries: How the Brain Processes Incentives and Rewards | Vikram S. Chib, Ph.D.

Johns Hopkins researcher Vikram S. Chib studies the way incentives and rewards work in the brain and how this can lead to breakthroughs in depression treatment.

If you’re one of the more than 14.8 million American adults who experiences major depression, you may feel so bad that you can’t get out of bed, be around the people you love or participate in activities that you usually enjoy. Actually, there are more than 50 different symptoms of major depression, ranging from the well-known—crying and sadness—to those you might never associate with depression, such as anger, workaholism and back pain.

Depression is a disease that affects every aspect of a person’s life, not just mood, says Johns Hopkins expert Andrew Angelino, M.D., Chair of Psychiatry at Howard County General Hospital. The World Health Organization predicts that by 2020, depression will be the second-leading cause of disability in the world, just behind cardiovascular disease.

People who are depressed are far more likely to have other chronic medical conditions, including cardiovascular disease, back problems, arthritis, diabetes, and high blood pressure, and to have worse outcomes. Untreated depression can even affect your immune response to some vaccines.

Depression is not just debilitating; it can be deadly. An estimated one out of five people with depression will attempt suicide at some point.

Causes and Risk Factors

Depression is not a mood you can just get over. It is a disease in which the brain ceases to register pleasurable activities, says Angelino. Indeed, MRI studies with depressed people have found changes in the parts of the brain that play a significant role in depression.

Women are about twice as likely as men to be diagnosed with depression. You’re also more likely to develop depression if you are between ages 45 and 64, nonwhite, or divorced, and if you never graduated high school, can’t work or are unemployed, and don’t have health insurance. Other risks for depression include factors such as these:

  • Experiencing stressful events in your life, such as losing your job, having problems in your marriage, major health problems, and/or financial challenges.
  • Having a bad childhood, such as one involving abuse, poor relationships with your parents, and/or your parents own marital problems.
  • Certain personality traits, such as getting extremely upset when you’re stressed.
  • A family history of depression, which can increase your own risk three or four times.

Depression is far more common than you might think, with nearly one out of 10 adults depressed at any time, about half of them severely.

Symptoms and Diagnosis

Symptoms of depression vary widely but can be divided into three main categories:

  • Emotional and cognitive (thinking) symptoms include a depressed mood, lack of interest or motivation in things you typically enjoy, problems making decisions, irritability, excessive worrying, memory problems and excessive guilt.
  • Physical symptoms include fatigue, sleep problems (such as waking too early, problems falling or staying asleep, sleeping too much), changes in appetite, weight loss or gain, aches and pains, headaches, heart palpitations, and burning or tingling sensations.
  • Behavioral symptoms include crying uncontrollably, having angry outbursts, withdrawing from friends and family, becoming a workaholic, abusing alcohol or drugs, cutting or otherwise hurting yourself, and, in the worst cases, considering or attempting suicide.

Depression can be classified as:

  • Major depressive disorder (MDD), which includes depressed mood and/or reduced interest and pleasure in life, considered “core” symptoms, and other symptoms that significantly affect daily life.
  • Dysthymia, (dis-THI-me-a), a milder form of depression that can progress to MDD.
  • Postpartum depression, which occurs within weeks of giving birth.
  • Psychotic depression, which comes with delusions and/or hallucinations.
  • Seasonal affective depression, which occurs as the days get shorter and improves with spring.

#TomorrowsDiscoveries: How the Brain Processes Incentives and Rewards | Vikram S. Chib, Ph.D.

Johns Hopkins researcher Vikram S. Chib studies the way incentives and rewards work in the brain and how this can lead to breakthroughs in depression treatment.


Cardiovascular (car-dee-oh-vas-cue-ler) disease: Problems of the heart or blood vessels, often caused by atherosclerosis—the build-up of fat deposits in artery walls—and by high blood pressure, which can weaken blood vessels, encourage atherosclerosis and make arteries stiff. Heart valve disorders, heart failure and off-beat heart rhythms (called arrhythmias) are also types of cardiovascular disease.

Cognitive behavioral therapy (CBT): Two different psychotherapies—cognitive therapy and behavioral therapy— in one. Cognitive therapy can help you improve your mood by changing unhelpful thinking patterns. Behavioral therapy helps you identify and solve unhealthy habits. When used in conjunction with each another, these therapies have been shown to improve problems such as depression, anxiety, bipolar disorder, insomnia and eating disorders.

Heart palpitations (pal-peh-tay-shuns): The feeling that your heart is thumping, racing, flip-flopping or skipping beats. Strong emotions, caffeine, nicotine, vigorous exercise, medical conditions (such as low blood sugar or dehydration) and some medications may cause heart palpitations. Call 911 if you also have chest pain, shortness of breath or unusual sweating, or feel dizzy or faint.

Immune response: How your immune system recognizes and defends itself against bacteria, viruses, toxins and other harmful substances. A response can include anything from coughing and sneezing to an increase in white blood cells, which attack foreign substances.

Interpersonal therapy (IPT): A treatment often used for depression that lifts mood by teaching you how to relate with others in a healthier way. A therapist will help you identify troubling emotions and their triggers, express emotions in a more productive way and examine past relationships that may have contributed to your current mental health issues.

Lean protein: Meats and other protein-rich foods low in saturated fat. These include boneless skinless chicken and turkey, extra-lean ground beef, beans, fat-free yogurt, seafood, tofu, tempeh and lean cuts of red meat, such as round steaks and roasts, top loin and top sirloin. Choosing these can help control cholesterol.

Omega-3 fatty acids (oh-may-ga three fah-tee a-sids): Healthy polyunsaturated fats that the body uses to build brain-cell membranes. They’re considered essential fats because our body needs them but can’t make them on its own; we must take them in through food or supplements. A diet rich in omega-3s—found in fatty fish, like salmon, tuna and mackerel, as well as in walnuts, flaxseed and canola oil—and low in saturated fats may help protect against heart disease, stroke, cancer and inflammatory bowel disease.

Whole grains: Grains such as whole wheat, brown rice and barley still have their fiber-rich outer shell, called the bran, and inner germ. It provides vitamins, minerals and good fats. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too.

By Susan Heitler — Written on May 15, 2021

How to know if you have depression

Have you caught yourself questioning, “Is my marriage making me depressed?” There are ways to tell if you’re suffering from situational depression that stems from relationship problems.

Depression can feel like you’re under a perpetual dark cloud and cause you to feel blue or in a grumpy mood. You may feel heavy, tired, and without interest in activities you usually enjoy.

Depression also causes uncharacteristically negative thoughts about yourself, others and your future.

But can a bad marriage cause depression?

There are many causes of depression, and problems in your marriage or relationship are just one reason you’re experiencing situational depression. Depression can come from a disorder of power, or it can come from a message from someone you care about that wounds your self-regard.

In general, women are more likely to experience depression after a divorce than men. However, men are less likely to talk openly about their depression.

What are the signs of an unhappy marriage?

Some signs of an unhappy marriage range from no longer having sex to minimizing each other’s feelings and concerns. In other words, you’re no longer having fun and your confidence is gone. You feel neglected and everything your partner does gets under your skin.

If you’re feeling powerless and/or hurt in a relationship, either in general or because of a particular event that happened, odds are high that depression will creep into your emotional state.

How do toxic relationships affect your mental health?

Toxic relationships stress you out, and stress shortens lifespans. Relationships like this may cause you to feel more insecure or lower your self-esteem, which allows hurtful thoughts to pop into your head. They make you feel helpless, scared, anxious, and even paranoid. These are all symptoms of depression.

And, believe it or not, a bad relationship can cause mental illness. All of those feelings are gateways to some very severe mental health issues like depression or anxiety.

Instead of ignoring these red flags, consider what you can do differently to prevent them from knocking you down.​ And if you feel your depression getting worse or need help or support, reach out to friends, family members and/or professionals. It doesn’t have to last forever.

Is it possible my marriage is making me depressed?

Yes, it’s entirely possible that your bad relationship or problems in your marriage are making you depressed — or at least contributing to your depression. These are general signs of an unhealthy relationship, so if you’re seeing these but are not depressed, you may still have reason to be concerned.

Here are 10 signs of situational depression caused by staying in toxic, emotionally abusive relationships or marriages:

1. You feel dominated.

Depression can emerge when you feel smaller and less powerful than the person you’re interacting with.

Not all power differences create depression. For instance, while a parent has most of the power in a healthy parent-child relationship, as long as the parent uses this power to nurture, rather than to dominate, over the child, all will be well. Similarly, employers have more power than employees.

In love relationships between two adults, though, shared power is healthier than a one-up, one-down power imbalance.

2. You feel criticized.

“I don’t like your hair that way.” “You shouldn’t have bought that new sweater.”

Criticisms are put-downs. Feedback is not a problem, but criticism is.

Feedback lets you know in a gentle way that something you have been doing is problematic and it usually starts with an “I” statement: “I felt uncomfortable when I saw your new sweater because I’m worried about whether we’re going to have enough money to cover our bills this month.”

Being constantly criticized by the one person you love is valid grounds to cause a breakdown, so this is a serious issue in your relationship that needs to be addressed immediately.

By contrast, critical words and a judgmental tone of voice make criticism problematic. Not only that, but constant criticism from your partner can make the voice inside your head turn on you as well, which will make the depression even more intense.

3. Your partner tells you what to do.

Bossy attitudes are demoralizing. Even a benign order like “Go get the paper for me, honey,” is likely to trigger either irritation or depression in the receiver because no one likes being told what to do. That’s the pattern when two autonomous people work together as a team.

Depression stems from feeling like you have insufficient power. Being told what to do conveys that the other person is the boss and you are a servant. It’s better to ask. Requests allow for yes or no as an answer.

4. Your partner tries to control you.

Controlling what you can do with your time, finances, friendship choices and how much you can visit your family: all these behaviors are likely to invite feelings of depression.

Getting mad at you if you didn’t load the dishwasher his way, or left dishes on the counter-top, are signs that your partner focuses on controlling you instead of being captain of his own ship.

Remember: depression is a disorder of power. When your partner takes away your power to make personal decisions (or at least to contribute jointly to decisions), depression is likely to be imminent.

5. Your partner is ‘always right.’

It’s fine for your loved one to be right, as long as he/she doesn’t require being right all the time.

If your partner’s being right means that there’s no ability to admit mistakes, that’s a problem. And if your partner being right means you are consistently wrong, look out.

6. With your partner, it’s ‘my way or the highway.’

Listening is loving in a healthy relationship because of the opinions and concerns of both of you count. That’s true whether you’re wondering what to eat for dinner or deciding where to live.

If your voice gets dismissed, you’ll be at risk of feeling powerless and depressed.

7. Your partner is depressed.

Depression is contagious. It’s not contagious in the same way as the flu, but one study showed it’s a social contagion theory, explaining that humans will naturally adopt the behavior that is around them.

When someone is depressed, he/she tends to see the world — including you — through dark glasses. If you adopt your partner’s view, you’ll sink down emotionally, too.

Encourage your husband or wife to attend therapy sessions or even take a walk outside. Sometimes little things like that can give them a sense of purpose and get them out of their head for a bit. However, a therapist would be best.

8. Your partner is irritable.

Irritability is low-intensity anger. Anger spreads toxic negative energy. This toxicity can induce depression in the receiver of anger.

How to know if you have depression

At some point (okay, maybe at several points), you have probably unleashed your inner dragoness, the one who gets enraged, spits a little fire and—goddess forbid!—isn’t a ray of sunshine. Traditionally, we’ve been taught that this side of ourselves is bad, bad, bad. And increasingly, we’re being prescribed antidepressants and antianxiety meds to proceed on a more even, less emotional keel. But Julie Holland, MD, a psychiatrist who specializes in psychopharmacology and is the author of the cheekily titled new book Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having, and What’s Really Making You Crazy, says that the more we medicate, the more we cheat ourselves out of rich, full lives. “I’m not saying women with clear psychiatric disorders, such as major chronic depression and bipolar disorder, should stop taking their meds,” says Holland. “But I do believe that too many women are being told to medicate away their essential, authentic selves.”

Research does show that mood disorders may be overdiagnosed: A 2013 study of more than 5,000 people found that nearly 62 percent had been told by a medical professional that they had depression even though they did not meet the clinical criteria. Holland’s advice: Embrace your moods. All of them. “One of the gifts women have is the ability to be sensitive to their environment and empathic to people around them,” she says. “We can intuit what’s going on and who needs what—and we shouldn’t tamp down our natural emotionality.” Yet while advocating against overmedication seems sensible enough, are things really that simple? We asked Holland, who has treated patients for nearly 20 years, to convince us that there’s a pill-free way to develop a healthy balance.

Q: What’s so great about being angry or anxious?

A: Many people don’t recognize that their feelings can be an important feedback system. Irritation or resentment could tip you off to an imbalance of effort or compassion in a relationship. Depression may mean something in your life needs to change. I had a patient who called me crying from work one day and said, “I think we need to up my antidepressants.” Then she proceeded to tell me a horrible story about her abusive boss. My response: “We don’t need to medicate away your indignant feelings. He behaved very badly, and for you to increase your medicine so you don’t mind that he behaved very badly doesn’t do anyone any favors.” My point was that being more accommodating and thick-skinned isn’t necessarily the answer. You can’t just medicate yourself so you don’t care! Silencing the signals that you need to make necessary changes in your life—like confronting a mean manager or ending a bad relationship—can leave you in a paralyzing state of denial.

Q: Are you saying antidepressants make it hard to take a clear-eyed look at our problems?

A: A large number of my patients feel happier and more relaxed on the antidepressants known as SSRIs (selective serotonin reuptake inhibitors), and nearly all antianxiety meds are sedating. These drugs can clearly work, but there may be a cost. Not only may you be more likely to experience apathy, you may also feel less empathy. And many women are on a combination of oral contraception and antidepressants. So they have artificially high estrogen levels from the pill and artificially high serotonin levels from the antidepressants, which may improve their moods to the point where there’s a lot of accommodating going on. They end up suppressing their own agenda and desires in service to others. Another issue is that women will say they don’t feel things as deeply, which may be a relief, but again, they’re not being their real selves.

Q: I was surprised to learn that fewer than 30 percent of Americans taking one antidepressant and fewer than half of those taking multiple meds have seen a mental health professional in the past year.

A: Here’s the analogy I use: If you’re going down a bumpy road, you need some shock absorbers. Otherwise, you’ll feel every pothole. Therapy is like a set of emotional shock absorbers. If you do the work, you learn how to create patterns in your thinking and behavior that can help you be more resilient in times of stress. If you’re only taking meds without also seeing a therapist, you’re not learning any new skills, so when you stop taking the drugs, you’re not really any better off. I encourage—borderline insist—that my patients go into therapy. I want people to adopt healthier coping strategies so they can get off meds. That’s the goal. You’re not meant to stay on these drugs for decades.

Q: So patients in therapy are more likely to eventually get off antidepressants?

A: Yes, but I would add that among my patients, the ones who are most likely to get off meds are also the ones who do regular cardio. I’ve seen it over and over. When people become regular exercisers, they need lower doses or they can get off their meds entirely. As much as I bug my patients about being in therapy, I really noodge them about physical activity. It makes a big difference in helping people feel their best—at which point they don’t have the need to blunt their natural emotions with medicine.

Q: You also say women should track their hormonal cycle in order to tap into their moods. Why?

A: I had a patient who told me that none of her previous doctors had ever brought up the idea that there could be a cyclical pattern to her depression. I actually have quite a few patients who never put it together until I asked them to find their natural emotional baseline by tracking their moods over the course of one monthly cycle. There are times when estrogen and serotonin are high—usually the first half of the cycle—when everything’s probably better and you feel resilient and efficient. That’s a time to get things done. Right before your period, when estrogen and serotonin levels bottom out, you may feel on edge—more aware of social slights, more sensitive to rejection. If you chart the highs and lows, you’ll know what to expect and prepare better.

Q: But should we have to plan our lives around our hormones?

A: Part of being authentic means owning the fact that you’re reactive, adaptive and emotional. On the days you’re less accommodating and more critical, I suggest you use that time to take an honest inventory. What’s important to you? What’s out of place? What’s overwhelming? When you’re feeling more diplomatic, you can start to implement some changes. But you have to own those critical feelings. Don’t brush them off as PMS. When you take stock and address any issues you notice, you’re giving yourself the chance to remain true to you.

June 29, 2021, 12:00 AM

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Losing a job, ending a relationship or being diagnosed with a chronic disease can all lead to feelings of sadness and despair. Feeling blue from time to time is a normal part of life. But when feelings of sadness last for more than two weeks and a sense of hopelessness settles in, you may be experiencing something more serious like depression.

Depression affects how a person feels, thinks and acts and may lead to both physical and emotional issues. Depression can occur at any age, but usually starts in adolescence or adulthood. Women are nearly twice as likely as men to be affected by depression, according to the American Psychiatric Association.

What Triggers Depression?

Depression can coexist with other health conditions such as cancer, heart disease, diabetes and hyperthyroidism. Family history, substance abuse and side effects from medications can also cause depression.

Sadness and grief from losing a loved one is normal and is generally not considered depression, unless the grief lasts for a few months and interferes with functioning.

“Certainly, stressful life conditions including unemployment, financial problems and the COVID-19 pandemic may contribute to depression,” says Dr. Richa Bhatia, director of psychiatry at Santa Rosa Community Health in California. “It’s understandable that the social isolation that many people faced during the pandemic may have contributed to significant psychological stress and depression.”

Different Types of Depression

Depression is classified as mild, moderate and severe or commonly called “major depression.” A diagnosis of depression is usually made after a doctor completes a physical and mental health exam.

Mild depression is more than just feeling a little sad. It occurs when these emotions last for a few months and start interfering with your job and personal life. Moderate and severe depression share many of the same symptoms of mild depression, but with more intensity.

Major depression is one of the most common mental disorders in the U.S., and it’s also the most common type of depression. An estimated 17.3 million U.S. adults experienced at least one major depressive episode over a yearlong period, which represented 7% of all American adults, according to a 2017 survey by the National Institute of Mental Health. For some individuals, major depression can result in serious impairments that interfere with or limit one’s ability to carry out major life activities.

Depression severity can be evaluated across four dimensions, including: frequency and duration of distress, intensity of the symptoms, number of symptoms and overall impairment, says Bethany Teachman, professor of psychology at the University of Virginia.

Teachman explains that for frequency of symptoms, those suffering mild depression might experience sadness or irritability on and off; but if those feelings happen every day for multiple hours then it might be advancing to moderate depression. Teachman adds: “For those suffering from severe depression, the negative feelings are constant and relentless without much break.”

For example, depression can impair your performance at work. In mild cases, there might be some minor mistakes made during the job, but if you’re failing to meet deadlines or show up for work, then the depression is becoming more advanced; and when you’re spending more of your time in bed and aren’t able to go to work, then it would be considered severe depression, explains Teachman.

Symptoms of Depression

There are many symptoms that we look for, but to be diagnosed with major depressive disorder there must be at least five symptoms present confirmed through a health examination, says Bhatia, author of the book “65 Answers about Psychiatric Conditions.” “At the first signs of lingering or significant sadness, talk to your doctor about what might be causing these emotions and whether or not you are experiencing depression.”

Depression may include some of these signs and symptoms:

— Difficulty thinking or concentrating.

— Diminished interest in socializing or activities.

— Fatigue or decreased energy.

— Irritability or anger.

— Loss of appetite.

— Low self-esteem or lack of motivation.

— Physical aches and pain.

— Reckless behavior, such as abuse of alcohol and drugs or gambling.

— Sadness and worthlessness.

Teachman adds: “There’s a misperception that suicidal thoughts only occur when someone is diagnosed with severe depression. In truth, suicidal thoughts can occur at any level of depression severity so it’s important to seek care if a person shows multiple warning signs of suicide, such as talking about wanting to die or talking about feeling hopeless or being a burden to others.”

Because depression alters patterns of thinking and feelings, people sometimes see suicide as the only answer to escape their pain. An estimated 2% of those being treated for depression will die by suicide, according to the Department of Health and Human Services. Any thought of suicide should be taken seriously. If you think you or a loved one may hurt themself, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

It’s important to get help right away, Teachman adds: “It’s easier to treat depression early on so we want people to seek help before things really feel hopeless, though it is never too late.”

How Can You Manage Depression?

The good news is that many people are able to manage depression once they seek help, Bhatia says. “But when left unmanaged, depression can get worse and affect your activities at home, work and school.”

For mild depression, doing moderate exercise, stress reduction and mindfulness-based interventions may help improve depression, in conjunction with psychotherapy, Bhatia says. Having a close family member or friend to talk to about feelings of sadness can make the biggest difference.

But even loved ones with great listening skills will not have all the answers. In moderate to severe cases, getting help from a professional can prevent depression from getting worse. Your doctor may recommend psychotherapy or “talk therapy” with a social worker or psychologist. Cognitive behavioral therapy, or CBT, is a common type of therapy to help people recognize and manage negative thoughts and gradually change their behavior to improve their outlook. There are many resources to help you find support from a professional. For example, finding a highly qualified mental health professional is a click away with the American Psychological Association’s free psychologist locator tool available here.

After an evaluation, your primary care doctor or a psychiatrist may recommend antidepressant medications, which may help improve the way your brain uses certain chemicals like serotonin, norepinephrine and dopamine. These chemical messengers are part of the nervous system that control many functions, ranging from mood, motivation, sleep and metabolism. Antidepressant medications used more commonly these days fall into three main categories: selective-serotonin reuptake inhibitors, selective-norepinephrine reuptake inhibitors and atypical antidepressants. Tricyclic antidepressants are another class of antidepressants, which was used more commonly in the past.

Antidepressants take time to work — usually four to eight weeks — and may cause some unwanted side effects such as sleep disturbance, headaches and upset stomach. And often, it’s a case of trial and error with your doctor to find the medication that’s right for you. Management of depression may require long-term treatment that includes both psychotherapy, antidepressants or both.