Have you ever looked at someone and thought they had it all together, only to learn later that they were silently battling depression? Have you ever wondered if you have depression yourself?
How does a person know if they are depressed?
The first step is to examine the signs and symptoms professionals use to establish a diagnosis.
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Major Depressive Disorder is diagnosed when five or more of the following symptoms are present nearly every day for at least two weeks:
Depressed mood most of the day
Loss of interest or pleasure in usual activities
Changes in weight or appetite
Sleep disturbances (insomnia or too much sleep)
Psychomotor changes (feeling slowed down or agitated)
Fatigue or loss of energy
Feelings of worthlessness or excessive guilt
Difficulty concentrating, indecision
Recurrent thoughts of death or suicide
Significant distress or impairment in social/occupational functioning
In this blog, we will examine the most common symptoms. Of course, discussing these symptoms and their causes with your doctor is always an important first step.
If you are currently experiencing thoughts of suicide, please reach out for help immediately. Here are some resources that can provide support:
It is important to note that these symptoms can arise from various causes. However, for this examination, we will assume they are not due to medication, another medical condition, or a temporary reaction to a challenging life event or period.
How do these symptoms translate into real life?
Let's unpack some of the symptoms above and see how they might manifest themselves in real life.
Emotional Effects
Persistent Sadness: This is a hallmark of depression, often accompanied by feelings of emptiness or hopelessness.
Irritability and Anger: Mood swings, outbursts, and a lower frustration tolerance are common.
Loss of Interest: Things that once brought joy no longer do, leading to apathy and disconnection.
Guilt and Worthlessness: Depressive thoughts often focus on self-blame, perceived failures, and a belief that they are unlovable.
Suicidal Thoughts: In severe cases, depression can lead to despair and a desire to escape the pain, making thoughts of suicide a significant risk. If this applies to you or someone you know, please contact the support services listed above.
Cognitive Effects
Difficulty Concentrating: Focus, decision-making, and even remembering simple things become harder with depression.
Negative Thinking Loops: Depression focuses the mind on negative experiences, filtering out positives, which further reinforces the depression.
Pessimism and Catastrophising: Expecting the worst, blowing small negatives out of proportion, and feeling paralysed by a perceived helplessness.
Physical Effects
Sleep Disturbances: This can be insomnia (trouble falling asleep) or hypersomnia (sleeping too much).
Changes in Appetite: Significant weight loss or gain due to under or overeating.
Fatigue and a Lack of Energy: Even simple tasks feel overwhelming; lethargy is a common complaint.
Unexplained Aches and Pains: Headaches, muscle tension, and other physical symptoms often accompany depression.
Weakened Immune System: Depression can make people more susceptible to getting sick and recovering slowly.
Societal & Behavioural Effects
Social Isolation: This most often means withdrawing from friends, family, and enjoyable activities.
Relationship Difficulties: Emotional strain, poor communication, and changes in libido caused by depression almost inevitably impact relationships.
Neglecting Responsibilities: Work, school, household chores, etc., can feel like impossibly exhausting tasks.
Reduced Productivity: Difficulty focusing severely impacts work performance.
Substance Abuse: Some people turn to alcohol or drugs to numb emotional pain, which creates its own problems.
While the symptoms listed above paint a predictively bleak picture, the reality of depression is often far more nuanced, complex and hidden from plain sight. Many individuals battling this illness become masters of disguise, concealing their pain behind carefully crafted public life and social media posts (often called the modern masks). Recognising these hidden struggles is crucial for offering support and understanding to those who need it most.
Behind the Mask - The behaviours that may be breadcrumbs...
If you had a severe case of the flu, you'd likely struggle to convince yourself or others that you were feeling well. But even in the darkest emotional journeys, people can still convey happiness and positivity to the outside world. Internal struggles don't always look like dramatic sadness. I know several people who have suffered from depression with a great sense of humour. They are sarcastic and very funny. In fact, it is not uncommon for comedians to struggle with depression. It is important to remember that sometimes cries for help might come in the form of a funny joke. It is a common coping mechanism and disguiser of pain at the same time.
Subtle Signs and Behaviours, the Illusions of the Depressionist
The Overcompensator
Is someone being excessively cheerful or energetic? Of course, this is not a guaranteed sign of depression, but if it seems out of character it could be an attempt to hide something much darker.
The Isolator Â
If someone is constantly making excuses to avoid social interactions and constantly signing up for things, then pulling out, often at the last minute, this might be a sign of depression.
The Perfectionist
Maintaining a facade of control and accomplishment is not uncommon for people struggling with depression. Think about social media posts of the perfect family, having the perfect day or the perfect holiday. Life must be wonderful.. Or is it...
The Undercover Addict
I have a close family but I had been on medication for many years and most of my family never knew. We seldom know what happens behind closed doors, so how can we even begin to know what's happening inside a person's head?
When Humor Hides Pain: Lessons from Matthew Perry's Life
A tragic, but perfect example of how this manifests can be seen if we look at the actor Matthew Perry. We were able to see how he portrayed the character Chandler Bing in the sitcom Friends. Due to his fame and media coverage, we were not short of insights into his personal life and thanks to his autobiography we could also see the inner workings of his mind. They portray a very different picture from the funny, 'having it all' guy that the media might have made us believe him to be.
Like Perry, I have often heard the phrase: " I can't tell if you are being sarcastic or genuine" and I often respond " I'm not sure either." Humour and sarcasm are a great way to deflect from inner turmoil. It's how you can say the words inside your head without analysis and examination.
But the thing with depression is that unless we can unlock and solve the root cause of the symptoms then many of depression's most insidious effects will only gain traction and grow.
Sadly in the case of Mathew Perry, this is exactly what happened. He struggled with alcohol and medication for most of his adult life. No matter the destruction it caused himself and those around him, he knew that 'it made him feel better' and this is why people can continually fall into the same traps and the cycle becomes difficult to interrupt.
Recognising the hidden signs of depression is vital for both seeking and offering the support and understanding that can make a real difference. However, unless we address the underlying causes of this hidden suffering, depression's most insidious effects will only continue to grow.
If you or someone you know is struggling with these symptoms, know that you are not alone. Seeking help from a mental health professional, friends and family is a crucial step towards recovery.
Stay tuned for the next part of our series, where we will explore how diet and nutrition can impact our mental health and help with preventing anxiety and depression.
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