Depression Symptoms

People with depressive disorders experience periods of depressed mood, which sometimes alternate with periods of elated mood. The specific symptoms vary depending on the individual and the person's type of depressive disorder. The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) has established defining symptoms for the different types of depressive disorders.

Major depression

• Depressed mood
• Noticeable loss of interest in pleasure of most activities
• Significant weight loss or weight gain due to poor appetite or overeating
• Insomnia or excessive sleepiness
• Unintentional and purposeless movement
• Fatigue or loss of energy
• Feelings of worthlessness, or excessive or inappropriate guilt
• Poor concentration, trouble thinking, or difficulty making decisions
• Recurrent thoughts about death or suicide, or have attempted suicide

The rarer major depression with psychotic features (psychotic depression) occurs when the symptoms of major depression become so severe that the person develops hallucinations (seeing or hearing things that aren't really there) or delusions (irrational thoughts and fears).

Dysthymia

On the majority of days for at least two years, a person with dysthymia has two or more of the following symptoms for most of the day:

• Decreased or increased appetite
• Decreased or increased sleep
• Fatigue or low energy
• Poor self-image
• Reduced concentration or indecisiveness
• Feelings of hopeless
  

Bipolar disorder

During the depressed phase, people experience two or more of the symptoms of major depression nearly every day. During the manic phase, they experience two or more of the following manic symptoms nearly every day:

• Inflated self-esteem or self-importance
• Excessive talking
• Decreased need for sleep or excessive sleepiness
• Unintentional and purposeless movement
• Racing thoughts
• Easily distracted
• Increased activity
• Excessive involvement in pleasurable activities with a high degree of bad consequences

Postpartum depression

The milder symptoms of the baby blues include:

• Anxiety
• Confusion
• Crying spells
• Depression
• Forgetfulness
• Increased appetite
• Insomnia
• Irritability or anger
• Mood swings
• Poor concentration

The symptoms usually start a few days after delivery and last for one week.

Premenstrual dysphoric disorder (PMDD)

The less severe depressive symptoms of premenstrual syndrome (PMS) resemble the symptoms of the baby blues. The symptoms usually start one week prior to menstruation and stop after menstruation begins.

Seasonal affective disorder

• Fall and winter SAD
  Fall and winter SAD (winter depression) is the most common type of SAD. The symptoms of major depression start in the late fall to early winter months and go away during the summer months. Some people with winter depression have an increased need for sleep and appetite.
• Spring and summer SAD
  Spring and summer SAD (summer depression) occurs less often. The symptoms of major depression start in the late spring to early summer and go away during the winter months.

Depression in children and adolescents

The first warning sign of depression in children and adolescents is usually a change in behavior. The behavior of depressed children is usually different from the behavior of depressed adults. Depressed children may:

• Pretend to be sick.
• Perform poorly in school.
• Refuse to go to school.
• Cling to a parent.
• Worry that a parent is going to die.

Depressed adolescents may:

• Become irritable, negative, or moody.
• Feel misunderstood.
• Get into trouble at school.

Because behavior normally changes from one childhood stage to another, it's difficult for parents and teachers to determine if a behavior change is part of the child's normal aging process or a sign of depression. The child's pediatrician can help determine whether the child should be evaluated by a child psychiatrist.

Depression in older adults

Although common, depression in older adults is often difficult to diagnose and is frequently undertreated. Depression is not a normal sign of aging and is often confused with dementia (loss of brain function). Medical conditions or medication side effects may mask the signs of depression or even contribute to depression. Many older adults who feel depressed are ashamed of their depression and are more willing to discuss their physical symptoms than their emotional feelings with a healthcare worker.

Depression in women

Twice as many women are believed to suffer from depression as men. The exact reason for the higher incidence of depression in women is unknown.

Hormonal factors associated with depression in women include:

• Menstrual cycle changes
• Miscarriage
• Pregnancy and the postpartum period
• Perimenopause (the period before menopause) and menopause

Depression in men

Depressed men typically deny they're having emotional problems and are less likely to get treated for their depression than women. Their depression is often unrecognized by family, friends, coworkers, and healthcare professionals. Instead of showing the typical signs of depression, many men become angry, abusive, or irritable when depressed. They're also more likely to respond to their depression by consuming alcohol and drugs, or becoming consumed by their work.