Signs of depression in friends

Q: How can you tell if someone’s depressed?

A: The recent suicide death of Robin Williams has brought new attention to depression and other mental health concerns. The actor-comedian had spoken publicly about his struggles with depression and addiction.

The National Institute of Mental Health estimates depression affects 17 million Americans each year. You may work with someone who’s depressed and not know it – one in eight U.S. workers have been diagnosed with depression, according to a Gallup poll. Even children can become depressed: Roughly 11 percent of kids between 13 and 18 years of age experience depression.

Everybody feels down sometimes. It might be related to a traumatic life event like the death of a loved one, a divorce, or losing your job. Even one of life’s great joys, the birth of a child, can make a new mother feel overwhelmed or moody. With depression, symptoms last longer and are more severe than normal feelings of sadness.

Depression is a common complication when a person is diagnosed with an illness. “Feeling sad or depressed about a chronic illness diagnosis is normal,” says psychologist Kristin Kuntz, PhD, an assistant professor of clinical psychiatry at Ohio State University. “But then you have to watch and see if the depressed mood persists.”

RELATED: Questions to Ask Your Doctor

So how do you spot depression? Besides persistent feelings of sadness, signs may include:

  • Difficulty sleeping or sleeping more than usual.
  • Changes in appetite.
  • Withdrawal from social interaction.
  • Loss of interest in things that used to be pleasurable.
  • Lack of energy, difficulty concentrating or remembering things.
  • Feeling worthless and helpless.
  • Most new moms experience “baby blues,” but they usually pass a week or two after delivery. If symptoms persist or worsen, it could be postpartum depression.
  • Younger children who are depressed may avoid school, complain of feeling ill, or become clingy with parents. Adolescents may become sulky and defiant.

Depression is a serious illness, and its signs should never be ignored. “Family and friends have a big influence on getting the person help,” says Dr. Kuntz. “They can’t make the diagnosis, but they can bring it to someone’s attention.”

Getting someone to seek help may not be easy. “People with depression typically don’t want to think about treatment,” says Kuntz. “The depression itself makes them less likely to get treatment too.”

If the person won’t respond to friends or family, it may be necessary to get a primary care doctor to intervene. More family doctors are screening for depression, and they often refer patients to a therapist who can come up with a treatment plan.

Several organizations, such as the National Alliance on Mental Illness and the Depression and Bipolar Support Alliance, offer education programs, support groups, and other resources for people with depression.

Do you have a health-related question for Dr. Gupta? You can submit it here. For more health news and advice, visit Health Matters With Dr. Sanjay Gupta.

1. Become informed

Not totally sure what depression is or what it means for your friend? A really great first step in helping your friend is to find out more about depression – which will help you better understand what they’re going through.

2. Be there to listen

If your friend feels like talking, ask them how they’re going. Try asking questions like, “What can I do to help?” and “What do you find helpful?” When you want to bring up a sensitive issue with a friend, try to choose a time and place when you’re both comfortable and relaxed. It’s a good idea to avoid talking to them about it if they’re upset.

3. Take their feelings seriously

If someone is suffering from symptoms of depression, it isn’t possible for them just to ‘snap out of it’, ‘cheer up’ or ‘forget about it’. When you listen to them and validate their feelings by saying things like ‘That must be really hard’ or ‘I’m here when you want to talk’, they’ll know you’re taking their feelings seriously.

4. Let them know about support services

If your friend has already seen a GP or mental health professional, that’s awesome. You could let them know there are also online and email counselling services. You could also recommend the ReachOut NextStep tool, which recommends relevant support options based on what the person wants help with.

5. Respond to emergencies

If you think your friend may be in danger or at risk of hurting themselves or someone else, seek help immediately. Call 000 to reach emergency services and also tell someone you trust.

6. Take care of yourself

It can be incredibly frustrating, exhausting and upsetting to deal with someone who is experiencing depression. You can be there to support your friend only if you look after yourself first. Remember to do the following to make sure your own wellbeing is looked after.

  • Monitor your mood. You might be really worried about a friend with depression, but it’s important that you also monitor your own mood and stress levels. This could include rating your mood out of 10 each day, to track how you’re doing.
  • Don’t give up the things you enjoy. Always make sure you’ve got the time to do your favourite things.
  • Make time to relax. Relaxation is great for helping you to unwind and deal with stress.
  • Set boundaries. You aren’t going to be able to be there for your friend all of the time. Set some limits around what you’re willing, and not willing, to do. For example, you might decide not to take any phone calls in the middle of the night, or not to miss social events just because your friend isn’t up to going.
  • Ask for support. It’s important that you’re getting your own emotional support. Talk to people you trust about how you’re feeling.

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This post has been written to assist the reader in observing signs of depression in a friend or loved one.

The Story:

A young couple I have treated for some time came into my office recently. Lisa was angry with Justin because he had been (in her opinion) distant and unloving towards her in recent weeks. No matter how hard she tried to please him, nothing seemed to work, and she began to wonder whether he had lost interest in her. After I asked Justin certain key questions, it became clear that he had gradually become depressed and, in doing so, had lost interest in pretty much everything that had previously given him pleasure – including Lisa. Once Justin’s depression was adequately treated, he became the warm, loving and attentive man with whom Lisa had fallen in love and chosen to spend her life with.

There are some important lessons to this story.

First, depression is not always obvious. It can masquerade as something else (in this case, lack of interest in your partner).

Second, it is valuable for friends or loved ones to learn the tell-tale signs of depression so that they can offer help as early in the process as possible because depression is a painful condition, both for the person suffering from it and his or her loved ones.

So, here are seven tell-tale signs of depression that will help you determine if your friend or loved-one is developing depression:

—–

1. Loss of interest in things that were previously pleasurable. Sometimes this loss of pleasure – also known as anhedonia – may not be complete. So your loved one may gravitate only to those things that are easily enjoyed and require the least amount of effort, such as playing video-games, sitting in front of the TV or surfing the Web. This readily leads to thoughts or comments such as “You have plenty of time and interest for surfing the Web, but not when it comes to spending quality time with me.” Engaging with another person and meeting that person’s needs require more effort than surfing the Web and therefore may be an early sign of depression.

2. Sleep difficulties. This may take the form of trouble falling asleep, or waking up during the night or the early hours of the morning. You may find your loved one in another room, trying to while away the time. This may disrupt your own sleep and may feel like abandonment, leading you to say things like, “Not only isn’t he/she available for me during the day, but even at night.” Again, it’s important not to take the symptom personally, but recognize it for what it is.

3. Eating changes – too little or too much – with corresponding weight changes in the expected direction. A husband (for example) can readily become angry with his wife and blame her for eating too much and gaining weight, misinterpreting the symptom as a sign that she no longer cares as much about their intimate life and is therefore “letting herself go.”

4. Anger and irritability. A depressed person struggles to get through the day. Ordinary obstacles and challenges become more difficult and can lead to frustration and the feelings that go along with that. This is another tell-tale sign of depression that is easy to take personally.

5. Expressing negative thoughts. You might feel enthusiastic about something and your friend or loved one might come back with a “downer” of a response, such as “I don’t think that will amount to anything,” or “What does it matter? It makes no difference.” Such negative thoughts are a cardinal symptom of depression, yet sometimes they feel almost calculated to throw a dampener on things. The depressed person is not trying to make life difficult for others even though that is often the effect of depressive thoughts and utterances.

6. Suicidal ideas. These may take a passive form such as, “I don’t care if I live or die” or a more active form, such as “Sometimes I feel like driving the car off the road.” Always take such statements very seriously. There is a common myth that if a person is really suicidal, they don’t tell others about it; they do it. By this erroneous logic, if the person is telling you about it, you might mistakenly conclude that they won’t actually do it. Nothing could be further from the truth. Not only are such statements key elements of depression (which warrants treatment in its own right), but they suggest that such treatment is urgent.

7. Loss of confidence in oneself and optimism about the future is sign of a depression. Depressed people feel poorly about themselves and their future. If your friend or loved one is usually more self confident and optimistic and this then changes, suspect depression.

If you detect one or more of these signs in a friend or loved one, you may want to look up a more comprehensive list of symptoms for major depression in the standard manual for psychiatric conditions, the DSM-IV.

Once you suspect depression, do encourage your friend or loved one to seek consultation and treatment with a qualified person, not only for his or her sake, but for yours. Sometimes it can also be helpful and comforting for you to offer to accompany the person to the consultation.

Wishing you Light and Transcendence,

Norman

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When Your Friend Is Depressed…Don’t and Dos

Then, worse than the sound of a game-ending buzzer, my blackberry made a noise. Instinctually, I answered and, despite the fact the Knicks just threw the ball away, I was pleased to hear the voice of a good friend, although her voice inflection seemed down. Eight forty left on the game clock.

“Hey, what’s up?” I soon understood her voice’s message. To summarize, one of her best friends, a very successful professional woman, had, like millions of others, fallen victim to clinical depression. Over the course of a year, her life had fallen apart. Divorce, a job loss, avoiding friends—the story is familiar to most mental health professionals. I was now listening attentively and I could hear the sadness and frustration in my friend’s words. She finished on the hope I could give her some advice on how to help her depressed friend.

I took a brief mental timeout to remind myself that her dilemma is common. Statistics alone would tell you that there is a good chance you have faced or will face the same challenge: help a friend when they are depressed. I also knew that despite good intentions, most people are ineffective in this daunting task.

In the next second, my course was clear. I broke the silence: “Listen, get a piece of paper. I am going to giving you some tips for helping your depressed friend.”

While she searched for a pen, I went to my nearby bookshelf and found what I was looking for: Contagious Emotions: Staying well when your loved one is depressed, by Ronald Podell, M.D. Podell is a practicing psychiatrist in Los Angeles and a leading expert in helping individuals effectively cope with the depression of their loved ones. I knew his tips would help my friend.

“Ready?”

“Go ahead,” she said.

First, I will tell you what NOT to do. You certainly don’t want to inadvertently make it worse.

1. Don’t try to be strong for your friend by telling him to “pull yourself up by your bootstraps and be tough.” Watch what you say despite your good intentions because you will tend to say the wrong thing many times and be discouraging.

2. Don’t get so involved and frustrated by your friend’s seeming lack of optimism and confidence that you wind up arguing with your friend—especially about what he should and should not do.

3. Do not join your depressed friend in his depression—your friend’s feelings are not your feelings.

I told her to keep those tips near her phone so when she spoke to her friend, she’d have a reminder.

Now write down what to do:

1. Maintain a warm, caring relationship free from hostility and tension.

2. Learn to cope with the hardships that relating frequently with a depressed person can impose such as the tendency to be lured into destructive criticism and arguments about your friend’s passivity.

3. Learn what depression is—a clinical disorder that is not something someone turns “on” or “off” and may be triggered by an event but becomes a brain chemistry disorder separate from that event.

I told her to keep these tips next to her phone and that she should immediately order a copy of Contagious Emotions.

She thanked me for listening, for helping her feel better—I was applying many of Podell’s tips—and said she would order the book as soon as we hung up.

How to spot depression in others

If the statistics are correct, between 8-12% of people living in Britain experience depression in any given year. So there’s a good chance that even if you’re not one of them, you may know someone who is affected.

Depression is a common mental disorder that affects people of all ages. But some are more susceptible than others. Studies show that those who are less well off, people with long-term illnesses and the unemployed are more likely to have depression than the rest of the population.

So what exactly is depression? All too often people say they’re depressed when they are feeling fed up or when things in their lives aren’t going as well as they would like. And equally often, after a few days, these feelings disappear.

Medically speaking, depression is when the way you feel starts to make your life more difficult, or when your low mood lasts for more than a few weeks or keeps coming back again and again.

Spot the signs

The thing to remember about recognising depression is that it’s not a one-size-fits-all disorder. There are many symptoms, and one person’s experience may be completely different from the next.

But if you suspect someone you know is depressed, here are some of the physical signs to look out for:

  • Lack of energy or feeling tired all the time
  • Restlessness and agitation
  • Having difficulty sleeping (or sleeping more than usual)
  • Poor appetite, which may lead to weight loss
  • Smoking and/or drinking more than usual, or using drugs
  • Lack of interest in sex
  • Unexplained physical aches and pains
  • Self-harming

Tell-tale emotions

As you may expect, there are also many emotional signs of depression, some of which may seem obvious while others are harder to spot. Among the most common things to look out for are:

  • Feeling sad and in low spirits all the time, and crying a lot
  • Having no interest in anything, not getting any pleasure out of life
  • Feeling anxious all of the time
  • Having difficulty concentrating or remembering things, plus difficulty in making decisions
  • Low self-confidence and self-esteem, withdrawing from family and friends
  • Being more irritable and impatient than usual
  • Feeling helpless and hopeless
  • Feeling guilty, as if everything that goes wrong is their fault

How you can help

If several of the above signs apply to someone you know, they may well be depressed. They also may not have spoken to anybody about their concerns, so try to get them to open up and talk about how they feel – but be careful how you approach the subject. Wading in with statements such as, ‘cheer up’ or ‘pull yourself together’ is never going to be helpful.

The best thing you can do, once you have encouraged them to start talking, is to simply listen. And while you may not feel qualified to offer any advice, letting them get everything off their chest and supporting them in any way you can think of could be invaluable.

Meanwhile, if you think it’s appropriate, encourage them to see their GP, who could offer them medical treatment or recommend a local support group.

Our mental wellbeing microsite is packed with advice, tips and tools to look after your mental wellbeing and improve your ability to deal with life’s ups and downs. With information such as practical ways to get back on track and common work-related challenges to our mental wellbeing. Discover how small changes can make a big difference.

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Life is all about up’s and down. Some days you might feel low and at times you have your high. However, for those who are suffering from depression, it’s more than just feelings of temporary sadness.

For some people, depression symptoms are so severe that it’s obvious something isn’t right. Other people feel generally miserable or unhappy without really knowing why. Listed here are few signs that could be possible indication that you or someone you know is suffering from depression. If you identify with several of the following signs, consider visiting a psychologist soon.

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1) Feelings of sadness, emptiness or unhappiness: Although feelings of hopelessness are common among individuals with clinical depression, they can be some of the most difficult feelings to experience. This can include feelings of dissatisfaction, failure, and a belief that nothing will get better. People suffering from depression often feel unhappy without any rhyme or reason.

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2) Angry outbursts, irritability or frustration, even over small matters: Many people don’t realise that low levels of chronic irritability and anger can mask an underlying depression. Constant irritability is also a symptom of depression seen in teenagers and children, one that could be written off as normal growing pains or teenage behaviour.

3) Loss of interest or pleasure in normal activities, such as exercise, games or even sex: We all have times when we feel a bit more introverted than usual, but when people have clinical depression, they can lose the sense of pleasure they used to get from their favourite activities or from engaging with others. This isolation can make it harder for friends and loved ones to see the other symptoms of depression a person may be exhibiting, which makes it more difficult to know when a person needs help.

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4) Sleep disturbances, including insomnia or sleeping too much: As tired as you may be, if you’re depressed you might also have trouble sleeping. Marked changes in sleeping patterns, like insomnia or increased time spent sleeping, is another symptom of clinical depression.

5) Tiredness and lack of energy, so that even small tasks take extra effort:

6) Changes in appetite —Some people either gain or lose weight when they have clinical depression because of their change in appetite. For some, this means an increase in appetite and possibly weight gain as a result. Others lose their appetite and struggle to eat much at all. In either case, a significant change is worth investigating.

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7) Anxiety, agitation or restlessness: If you know someone who is always restless or is agitated without a specific reason, it is possible that the person is suffering from depression. Things like excessive worrying, pacing, hand-wringing or an inability to sit still could be one of the major signs of depression.

8) Slowed thinking, speaking or body movements: People who are depressed may eventually become slow thinkers and will take longer to speak even a single sentences. Some might even experience slow body movements.

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9) Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility: A feeling of worthlessness or guilt is typically experienced by someone who is suffering from depression, although many people experience occasional feelings of guilt or worthlessness. It’s a simple sense that our own worth in this world is of little value in the moment, or that we feel responsible for another’s reaction or behavior. It may include unrealistic negative evaluations of one’s own worth or guilty preoccupations or ruminations over minor past failings.

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10) Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide: This is the most serious symptom of depression. When you’re severely depressed, suicidal thoughts can become so prominent, you begin to make a plan for ending your life, as you feel there are no other options. If you are experiencing suicidal thoughts, seek help or tell a trusted person in your life and ask for help.

11) Trouble thinking, concentrating, making decisions and remembering things: It’s more often thought of as a symptom of ADHD, but an inability to concentrate or hold focus on one’s activities can be a sign of clinical depression. People with clinical depression often have memory issues that can add to their difficulties in maintaining day-to-day activities.

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12) Unexplained physical problems, such as back pain or headaches: Yes, depression can literally hurt. There is increasing recognition of the physical symptoms of depression, which include headaches, stomach pain, and back pain. One study found half of patients with depression from around the world reported unexplained physical symptoms. But because these physical symptoms are often vague or have no logical explanation, they can be missed as symptom of depression.

13) Fatigue: Many people with depression find it difficult to get out of bed — and we’re not just talking about hitting the snooze button. For some, getting up seems nearly impossible. They may also find themselves spending unusual amounts of time in bed throughout the day, or having trouble with normal activities because of fatigue.

Depression Symptoms and Warning Signs

Do you think you might be depressed? Here are some of the signs and symptoms to look for—and tips for getting the help you need.

Feeling down from time to time is a normal part of life, but when emotions such as hopelessness and despair take hold and just won’t go away, you may have depression. More than just sadness in response to life’s struggles and setbacks, depression changes how you think, feel, and function in daily activities. It can interfere with your ability to work, study, eat, sleep, and enjoy life. Just trying to get through the day can be overwhelming.

While some people describe depression as “living in a black hole” or having a feeling of impending doom, others feel lifeless, empty, and apathetic. Men in particular can feel angry and restless. However you experience depression, left untreated it can become a serious health condition. But it’s important to remember that feelings of helplessness and hopelessness are symptoms of depression—not the reality of your situation.

No matter how hopeless you feel, you can get better. By understanding the cause of your depression and recognizing the different symptoms and types of depression, you can take the first steps to feeling better and overcoming the problem.

Signs and symptoms of depression

Depression varies from person to person, but there are some common signs and symptoms. It’s important to remember that these symptoms can be part of life’s normal lows. But the more symptoms you have, the stronger they are, and the longer they’ve lasted—the more likely it is that you’re dealing with depression.

10 common symptoms of depression:

  1. Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
  2. Loss of interest in daily activities. You don’t care anymore about former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
  3. Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
  4. Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping.
  5. Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
  6. Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
  7. Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
  8. Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
  9. Concentration problems. Trouble focusing, making decisions, or remembering things.
  10. Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain.

The link between depression symptoms and anxiety

Depression and anxiety are believed to stem from the same biological vulnerability, which may explain why they so often go hand-in-hand. Since anxiety makes depression worse (and vice versa), it’s important to seek treatment for both conditions.

Is it depression or bipolar disorder?

Bipolar disorder, also known as manic depression, involves serious shifts in moods, energy, thinking, and behavior. Because it looks so similar to depression when in the low phase, it is often overlooked and misdiagnosed. This can be a serious problem as taking antidepressants for bipolar depression can actually make the condition worse. If you’ve ever gone through phases where you experienced excessive feelings of euphoria, a decreased need for sleep, racing thoughts, and impulsive behavior, consider getting evaluated for bipolar disorder.

Depression and suicide risk

Depression is a major risk factor for suicide. The deep despair and hopelessness that goes along with depression can make suicide feel like the only way to escape the pain. If you have a loved one with depression, take any suicidal talk or behavior seriously and watch for the warning signs:

  • Talking about killing or harming one’s self
  • Expressing strong feelings of hopelessness or being trapped
  • An unusual preoccupation with death or dying
  • Acting recklessly, as if they have a death wish (e.g. speeding through red lights)
  • Calling or visiting people to say goodbye
  • Getting affairs in order (giving away prized possessions, tying up loose ends)
  • Saying things like “Everyone would be better off without me” or “I want out”
  • A sudden switch from being extremely depressed to acting calm and happy

If you think a friend or family member is considering suicide, express your concern and seek help immediately. Talking openly about suicidal thoughts and feelings can save a life.

If you are feeling suicidal…

When you’re feeling depressed or suicidal, your problems don’t seem temporary—they seem overwhelming and permanent. But with time, you will feel better, especially if you get help. There are many people who want to support you during this difficult time, so please reach out!

Read Suicide Help or call 1-800-273-TALK in the U.S. or visit IASP or Suicide.org to find a helpline in your country.

How depression symptoms vary with gender and age

Depression often varies according to age and gender, with symptoms differing between men and women, or young people and older adults.

Depression in men

Depressed men are less likely to acknowledge feelings of self-loathing and hopelessness. Instead, they tend to complain about fatigue, irritability, sleep problems, and loss of interest in work and hobbies. They’re also more likely to experience symptoms such as anger, aggression, reckless behavior, and substance abuse.

Depression in women

Women are more likely to experience depression symptoms such as pronounced feelings of guilt, excessive sleeping, overeating, and weight gain. Depression in women is also impacted by hormonal factors during menstruation, pregnancy, and menopause. In fact, postpartum depression affects up to 1 in 7 women experience depression following childbirth.

Depression in teens

Irritability, anger, and agitation are often the most noticeable symptoms in depressed teens—not sadness. They may also complain of headaches, stomachaches, or other physical pains.

Depression in older adults

Older adults tend to complain more about the physical rather than the emotional signs and symptoms of depression: things like fatigue, unexplained aches and pains, and memory problems. They may also neglect their personal appearance and stop taking critical medications for their health.

Types of depression

Depression comes in many shapes and forms. While defining the severity of depression—whether it’s mild, moderate, or major—can be complicated, knowing what type of depression you have may help you manage your symptoms and get the most effective treatment.

Mild and moderate depression

Mild and moderate depression are the most common types of depression. More than simply feeling blue, the symptoms of mild depression can interfere with your daily life, robbing you of joy and motivation. Those symptoms become amplified in moderate depression and can lead to a decline in confidence and self-esteem.

Recurrent, mild depression (dysthymia)

Dysthymia is a type of chronic “low-grade” depression. More days than not, you feel mildly or moderately depressed, although you may have brief periods of normal mood.

  • The symptoms of dysthymia are not as strong as the symptoms of major depression, but they last a long time (at least two years).
  • Some people also experience major depressive episodes on top of dysthymia, a condition known as “double depression.”
  • If you suffer from dysthymia, you may feel like you’ve always been depressed. Or you may think that your continuous low mood is “just the way you are.”

Major depression

Major depression is much less common than mild or moderate depression and is characterized by severe, relentless symptoms.

  • Left untreated, major depression typically lasts for about six months.
  • Some people experience just a single depressive episode in their lifetime, but major depression can be a recurring disorder.

Atypical depression

Atypical depression is a common subtype of major depression with a specific symptom pattern. It responds better to some therapies and medications than others, so identifying it can be helpful.

  • People with atypical depression experience a temporary mood lift in response to positive events, such as after receiving good news or while out with friends.
  • Other symptoms of atypical depression include weight gain, increased appetite, sleeping excessively, a heavy feeling in the arms and legs, and sensitivity to rejection.

Seasonal affective disorder (SAD)

For some people, the reduced daylight hours of winter lead to a form of depression known as seasonal affective disorder (SAD). SAD affects about 1% to 2% of the population, particularly women and young people. SAD can make you feel like a completely different person to who you are in the summer: hopeless, sad, tense, or stressed, with no interest in friends or activities you normally love. SAD usually begins in fall or winter when the days become shorter and remains until the brighter days of spring.

Depression causes and risk factors

While some illnesses have a specific medical cause, making treatment straightforward, depression is far more complicated. Certain medications, such as barbiturates, corticosteroids, benzodiazepines, opioid pain killers, and specific blood pressure medicine can trigger depression symptoms in some people—as can hyperthyroidism (an underactive thyroid gland). But most commonly, depression is caused by a combination of biological, psychological, and social factors that can vary wildly from one person to another.

Despite what you may have seen in TV ads, read in newspaper articles, or maybe even heard from a doctor, depression is not just the result of a chemical imbalance in the brain, having too much or too little of any brain chemical that can be simply cured with medication. Biological factors can certainly play a role in depression, including inflammation, hormonal changes, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. But psychological and social factors—such as past trauma, substance abuse, loneliness, low self-esteem, and lifestyle choices—can also play an enormous part.

Risk factors that can make you more vulnerable to depression

Depression most often results from a combination of factors, rather than one single cause. For example, if you went through a divorce, were diagnosed with a serious medical condition, or lost your job, the stress could prompt you to start drinking more, which in turn could cause you to withdraw from family and friends. Those factors combined could then trigger depression.

The following are examples of risk factors that can make you more susceptible to developing depression:

Loneliness and isolation. There’s a strong relationship between loneliness and depression. Not only can lack of social support heighten your risk for depression, but having depression can cause you to withdraw from others, exacerbating feelings of isolation. Having close friends or family to talk to can help you maintain perspective on your issues and avoid having to deal with problems alone.

Marital or relationship problems. While a network of strong and supportive relationships can be crucial to good mental health, troubled, unhappy, or abusive relationships can have the opposite effect and increase your risk for depression.

Recent stressful life experiences. Major life changes, such as a bereavement, divorce, unemployment, or financial problems can often bring overwhelming levels of stress and increase your risk of developing depression.

Chronic illness or pain. Unmanaged pain or being diagnosed with a serious illness, such as cancer, heart disease, or diabetes, can trigger feelings of hopelessness and even lead to depression.

Family history of depression. Since it can run in families, it’s likely some people have a genetic susceptibility to depression. However, there is no single “depression” gene. And just because a close relative suffers from depression, it doesn’t mean you will, too. Your lifestyle choices, relationships, and coping skills matter just as much as genetics.

Personality. Whether your personality traits are inherited from your parents or the result of life experiences, they can impact your risk of depression. For example, you may be at a greater risk if you tend to worry excessively, have a negative outlook on life, are highly self-critical, or suffer from low self-esteem.

Early childhood trauma or abuse. Early life stresses such as childhood trauma, abuse, or bullying can make you more susceptible to a number of future health conditions, including depression.

Alcohol or drug abuse. Substance abuse can often co-occur with depression. Many people use alcohol or drugs as a means of self-medicating their moods or cope with stress or difficult emotions. If you are already at risk for depression, abusing alcohol or drugs may push you over the edge. There is also evidence that those who abuse opioid painkillers are at greater risk for depression.

The cause of your depression may help determine the treatment

Understanding the underlying cause of your depression may help you overcome the problem. For example, if you are depressed because of a dead-end job, the best treatment might be finding a more satisfying career rather than simply taking an antidepressant. If you are new to an area and feeling lonely and sad, finding new friends will probably give you more of a mood boost than going to therapy. In such cases, the depression is remedied by changing the situation.

Whether you’re able to isolate the causes of your depression or not, the most important thing is to recognize that you have a problem, reach out for support, and pursue the coping strategies that can help you to feel better.

What you can do to feel better

When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.

To cope with depression

Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. They just need to be a good listener—someone who’ll listen attentively without being distracted or judging you.

Get moving. When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there.

Eat a mood boosting diet. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids.

Find ways to engage again with the world. Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better.

When to seek professional help

If support from family and friends and positive lifestyle changes aren’t enough, it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:

Therapy. Effective treatment for depression often includes consulting a therapist who can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent depression from coming back.

Medication may be imperative if you’re feeling suicidal or violent. But while it can help relieve symptoms of depression in some people, it isn’t a cure and is not usually a long-term solution. It also comes with side effects and other drawbacks so it’s important to learn all the facts to make an informed decision.

Kendal at Home Blog

It’s summertime—the sun is shining, birds are chirping, and flowers are growing. Yet, despite the happy times often associated with the summer months, for many, depression can act as a dark cloud.

Depression in older adults is surprisingly common and often goes untreated. However, this does not have to be the case. If you or a friend is exhibiting signs of depression, you deserve to feel the best you can mentally, no matter your age.

The problem is that many older adults don’t know how to recognize depression in themselves or others. While the term itself is synonymous with sadness, there are many other ways depression can manifest in older adults. Knowing the signs can help you stay proactive about your mental health or possibly come to the aid of a friend in need.

10 Signs of Depression to Watch for in Older Adults

  • A loss of interest in activities you once enjoyed. While changing your interests is certainly normal, losing interest in activities that once brought you joy could signal a more serious problem.
  • Excessive fatigue or lack of energy. If you can’t connect your excessive fatigue with a corresponding increase in activity, your lack of energy might be related to depression.
  • Loss of motivation. This could manifest in several different areas of your life, but finding yourself unable to summon the motivation for basic, everyday tasks can be a sign of depression.
  • Memory problems. One of the main reasons depression goes undiagnosed in older adults is that it’s often confused with dementia since many of the symptoms are similar. Regardless of what might be causing your memory trouble, it’s always best to bring it to your doctor’s attention and discuss treatment options.
  • Increase in anxiety. Distinguishing between normal, everyday concerns and a level of anxiety that affects your daily lifestyle is important for defining anxiety and understanding how it may be symptomatic of depression.
  • Irritability. Unexplained irritability you feel you can’t control can be frustrating. It can also be a sign of depression.
  • A decline in personal care. This might come in the form of a decreased interest in hygiene or characterized by weight gain or weight loss.
  • Feeling hopeless or helpless. We mentioned that depression isn’t necessarily linked to sadness, but hopelessness or helplessness are two other common emotions to look out for if you suspect you or a loved one might be suffering from depression.
  • Aches and pains. It might seem counterintuitive that physical complaints could actually be signs of depression, but aggravated arthritis or headaches are commonly associated with depression in older adults.
  • Slowed language or motor skills. Different from other conditions that could lead to impaired motor skills, depression can sometimes be signaled by motor skills that are normal but slower than usual.

Older adults suffering from depression struggle to tell the difference between grief—whether due to the loss of a loved one or a change in lifestyle—and clinical depression. Just remember that grief tends to come in waves and will be marked by times of relief and happiness. Depression is more likely to be constant with next to no feelings of relief.

If you think your or someone you know is depressed, don’t hesitate to seek help. Stay tuned for our next post, where we’ll discuss ways to combat depression.

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