Depression Symptoms & Warning Signs

Understanding Depression

Learn more about depression

Nearly everyone will go through periods of sadness and upset within their lives. However, when emotions like these continue on for long periods of time, or happen so frequently that an individual is unable to function, then that person might be experiencing clinical symptoms of depression. In many instances, those who develop depression attempt to utilize drugs and/or alcohol to self-medicate their psychological and emotional pain. Engaging in behaviors such as these can cause a number of dangerous outcomes to develop, including agitating the symptoms of depression and triggering the development of a substance use disorder.

There are various types of depression, all of which are categorized by feelings of sadness, irritability, and emptiness that come along with cognitive and somatic changes. Some of the most common forms of depression include major depressive disorder, persistent depressive disorder, premenstrual dysphoric disorder, and substance/medication-induced depressive disorder:

Major depressive disorder: Those who experience five or more of the symptoms noted below for most of the day almost every day within a period of two weeks, and who have severe distress or functional impairment because of these symptoms, likely have major depressive disorder:

  • Indecisiveness or diminished ability to think or concentrate
  • Recurrent thoughts of death, planning for suicide, or attempting suicide
  • Melancholy mood
  • Markedly diminished interest or pleasure in all or most activities
  • Psychomotor retardation or agitation
  • Fatigue or loss of energy
  • Significant change in appetite or unintentional change in weight
  • Hypersomnia or insomnia

Persistent depressive disorder: In the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the criteria needed to diagnose this disorder includes depressed mood for most of the day, for more days than not, for a minimum of two years, plus the presence of two of the symptoms below:

  • Fatigue or low energy
  • Poor concentration and/or problems making decisions
  • Sense of hopelessness
  • Poor self-esteem
  • Overeating or poor appetite
  • Disrupted sleep patterns, including insomnia or hypersomnia

Throughout the two-year long period that the individual goes through these symptoms, an individual with persistent depressive disorder will not be asymptomatic for longer than two months.

Premenstrual dysphoric disorder: The primary characteristics of premenstrual dysphoric disorder are continued occurrences of mood lability, anxiety symptoms, dysphoria, and irritability during the premenstrual part of a woman’s menstrual cycle. Symptoms of premenstrual dysphoric disorder will taper off shortly after a woman’s menses has started. To obtain a diagnosis for this type of disorder, a woman must have five symptoms, including at least two from each group:

Group 1

  • Depression, hopelessness, and self-deprecating thoughts
  • Anxiety, tension, and/or feelings of being on edge
  • Mood swings or increased sensitivity to rejection
  • Increased irritability or anger

Group 2

  • Feeling of being overwhelmed
  • Breast tenderness or swelling, joint or muscle pain, weight gain, and other physical symptoms
  • Decreased interest in usual activities
  • Problems with concentration
  • Significant change in appetite, including overeating or specific food cravings
  • Disrupted sleep patterns, including hypersomnia or insomnia
  • Lethargy, fatigue, or significant lack of energy

To obtain a diagnosis for this depressive disorder, one must have had these symptoms during the majority of her menstrual cycles over the past 12 months.

Substance/medication-induced depressive disorder: A diagnosis of this depressive disorder is dependent on the following symptoms:

  • Disturbed mood that is not better explained by a non-substance-related depressive disorder
  • Disturbance does not occur exclusively during delirium, and the disturbance causes significant stress or impairment in important areas of functioning
  • Prominent and persistent depressed mood or significantly diminished interest and/or pleasure in all or almost all activities
  • Symptoms occur during or soon after substance intoxication or withdrawal, and the substance in question is capable of producing these symptoms.

Depressive disorders can lead to extreme psychological pain, and can have significantly negative impacts on an individual’s life. However, each of these depressive disorders is treatable. With the appropriate professional care, those who have developed any of the depressive disorders listed above can lives that are happy, healthy, and free from the symptoms of these mental illnesses.


Statistics on depression

According to the National Alliance on Mental Illness (NAMI), roughly 14.8 million American adults are affected by major depression. The National Institute of Mental Health (NIMH) states that 18 to 25 year-olds suffer with depression the most, with the 26-49 age group following closely behind. After that comes those 50 and older. Depressive disorders are very common amongst women, as men have a lower prevalence rate of this disorder. For example, the 12-month prevalence of a major depressive episode is 8.1% amongst women aged 18 and older in the United States, while only 5.1% of adult men are affected.

Causes and Risk Factors

Causes and risk factors for depression

The development of a depressive disorder can be impacted by a number of causes and risk factors that can work in concert. Below are some of the most common causes and risk factors for the development of a depressive disorder:

Genetic: Depression has a strong genetic tie. The American Psychiatric Association (APA) states that those who have parents or siblings with this disorder are 400% more likely to develop it, too.

Environmental: Events such as adverse childhood experiences and extreme life stress can add to an individual’s likelihood of developing a depressive disorder. This is especially true when one has a history of experiencing repeated traumatic events.

Risk Factors:

  • Substance abuse
  • Trauma
  • Gender (depression is more common among women)
  • Age (depression is more common within the 18-29 age group)
  • Family history of depression
  • Loss of parent through separation, divorce, or death
  • Negative affectivity

Signs and Symptoms

Signs and symptoms of depression

The symptoms of a depressive disorder can vary based on a number of aspects, including the type of depressive disorder that is present. Below are some of the most common signs and symptoms of a depressive disorder:

Behavioral symptoms:

  •  Slowed speech
  • No longer participating in enjoyable activities
  • Tearfulness
  • Angry outbursts
  • Drop in academic or occupational performance
  • Jitteriness

Physical symptoms:

  •  Fatigue
  • Insomnia
  • Change in weight
  • Headaches
  • Stomachaches
  • Hypersomnia
  • Change in appetite

Cognitive symptoms:

  •  Slowed thoughts
  • Distractibility
  • Difficulty focusing
  • Difficulty concentrating
  • Indecisiveness
  • Racing thoughts

Psychosocial symptoms:

  • Withdrawal
  • Sadness, shame, and/or guilt
  • Irritability
  • Suicidal ideation


Effects of depression

Depressive disorders that go untreated can lead to a variety of negative repercussions within an individual’s life, including:

  • Substance abuse and the development of a substance use disorder
  • Sleep disorders
  • Suicidal ideation
  • Suicide attempts
  • Social withdrawal and isolation
  • Self-harm
  • Strained or ruined interpersonal relationships
  • Dangerous, reckless, and risky behaviors
  • Diminished occupational performance, job loss, and/or ongoing unemployment
  • Family discord

Co-Occurring Disorders

Co-occurring disorders

Those who develop a depressive disorder might be at a greater risk for also struggling with the co-occurring mental health conditions listed below:

  • Obsessive-compulsive disorder (OCD)
  • Posttraumatic stress disorder (PTSD)
  • Eating disorders
  • Substance use disorder
  • Anxiety disorders