Feeling down from time to time is a natural part of life’s ups and downs. Life events like the loss of a loved one or experiencing a setback at work can understandably leave us feeling blue. However, when that sense of hopelessness lingers for more than a couple of weeks and begins to interfere with daily life, it may be a red flag of something more serious – depression.
Depression, also referred to as major depression or clinical depression, is a prevalent mood disorder. It manifests in severe symptoms that impact emotions, cognitive processes, and daily functioning, including sleep, appetite, and work performance. It can affect anyone, regardless of age, race, ethnicity, or gender.
As per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), the following red flags indicate potential depression.
Depression warning signs
1) Persistent feelings of sadness, emptiness, or hopelessness
Persistent feelings of sadness, emptiness, or hopelessness are hallmark symptoms of depression. Unlike normal fluctuations in mood, these emotions endure for an extended period, typically more than two weeks.Â
Sadness is a normal human emotion that everyone experiences at various points in life. However, in depression, this sadness goes beyond the typical ups and downs and becomes more profound, persistent, and overwhelming. It may not be directly linked to any specific event or circumstance and can persist even when there is no apparent reason for it.
Emptiness refers to a profound sense of feeling hollow or devoid of emotions as if there is a void inside. This feeling of emptiness can be distressing and may lead people to feel disconnected from themselves and the world around them.
Hopelessness is the belief or perception that things will never get better, regardless of efforts or interventions. Those experiencing hopelessness may struggle to see a future for themselves and may feel as though there is no point in trying to improve their situation. This sense of hopelessness can contribute to a pervasive feeling of despair and helplessness.
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2) Loss of interest or pleasure in activities once enjoyed
Loss of interest or pleasure in activities once enjoyed is a symptom of depression characterised by a significant decrease in the enjoyment or satisfaction derived from previously enjoyable activities. In depression, people may find themselves no longer interested in hobbies, socialising, or activities they once found fulfilling. This loss of interest extends beyond mere disinterest and can lead to a sense of detachment or emotional numbness towards previously enjoyable pursuits. It can contribute to feelings of emptiness and exacerbate other depressive symptoms, such as sadness and hopelessness.Â
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3) Significant changes in appetite or weight
In some cases, the person affected may experience a decrease in appetite, leading to weight loss. They may find it difficult to eat or have little interest in food. Conversely, others may experience an increase in appetite, leading to weight gain. This change in eating habits can occur due to alterations in mood, metabolism, or hormonal imbalances associated with depression. It’s important to note that these changes are not typically linked to intentional dietary changes or lifestyle choices.Â
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4) Insomnia or excessive sleeping
Insomnia or excessive sleeping are common sleep disturbances associated with depression. Insomnia refers to difficulty falling asleep, staying asleep, or waking up too early and being unable to return to sleep. On the other hand, excessive sleeping, known as hypersomnia, involves sleeping excessively, often for extended periods, without feeling rested. Both insomnia and excessive sleeping disrupt the sleep-wake cycle and can exacerbate other symptoms of depression, such as fatigue, irritability, and difficulty concentrating. These sleep disturbances are often indicative of underlying emotional and physiological imbalances and can significantly impact an individual’s quality of life.Â
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5) Agitation or psychomotor retardation (slowed movements or speech)
Agitation involves restlessness, fidgeting, and a general sense of inner tension or nervousness. You may find it difficult to sit still, may pace or engage in repetitive movements, and may feel constantly on edge. This heightened state of arousal can contribute to feelings of irritability and difficulty focusing.
On the other hand, psychomotor retardation refers to slowed movements or speech. People may appear physically sluggish or lethargic, with slowed speech, decreased motor activity, and delays in responding to stimuli. Tasks that were once performed with ease may now feel like a struggle, and there may be a notable lack of energy or initiative.
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6) Fatigue or loss of energy
Those with depression may find it challenging to complete daily tasks or engage in activities that require physical or mental effort. This fatigue is not solely alleviated by rest or sleep and can significantly impact overall functioning and productivity. It may manifest as physical exhaustion, mental fatigue, or a combination of both. Fatigue in depression can stem from various factors, including disrupted sleep patterns, altered neurotransmitter levels, and emotional distress.
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7) Feelings of worthlessness or excessive guilt
In depression, people may experience an overwhelming sense of self-doubt, inadequacy, or unworthiness. They may believe that they are inherently flawed or inferior to others, regardless of any evidence to the contrary. These feelings of worthlessness can be accompanied by guilt, where individuals blame themselves excessively for perceived failures or shortcomings, even if they are not objectively responsible.
These feelings of worthlessness and guilt can be debilitating, leading to a distorted self-image and undermining self-esteem. They may also contribute to a sense of hopelessness and despair about the future.Â
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8) Difficulty concentrating or making decisions
In depression, people may experience challenges in maintaining focus, processing information, and making decisions effectively. This cognitive impairment can manifest as forgetfulness, indecisiveness, and a general feeling of mental fog or confusion.
You may struggle to complete tasks, meet deadlines, or follow through with plans, leading to frustration and decreased productivity. The inability to concentrate or make decisions can exacerbate feelings of inadequacy and contribute to a sense of hopelessness about the future.Â
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9) Recurrent thoughts of death or suicide, suicide attempts, or self-harming behaviours
Someone with depression may experience persistent and intrusive thoughts about death, dying, or ending their own lives. These thoughts may range from fleeting considerations to detailed plans for suicide. They may also engage in suicide attempts, where they intentionally harm themselves with the intent to end their lives. These attempts can vary in severity, ranging from non-lethal self-injury to more serious suicide attempts requiring medical intervention.
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10) Symptoms causing significant distress or impairment in social, occupational, or other important areas of functioning
Socially, depression can lead to withdrawal from friends, family, and social activities. You may isolate yourself, avoid social interactions, or struggle to connect with others due to feelings of sadness, worthlessness, or guilt. This social withdrawal can exacerbate feelings of loneliness and contribute to a cycle of negative thoughts and emotions.
Occupationally, depression can impair performance at work or school. The person may struggle to concentrate, meet deadlines, or complete tasks effectively. Absenteeism, decreased productivity, and difficulty making decisions are common challenges in the workplace or academic settings.
In addition to social and occupational impairment, depression can impact other important areas of functioning, such as self-care, household responsibilities, and leisure activities. People may neglect their physical health, have difficulty maintaining their living environment, or lose interest in hobbies and interests they once enjoyed.
Further reading
Do you offer depression therapy near me?
Edinburgh Therapy Service offers both in-person depression counselling in Edinburgh (United Kingdom), and online therapy accessible worldwide. We specialise in acceptance and commitment therapy (ACT), cognitive-behavioural therapy (CBT), compassion-focused therapy (CFT) and mindfulness-based cognitive therapy (MBCT).