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Symptoms of depression vary between individuals and by the type of depression they have. Depression symptoms can change over time and become more mild or severe. Treatments can effectively manage depression symptoms in most people.
The primary symptom of depression is low mood. Mood problems can manifest as sadness, anxiety, panic, or a feeling of emptiness. A person with depression may often feel hopeless or pessimistic. Depression causes some people to be more irritable or easily frustrated. They may also feel a sense of guilt or worthlessness, and self-confidence is often low. It is common for people who are depressed to feel less passionate about hobbies and lose interest in causes they previously held dear.
People suffering from depression may withdraw from social situations – this behavior is called hibernation in people with seasonal affective disorder. Depressed people may also engage in risky behavior such as unprotected sex, binge drinking, and abusing illicit or prescription medications. Thoughts of death may prompt a person with depression to plan or attempt suicide. Some people with depression, especially those with psychotic depression, may behave violently towards others. Those with mania caused by bipolar disorder can experience extreme hyperactivity and may make decisions with dramatic consequences, such as spending large amounts of money or saying things to loved ones that are out of character..
Extreme fatigue is a common symptom of depression. Fatigue may be due to insomnia or difficulty sleeping but may occur even with a full night’s sleep. When someone is depressed, they may have headaches, cramps, digestive problems, or aches and pains that do not have an identifiable physical cause or improve with treatment. People with depression often have cognitive symptoms – problems with memory, concentration, and decision-making. They may also experience appetite or weight changes, which can also be a side effect of some antidepressant medications. Depression often causes lowered libido; many antidepressants also cause loss of interest in sex, or sexual dysfunction such as difficulty getting an erection (in men) or having an orgasm (in men or women).
There are two main types of psychotic symptoms: delusions and hallucinations. Delusions are strong beliefs that are often irrational or untrue, and hallucinations involve hearing or seeing people or objects that are not there. Delusions can include paranoid and suspicious thoughts, giving great significance to trivial items or remarks, or even thoughts of power and strength. People who have psychotic symptoms often display a sudden decline in self-care, withdraw from friends and family, and have difficulty focusing and remembering.
Different types of depression begin at different ages. Major depressive disorder can start at any age, but the median age of onset is 32. Bipolar disorder usually begins between the mid-teens and late 20s. Seasonal affective disorder is common in children and teenagers but may begin in adulthood.
For most people with major depression disorder, depression episodes are usually limited, and symptoms improve with treatment such as psychotherapy and antidepressants. Some studies estimate that the average length of a depressive episode is about 20 weeks. However, some people have chronic depression – lasting two years or more – that is resistant to treatment and prone to relapse. There are different medications or other therapeutic approaches that may be effective in cases of chronic depression when antidepressants have failed. People with chronic depression may need to try several different treatment approaches to find one that works for them.
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