Depression symptoms

HOME Depression symptoms

You distinguish between different degrees of depression. Below you can read about these distinctions. You can also read more about the different symptoms of depression here.

Mild depression

Despite its name a mild depression is painful. The symptoms of mild depression are the following:

You generally feel sad and lack energy to carry out the chores that you normally do. You might be able to pull yourself together but not for very long at a time.

  • The things that used to interest you don't appeal to you as much anymore.

  • You are markedly tired and getting a good night's sleep doesn't help.

  • You can misinterpret the tiredness and believe that you have got a physical disease.

  • You can have diffuse physical symptoms. That means that you might feel pain "here and there", feel dizzy and a weight on the chest, etc.

If you have physical symptoms for a prolonged period of time that you cannot explain, they might be caused by a mild depression. You should therefore go to see your GP.

Moderate depression

The symptoms of moderate depression are similar to those of mild depression but the symptoms are worse and are present almost all the time. You are only able to pull yourself together for very short periods at a time. You are sad, lack energy and you are not very interested in the people around you. Your thoughts are revolving around low self-esteem and feelings of guilt, even though your family, friends and other people around you find it difficult to understand why you have feelings of guilt.

You also experience a lack of joy about people or things that used to be a source of joy. Your interest in your family and your work is small. Your level of concentration is greatly reduced, and you are no longer able to read books or keep up with reading the newspapers or watching TV and films.

The small decisions that daily life presents seem insurmountable to you. It can be difficult to decide what you should buy for tonight's supper. You don't feel like going out or having visitors and just want to be by yourself at home.

Twenty-four-hour variation

If you are suffering from moderate depression, it is common for you to have a twenty-four-hour variation in your mood. That means that you can feel lousy in the morning and start feeling better towards the evening.

You don't sleep very well and don't feel refreshed. You might find it relatively easy to fall asleep but you wake up after a few hours of sleep and cannot get back to sleep. Many people find lying awake in the early hours of the morning the biggest strain. You are completely alone then with your sad thoughts.

Reduced appetite

You usually have a reduced appetite in connection with moderate depression. It is not uncommon for you to loose 5-10% of your normal weight.

A prolonged state of depressed mood and sadness is the crux of a depression. Psychiatrists use the expression "depressed mood". That simply means that your basic mood has been lowered. You are therefore sad - but more than that:

  • If you are suffering from depression, you are not just sad - but very sad!

  • If you are suffering from depression, you are not just sad often - but sad all the time!

  • If you are suffering from depression, you are not just sad about something - but sad about nearly everything!

  • If you are suffering from depression, you are not just sad about it for a while - but sad about it for a long time!

  • Loosing the ability to feel happiness

Your sadness goes on and on. Even though you once in a while can see that it is unrealistic to be so sad and pessimistic, everything seems unimportant or threatening. You can have the feeling that something ominous is going to happen, which you are not in control over.

Depression can furthermore cause you to loose your ability to feel happiness so that you

  • loose the ability to have fun

  • loose the ability to enjoy sex

  • have a pessimistic attitude and feel that everything is hopeless

  • have the feeling that everything is sad and unimportant

  • Twenty-four-hour variation

But even though you are depressed all the time, you can feel better at certain times of the day than at other times. This is called the twenty-four-hour variation

You often see the twenty-four-hour variation in depression: You wake up early in the morning and feel really awful. This condition has been given the old fashioned name: "morning agony".

During the day things improve a little and towards the evening you are able to socialize a little with others. You can get a little done of what you need to do. You feel a little less depressed.

There are many people who have a twenty-four-hour rhythm, where they are grumpy in the morning but cheer up a little later in the day. When you suffer from depression, this twenty-four-hour rhythm continues but at a lower level, where each morning is unbearable and each evening is just tolerable.

You can have negative thoughts which are closely linked with sadness. Everyone who is suffering from depression has negative thoughts such as:

  • "I'm not good at anything"

  • "I'm hopeless"

  • "Nobody understands me"

  • "Life is unfair"

  • "I have deserved that everything goes wrong"

  • "I deserve to be punished"

  • "Death would be a liberation"

Perhaps you feel that you don't live up to your own or others' expectations. You may feel that you are bad at or unsuitable for the work you do. You can also feel that you are lazy, indulgent or too hard on your family. Or perhaps you label yourself as a bad person.

Feelings of guilt

You might also have feelings of guilt over things that you have done. These feelings can also be related to things that you have done or they can be related to things that you ought to have done.

Your negative thoughts can contain real substance. But your feelings of guilt are exaggerated. Sometimes they are completely unrealistic and psychotic. Here is an example of such an exaggerated feeling of guilt:

When a man of about 50 years of age became depressed, he referred time and time again to his youth. He was employed in a big company then. The company distributed work clothes to the staff. The man had at some point taken a pair of work trousers home with him. He could not really explain whether he had stolen the trousers or not. Perhaps he had just forgotten to take them off as he went home.

Now, approximately 30 years later in his depression, he was full of guilt feelings about the trousers. He was adamant that the trousers event was proof of his bad and thieving character. He felt that he ought to go to the police and receive a hard punishment.

A psychotic depression requires admission to hospital and can take a while to treat. But the man ended up getting well again.

If you are suffering from depression, you don't feel like or have the energy to be with other people. If you need to go out, you have to force yourself to do it. You keep yourself to yourself and you are definitely not an entertaining or funny person. Afterwards, you feel tired, worn out and sad. You can also be full of contempt for your own poor effort.

Even with milder depression, you feel tired and lack energy, and you are therefore not up to much in company with others. You do know that you ought to look after your family and friends. You also do know that you ought to look after yourself but you simply haven't got the strength to do it.

You know that you ought to be more interested in others. You ought be to be more entertaining, get good ideas and put things in motion. You do know that you ought to show initiative but: You simply haven't got the energy.

If you are depressed, you prefer to be left alone, because you simply haven't got the energy for anything else. But it only makes the depression worse and so the vicious circle is in motion.

If you are suffering from depression, you will also often be very worried and anxious. Your anxiety can be connected with financial circumstances and other well-known problems, or you may be anxious about getting a serious disease, getting panic attacks or a compulsion neurosis

If you are suffering from very severe depression, you might be terrified of catastrophes, which you think are inevitable

In a so-called agitated depression, anxiety, perplexity and restlessness are the obvious symptoms. In these depressions, the suicide risk can be high and the treatment should be carried out whilst hospitalized.

Men

Mood swings in men can be manifested as increased irritability rather than sadness. You might become

  • discontented

  • touchy

  • quick-tempered

  • restless

  • aggressive

Instead of becoming passive you are active. But you don't get anything out of your activity. As with other depressions your thoughts are marked by feelings of inferiority, pessimism and seeing black.

If you are depressed, your psychomotor function is often significantly reduced. This means that you think, speak and act more slowly than normally. It might be physical inhibitions such as

  • reduced and sparse facial expression

  • lack of smiles

  • less eye contact with others

  • slow and brief speech; hardly saying anything

  • long pauses and periods of waiting when you speak

  • moving hands and arms much less when you speak

  • sitting motionless for a long time

  • moving at a reduced tempo and without big movements

It might also be mental inhibitions, where you

  • think more slowly

  • have difficulties remembering and concentrating

  • have difficulties making a decision

  • don't take an interest in yourself or the people around you You might therefore risk becoming unfit for work

Psychomotor inhibitions are characteristic of depression. But they can also occur in connection with other illnesses such as Parkinson's Disease and Dementia.

Nearly everyone who suffers from depression experiences changes in their sleep. You might experience the changes as

  • having difficulty falling asleep

  • sleeping less in total

  • never feeling refreshed

  • sleeping shallowly

  • waking several times during the night

  • waking up early in the mornings

  • having an increased number of sleeping cycles

  • getting disturbed by the so-called REM sleep, which is one of the sleeping phases you normally go through one or more times during your sleep. Recent research indicates that REM sleep among other things has an effect on memory and learning.

In an atypical depression, it is the other way around: here you sleep more than you normally do.

Depression can lead to a number of physical symptoms. If you are depressed, it is quite common for instance for you to have a reduced appetite. You don't feel any pleasure in eating and the food doesn't seem tasty. If you do eat, it is more out of a sense of obligation. You are eating too little and might loose a significant amount of weight, which again can cause you to be even more tired and energy deprived so much so that you don't feel like eating anything. And so the vicious circle continues.

It can also happen that your appetite increases, if you are suffering from atypical depression. Perhaps you feel better when eating, and in such a case your weight might increase. You should therefore be aware that appetite and weight changes without any explanation can be symptoms of depression.

Pain

If you have chronic pain, for example due to rheumatism or a bad back, your pain will intensify when you are depressed. Even though you don't already have chronic pain, depression can cause different pain symptoms such as

  • sore muscles and joints

  • stomach-ache or other stomach problems

  • headache

It is often the pain which makes you go to your doctor. It is therefore important that the doctor keeps depression in mind if you get or have pain which has got worse without any clear physical reason. However, pain and other chronic symptoms can also increase your chances of developing depression.

Tension

Depression makes it difficult for you to relax both physically and mentally. Your thoughts are spinning around in circles without you being able to make decisions. Your muscles are tense and maybe even sore, and even though you are tired, you are unable to relax and find rest. This tension increases your feeling of being unwell and hence increases your depression.

Tiredness and lack of energy

Most depressed people are tired and complain about a reduced level of energy. Tiredness and lack of energy can be so dominant that you perhaps are unable to get up, have a bath or do anything. The tiredness isolates you, as you can't manage to pick up the telephone, have visitors or relate to other people, not even to those closest to you.

If you are suffering from severe depression, you might get psychotic symptoms. With a psychotic depression you also have negative thoughts. But your thoughts have become unrealistic and difficult for others to understand, as they bear no resemblance to reality.

You might have thoughts about being to blame for serious accidents and catastrophes. You can also be convinced that you are a bad person, and you can feel so sinful that you believe you deserve to die or be punished severely.

Your appetite and thirst can become so reduced that it becomes critical, and in a few cases you might stop eating and drinking altogether. Such a condition can quickly become life threatening and you therefore have to be admitted to a psychiatric ward as quickly as possible.

Can become dangerous

When you are suffering from a psychotic depression, you have an unrealistic perception of reality. You are not fully capable of taking care of yourself - and the situation can become dangerous. With a psychotic depression you always need to be admitted to hospital, in order to be protected and treated. If the situation becomes critical or dangerous, the doctor always needs to be called in. The doctor will arrange the admission. If it is necessary, you might be committed to hospital against your will.

Paranoia

With a psychotic depression you can become paranoid and feel persecuted. You can convince yourself that certain people or secret organisations are out to hurt or punish you. You might believe that you are an innocent victim. But often your depressive thoughts cause you to believe that you have deserved to be persecuted and punished.

Hallucinations

With a psychotic depression you also get hallucinations. You might be hearing voices that speak derogatorily about you or tell you that you must be punished. The voices can also encourage you to punish yourself - perhaps commit suicide. With a severe depression you might also have serious suicidal thoughts without having hallucinations. Severe depression is therefore a very serious disease, which require admission to a psychiatric ward.