How you can tell someone is suffering from depression

Even though depression causes you to feel hopeless and helpless, it is treatable. With a combination of medication and talk therapy, most people can get better.

Depression is a feeling of sadness that stays with you for two weeks or longer. It interferes with your daily life activities. Sometimes people may experience an episode of depression only once in their life, but most people generally experience it more than once.

The symptoms of depression most often span across the physiological, emotional, social and occupational, and psychological domains.  

Physiological symptoms:

Physiologically, changes in appetite, sleep patterns, decreased interest in sex, increased aches and pains, lowered energy levels, and chronic fatigue are noticeable signs of depression in a person. It can increase your susceptibility to a number of diseases and medical conditions. The person may experience an increase in their levels of stress hormones, such as cortisol or adrenaline. Depression can affect the immune system and is linked to heart disease and an increased risk for substance abuse.

Cognitive symptoms:

In terms of cognition, depression can affect one’s decision-making skills, problem-solving abilities as well as concentration. For example, a client, who was a high school student, faced the issue of not being able to concentrate and focus when studying for her approaching exams, which was stressing her out. Instead of dealing with the stress of the oncoming exams, in therapy, we uncovered the underlying cause for her lack of concentration and discovered symptoms of clinical depression that needed to be dealt with on priority. Psychologically it can be a lack of motivation or desire to get things done.

Most common symptoms:

One of the most recognisable symptoms of depression is excessive sleeping. You will sometimes find that people with depression sleep for hours together, right into the day. One of the consequences for this is missing out on the commitments for that day or skipping work/school.

Change in eating patterns is another important sign. The person may have a sudden unexplained increase or decrease in appetite. Some people end up overeating and put on weight. These are people who invariably turn to food to lift their mood. They eat to fill a void or to escape from uncomfortable or negative feelings such as sadness, shame or loneliness. These people could be craving soothing comfort foods or foods rich in carbohydrates, such as ice cream and cake because such food items increase the levels of serotonin, a brain chemical that elevates mood.

Others find that they have low motivation for preparing food, and this combined with low appetite leads to poor food choices and irregular eating patterns. They begin to lose weight unintentionally. It is best to seek treatment for depression before changing eating patterns.

Formally, to qualify for a diagnosis of major depressive episode, the patient must meet criteria A through E.

A. Five or more of the following symptoms should have been present and documented during the same two-week period and must represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Do not include symptoms that are clearly attributable to another medical condition.

1. Depressed mood most of the day, nearly every day, as reported by either by self (e.g., feels sad, empty, hopeless) or by others (e.g., appears tearful)
2. Marked drop in interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation)
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than five percent of body weight in a month), or decrease or increase in appetite nearly every day
4. Insomnia or excessive sleeping nearly every day
5. Marked increase in purposeless physical activity or sluggishness nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The episode cannot be attributed to the effects of a consumed substance or to another medical condition.

Note: Criteria A-C represent a major depressive episode.

Note: Responses to a significant loss (e.g., bereavement, financial ruin, losses from a natural disaster, a serious medical illness or disability) may include feelings of intense sadness, rumination about the loss, insomnia, poor appetite and weight loss noted in Criterion A, which may resemble a depressive episode. Although such symptoms may be understandable or considered appropriate to the loss, the presence of a major depressive episode in addition to the normal response to a significant loss should also be carefully considered. This decision inevitably requires the exercise of clinical judgment based on the individual's history of and the cultural norms for the expression of distress in the context of loss.

D. The occurrence of the major depressive episode is not better explained by another disorder like schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.

E. There has never been a manic episode or a hypomanic episode.

Even though depression causes you to feel hopeless and helpless, it is treatable. With a combination of medication and talk therapy, most people can get better.