Signs of depression

Photo of two men chatting (PantherMedia / M.G. Mooij)

It is not always easy to diagnose depression. Several typical symptoms lasting for more than two weeks may be a sign that someone is depressed. In children and teenagers, however, depression often has different symptoms.

We all experience deep sadness and anxiety every now and again, especially when faced with a particularly challenging or painful situation in life. That can sometimes lead to depression. Depression is more than simply feeling blue or having a bad day. Typical symptoms include long periods of feeling down, lack of motivation and lack of interest. People no longer enjoy things they used to enjoy, find it difficult to work or study, and neglect their friends and family.

How depression is diagnosed

To find out whether someone is depressed, doctors ask about symptoms that could be signs of depression. And they try to rule out other medical conditions or problems that can cause similar symptoms. There is no accurate test for diagnosing depression.

If someone has several of the following symptoms over a longer time period (at least two weeks), they could be depressed:

  • Continuously feeling down
  • Listlessness
  • Doing less than before
  • Lack of enjoyment and general loss of interest (even in hobbies and other activities that used to be fun)
  • Low self-esteem and low self-confidence
  • Feeling guilty about things you can’t actually help
  • Feeling tired
  • Sleep problems
  • Loss of appetite
  • Trouble concentrating

In some people depression mainly manifests itself in physical symptoms such as weight loss, sleep problems, inexplicable pain, constipation or a loss of sexual desire. Depression not only causes listlessness, it can also make people more irritable.

As well as these symptoms, other problems like an increase in alcohol consumption or an addiction sometimes play a role too. People who are depressed may also have other mental health problems, such as anxiety disorders.

Symptoms in children and teenagers

Which symptoms of depression occur and how strong and frequent they are varies from person to person, and differs between age groups, too.

  • Pre-school children probably don’t get depressed very often, and it can be hard to tell if they are. Pre-schoolers who are depressed cry a lot, are not interested in playing and are very anxious. Many try unusually hard to be nice and obedient. In some children it can set back their development.
  • School-aged children who are depressed often lose interest in hobbies and other activities, and may be hostile to others. They lose their temper, easily get upset about little things and have low self-esteem.
  • With teenagers it can be hard to tell whether these are part of "normal” puberty-related mood swings or actually symptoms of depression. Even healthy young people are sometimes defiant, aggressive, indifferent, have low self-esteem or retreat into themselves. As well as feeling down all the time, things like weight changes, drug and alcohol abuse, extreme tiredness and suicidal thoughts can be signs of depression in teenagers.

Severe depression

Doctors differentiate between mild, moderate and severe depression. The number of symptoms and how bad they are can indicate how severe someone’s depression is. People who have severe depression may seriously consider suicide. People who have thoughts about taking their lives need urgent help.

Bipolar disorder (often called manic depressive disorder or manic depression) is a specific form of depression. It is a lot less common than depression. People who have bipolar disorder go through alternating phases of being depressed and phases of being extremely energetic and euphoric (“manic”). They may lose touch with reality and get into difficult situations.