Symptoms of Depression

Most of us feel sad, lonely, or depressed at times. It's a normal reaction to loss, life's struggles, or injured self-esteem. But when these feelings become overwhelming, cause physical symptoms, and last for long periods of time, they can keep you from leading a normal, active life.

That's when it's time to seek medical help.

Your regular doctor is a good place to start. They can test you for depression and help manage your symptoms. If your depression goes untreated, it may get worse and last for months, even years. It can cause pain and possibly lead to suicide, as it does for about 1 of every 10 people with depression.

Recognizing the symptoms is key. Unfortunately, about half the people who have depression never get it diagnosed or treated.

Symptoms

They can include:

• Trouble concentrating, remembering details, and making decisions
• Fatigue
• Feelings of guilt, worthlessness, and helplessness
• Pessimism and hopelessness
• Insomnia, early-morning wakefulness, or sleeping too much
• Crankiness or irritability
• Restlessness
• Loss of interest in things once pleasurable, including sex
• Overeating, or appetite loss
• Aches, pains, headaches, or cramps that won't go away
• Digestive problems that don't get better, even with treatment
• Persistent sad, anxious, or "empty" feelings
• Suicidal thoughts or suicide attempts

Diagnosis

There isn't a "depression test" a doctor can use to see if you have it, so figuring that out often starts with a thorough history and physical exam.

Your doctor will want to know:

• When your symptoms started
• How long they've lasted
• How severe they are
• If depression or other mental illnesses run in your family
• If you have a history of drug or alcohol abuse

You'll also be asked if you've had similar symptoms of depression before, and if so, how they were treated.

Treatment

If your doctor rules out a physical cause for your symptoms, they may start you on a treatment or refer you to a mental health professional. This specialist will figure out the best course of treatment. That may include medicines (such as antidepressants), a type of therapy called psychotherapy, or both.

Be prepared for the process to take some time. You may need to try different treatments. And it may take more than a month for drugs to take their full effect.

Are There Warning Signs of Suicide With Depression?

Depression carries a high risk of suicide. Suicidal thoughts or intentions are serious. Warning signs include:

• A sudden switch from sadness to extreme calmness, or appearing to be happy
• Always talking or thinking about death
• Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse
• Taking risks that could lead to death, such as driving through red lights
• Making comments about being hopeless, helpless, or worthless
• Putting affairs in order, like tying up loose ends or changing a will
• Saying things like "It would be better if I weren't here" or "I want out"
• Talking about suicide
• Visiting or calling close friends and loved ones

If you or someone you know shows any of the above warning signs, call your local suicide hotline, contact a mental health professional right away, or go to the emergency room.

Are There Other Therapies to Treat Symptoms of Depression?

There are other treatments your doctor may consider. Electroconvulsive therapy, or ECT, is a treatment option for people whose symptoms don't get better with medicine or who have severe depression and need treatment right away.

Transcranial magnetic stimulation, or TMS, involves using a noninvasive device that is held above the head to induce the magnetic field. It targets a specific part of the brain that can trigger depression.

With vagus nerve stimulation, or VMS, a pacemaker-like device is surgically implanted under the collarbone to deliver regular impulses to the brain.

When Should I Seek Help?

If your symptoms of depression are causing problems with relationships, work, or your family -- and there isn't a clear solution -- you should see a professional.

Talking with a mental health counselor or doctor can help prevent things from getting worse, especially if your symptoms stay for any length of time.

If you or someone you know is having suicidal thoughts or feelings, get help right away.

It's important to understand that feeling depressed doesn't mean you have depression. That condition involves not only changes in mood, but also changes in sleep, energy, appetite, concentration, and motivation.

If you have physical symptoms like these and find yourself feeling depressed much of the time for days or weeks, see your doctor.

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