Feeling down in the dumps every so often is a normal part of life. But when you're gripped by an unrelenting sadness or hopelessness that keeps you from going about your usual routine, it's time to pay attention, as this is the hallmark sign of clinical depression.
According to National Survey of Drug Use and Health (NSDUH) data, in 2020, 8.4% of adults in the U.S. aged 18 and older experienced a major depressive episode.
Still, it’s tough to know if you’re depressed. “Almost all of the symptoms of depression on their own are experienced by everyone at one time or another,” said Jennifer Payne, MD, director of the Women’s Mood Disorders Center at Johns Hopkins University in Baltimore.
According to the National Institute of Mental Health (NIMH), to be diagnosed with depression, most of the symptoms must be present every day, nearly all day, for at least two weeks.
One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities.
If you think you may have depression, talk to your healthcare provider.
You're Eating More (or Less) Than Usual
Depression leaves you withdrawn and checked out, which can manifest as a loss of appetite.
“If your brain is preoccupied with negative thoughts, you may forget to eat or lose interest in cooking or preparing meals,” said Yvonne Thomas, PhD, Los Angeles-based psychologist specializing in depression and self-esteem.
Sometimes depression has the opposite effect, driving you to overeat. "The mix of emotions that tend to accompany depression—sadness, pessimism about the future, and low self-esteem—can compel you to try to soothe your feelings with food binges," said Thomas.
You're Sleeping Too Much or Too Little
Some people with depression find themselves sleeping more; the disengagement and dip in energy make you tired all the time.
"Sleeping more is also a way depressed people escape from their sadness; it becomes a refuge," said Thomas.
Others with depression experience restless or interrupted sleep or even insomnia—they're too wired by obsessive thoughts or ruminations to wind down and score the seven to eight hours per night most adults need.
Sleep changes can help you know if you're depressed but also worsen the depression. When you're not getting the proper amount of shuteye, your body's internal clock gets out of sync, and you're even more tired and unfocused—and less able to cope.
Small Things Agitate You
It’s a sneaky sign few people recognize: Depression can show up as heightened irritability, said Jennifer Wolkin, PhD, a New York-based health psychologist.
You might feel grumpy; little things that normally wouldn't register set you off and leave you snapping at friends and coworkers. It could also be triggered by the weight of so many heavy emotions.
"When people are in physical pain, they often get angry and irritated easily, and it's the same with psychological pain—you don't feel good or like your usual self, and that saps your patience and puts you more on edge," said Thomas.
You Can't Concentrate or Focus
Forgetting work deadlines or when to pick up your kids from a playdate? Feeling like your mind resembles an out-of-focus photo, and the fuzziness has made a dent in how you weigh choices and make decisions? That could be depression.
Being preoccupied with thoughts of sadness and emptiness can plunge you into a head fog that affects your job, memory, and decision-making skills, said Wolkin. That unfocused thinking can lead you to make poor choices or take on unhealthy, risky behavior.
You Don't Enjoy the Things That Once Made You Happy
You used to hit happy hour with your favorite group of coworkers, but you've been ducking out for the last few weeks. Or you always looked forward to your nightly run, but you can't muster the interest these days. Not taking part in things you once enjoyed because they no longer give you pleasure is a telltale sign of depression.
"A person who is simply blue might skip a few outings, then get back in the swing of things," said Wolkin. "But depression makes you apathetic about activities and hobbies that once gave you joy, and that makes you isolate yourself."
It sets up that vicious cycle: Depression robs you of your ability to derive pleasure from experiences, so you stop doing the very things that could brighten your mood.
You Feel Down on Yourself and Worthless
If you're constantly putting yourself down, or you feel worthless or inconsequential, something is up.
"Repetitive thoughts along the lines of 'I'm not good enough' or 'I don't matter' are dangerous because they can fuel self-harming behavior," said Wolkin. When you think this way, you tend to find ways to verify the negativity, making you more depressed and at risk.
Extreme guilt for things you aren't solely responsible for—for example, a bad breakup or sudden job loss—also bashes your self-esteem and is a tip-off that you're depressed, said Dr. Payne.
You're Preoccupied With Thoughts of Death
Persistent thoughts about ending your life, wondering how friends and family would feel if you went and did it, pondering different ways to carry out the act, and even general thoughts about death are all strong indicators that it’s time to reach out to professional help, said Wolkin.
"Because these thoughts pose such a direct threat to your life, it's important to seek help even if you don't recognize any other symptoms of depression in yourself," Wolkin told Health.
If you or someone you know is having thoughts about hurting themselves or attempting suicide’ please seek immediate help. The following resources, as suggested by the Centers for Disease Control and Prevention (CDC), can help:
- Call 1−800−273−TALK (8255) to reach a 24−hour crisis center or dial. 911. 1−800−273−TALK is the National Suicide Prevention Lifelineexternal icon, which provides free’ confidential help to people in crisis. The Substance Abuse and Mental Health Services Administration runs this lifeline.
- Call your mental health provider.
- Get help from a healthcare provider.
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader, or someone else in your faith community.
Your Energy Level Has Hit the Wall
Depression-related lethargy may result from not eating enough or sleeping too much. But it's also the result of having a black cloud of sadness or hopelessness over you all the time. Dealing with chronic emotional pain is an energy suck, and it makes you too dragged and tired to tackle routine tasks, not to mention work and family responsibilities.
“You feel overwhelmed by day-to-day life; even getting out of bed and taking a shower becomes exhausting,” said Wolkin. When you’re always tired and that fatigue impairs your life, it’s time to seek help.
You're Dealing With Unexplained Aches and Pains
"Emotional pain from depression that you aren't getting help for can be channeled throughout your body and show up as physical ailments, like headaches, stomach problems, neck and back pain, even nausea," said Thomas. "I see this with many of my patients; they're holding so much sadness and distress inside, these feelings end up playing out in other ways."
Not every cramp or twinge is a sign that you are depressed, of course. If you have a chronic ailment you can’t attribute to another cause that isn’t clearing up on its own, “see a healthcare provider to get it checked out, but also consider it a possible sign of depression too,” said Thomas.