8 Depression Symptoms You Shouldn’t Ignore

If you or someone you know is struggling with depression, you’re far from alone. In 2020, 8.4 percent of U.S. adults — approximately 21 million people — had at least one major depressive episode, according to the National Institute of Mental Health. What’s more, a study from 2020 found that the prevalence of depression symptoms tripled in the United States during the COVID-19 pandemic.

Depression symptoms aren’t always as obvious as frequent crying and overwhelming despair. “Oftentimes the changes are subtle, and the person may not notice, but their friends and loved ones may,” says Boadie Dunlop, MD, director of the mood and anxiety disorders program in the psychiatry department at Emory University School of Medicine in Atlanta.

There’s no one pattern to depression, and the condition can vary in progression from person to person. Symptoms may gradually go from mild, such as choosing to stay home to watch TV instead of going out for a walk with a friend, to more severe, such as not even getting out of bed to shower or persistent thoughts of suicide. Others may quickly progress from their usual state to a severe depressive episode.

“Depression symptoms are particularly troubling if someone displays more than one or if they persist for more than two weeks,” says Simon Rego, PsyD, a professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine and the chief of psychology at Montefiore Medical Center in the Bronx, New York.

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To help you recognize depression that warrants concern, whether in yourself or a loved one, here are eight depression symptoms — some of which you might even find surprising — that you shouldn’t ignore.

1. Trouble Sleeping Although depression can sap energy and motivation during the day, a person may often lie awake at night, unable to sleep, says Sarah Altman, PhD, a clinical psychologist in the department of psychiatry and behavioral health at The Ohio State University Wexner Medical Center in Columbus. On the other hand, some people with depression may find it difficult to get out of bed and may sleep for long periods during the day.
2. Loss of Interest in Favorite Activities Some people turn to hobbies they enjoy when they feel blue, but those with major depression tend to avoid them, according to the American Psychiatric Association (APA). If you or someone you know usually loves to garden but can’t muster the energy to go outside, let alone work in the yard, that can be a red flag.
3. Increase in Energy Ironically, when depressed people have made a decision to do something drastic, such as harming themselves, they may go from slowed down to far more energetic. That’s because they feel a sense of relief in having come to a resolution, so if you notice a drastic change like this in someone you love, it’s a big cause for concern. This can also manifest as reckless behavior — particularly in men — such as indulging in risky sexual behavior, overspending, or abusing substances, such as alcohol or drugs, according to the Anxiety and Depression Association of America (ADAA).
4. Change in Appetite Some people overeat when they’re depressed or anxious, but in people with severe depression, the opposite is often true. Reduced appetite and weight loss can be a sign of depression, notes the Mayo Clinic, along with food cravings and weight gain.
5. Feeling or Seeming On Edge “In many people, depression can manifest with irritability, impatience, or anxiety and worry. Women are especially prone to anxiety symptoms along with depression,” says Diane Solomon, PhD, CNM, a psychiatric nurse practitioner in Portland, Oregon. Trouble concentrating is another related symptom.
6. Expressions of Guilt Feeling excessive guilt or worthlessness can also be a hallmark of depression, according to the APA. People might feel guilty because they are depressed or aren’t doing enough at home or at work.
7. Unexplained Physical Symptoms Since the body and mind are connected, depression can also start to manifest in physical ways that are resistant to treatment, such as persistent headaches, digestive issues, or unexplained pain, according to the ADAA.
8. An Emerging Dark Side A person who is severely depressed may become preoccupied with death and other morose topics, the APA notes. For example, they may talk about what things will be like “after I am gone” and may also become more likely to take uncalculated risks.

The Next Step: Getting Help

If you notice any of these serious depression symptoms in yourself or someone you love, reach out and get help. In most people, even major depression is a very treatable disorder, with a wide range of medications and therapies that have been shown to work, according to the APA.

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If Your Loved One Has Symptoms

• Encourage your loved one to seek professional help. If your loved one is considering harming themselves or having other dark thoughts, immediate treatment is critical. Go to the nearest emergency room or contact a local mental health provider. You can also call the 988 Suicide and Crisis Lifeline by simply dialing 988.
• Create a safe environment. “If the person expresses suicidal thoughts, remove any potentially lethal items from the home, such as guns,” Dr. Dunlop says.
• Be kind. “Blaming or chastising depressed people for feeling low or unmotivated is not helpful and typically serves to reinforce negative feelings they already have,” Dunlop says. “Instead, open the discussion in a nonjudgmental way and encourage the person to seek help.”
• Be willing to support treatment. Offer to help your loved one prepare a list of questions for a provider about depression or drive them to appointments.

If You’re Experiencing Symptoms

• Recognize if you’re starting to slip. If you are struggling with new or worsening symptoms, don’t hesitate to seek help. If you already have a therapist, reach out to them right away. If you do not have one, call the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-662-HELP (4357) for a free, confidential referral for treatment. If you’re considering harming yourself, contact the 988 Suicide and Crisis Lifeline at 988.
• Ignore incorrect attitudes. The old idea of “pulling yourself up by your own bootstraps” is not only outdated, but also not based in science. “If you feel depressed, there is no cause for guilt,” says Dr. Solomon.

Depression Resources

Many organizations also have online resources for depression. These include:

• National Institute of Mental Health
• National Alliance on Mental Illness
• American Psychiatric Association
• Depression and Bipolar Support Alliance
• Anxiety and Depression Association of America

Additional Reporting by Erica Patino