Everyone feels sad sometimes. For most people, the blues pass after a few days. Depression is marked by feelings of sadness that last most of the day, stretch into weeks, and interfere with daily life. It causes the sufferer and close friends or loved ones significant pain. The average age of onset is 18 years old. Other symptoms of major depression include:
• Loss of interest in activities
• Change in appetite
• Difficulty sleeping, or sleeping more than usual
• Fatigue or lack of energy
• Agitation or irritability
• Feelings of worthlessness, hopelessness, guilt or inadequacy
• Difficulty concentrating or making decisions
• Recurrent thoughts of death or suicide
• Unexplained aches and pains
It can be very difficult to distinguish major depression from a more severe form called bipolar mood disorder (BMD) – depressed phase. These two types of depression look almost exactly the same and even well-trained mental-health professionals struggle to separate them, especially in the early years of depressive symptoms. Features that would lead your clinician to consider the possibility of a bipolar type depression include:
• A relative with bipolar disorder or chronic alcoholism.
• “Leaden paralysis,” in which the person remains mentally sharp, but has so little energy that he feels like he is made of lead. It is a challenge for him to even move around the house.
• A lack of confusion and memory loss, which are common in major depression.
• A lack of meaningful response to traditional antidepressant medications. Although the symptoms seem the same, major depression and bipolar disorder are different conditions that respond to different medications and talk therapies.
• Having ADHD as well. About 25 to 40 percent of people with bipolar disorder have ADHD. About five to seven percent of people with ADHD will have a bipolar diagnosis at some time in their lives compared with one percent of the general population.
• The presence of the exact opposite mood, called mania, in which once-depressed people have an over-abundance of energy and drive.
Signs and symptoms of mania include:
• Inflated ego
• Increased energy and decreased need for sleep
• Inappropriate excitement or irritability
• Increased talking
• Sexual promiscuity
• Racing thoughts
• Impulsive behavior and poor judgment
If you experience one or more of these symptoms for two weeks or longer, consult a doctor or mental-health professional. If you think about suicide, or if you feel so bad that you can’t work or spend time with people, seek help immediately.
Signs and Symptoms of Depression in Children
The signs of depression in children ages six to 12 are similar to those seen in adults. A sudden drop in school grades or apathy about the future can also indicate depression in children. The American Academy of Pediatrics (AAP) estimates that nearly half of all kids with ADHD also suffer from conditions like depression, learning disabilities, and anxiety disorders. If you think your child might be depressed, talk to your child about life at school and home, and ask about bullying. Also talk with your child’s pediatrician, and try to determine if psychotherapy will help. Any thoughts of suicide should be dealt with as an emergency. Suicide is the third leading cause of death among adolescents aged 15 to 24 years.
The first step to getting a diagnosis is visiting a doctor. Your doctor may refer you to a mental health specialist. Your primary care physician or a psychiatrist will need to prescribe any medication; for children, a child and adolescent psychiatrist. A psychologist can provide therapy. Depression brings mood problems, forgetfulness, and an inability to focus. Depressive moods are pervasive and chronic, and have no triggering event or cause. They can last for weeks or months, and there is nothing you can do to “snap yourself out of it.” Depressed people are lethargic and can’t initiate any activity due to lack of energy. They often fall asleep right away, but awake many times during the night with anxiety and negative thoughts.
Certain medications or other medical conditions can cause symptoms similar to depression. Part of obtaining an accurate diagnosis is working with your doctor to rule out these other possibilities through a physical examination, psychological interview, and lab tests.
There is no blood test that can quickly and easily diagnose depression. Lab tests might rule out other conditions your doctor suspects, like hypothyroidism. An exam can turn up physical signs of depression like lethargy or slow movements, poor concentration, lack of eye contact, or tearfulness. Your physician may ask if you have a family history of depression or other mental health disorders, and go through a full list of symptoms with you. Be sure to explain how long you’ve been experiencing symptoms, and if you have had bouts of depression previously. The next step is devising the right treatment plan with your physician.