What Does Depression Look Like in Adults?

Roughly one quarter of all adults with ADHD also experience symptoms of depression, which include feelings of sadness that last most of the day, stretch into weeks, and interfere with daily life. Depression, which typically begins to manifest around age 18, causes the sufferer and his or her loved ones significant pain. It is a serious illness that requires swift diagnosis and treatment; depression is a leading cause of suicide among adults.

Common symptoms of major depressive disorder (the most common type of depression) in adults include the following, when sustained for two weeks or more:

• Loss of interest in activities
• Change in appetite
• Difficulty sleeping, or sleeping more than usual
• Fatigue or lack of energy
• Agitation or irritability with co-workers and family
• Feelings of worthlessness, hopelessness, guilt or inadequacy
• Difficulty concentrating or making decisions at work
• Recurrent thoughts of death or suicide
• Unexplained aches and pains

Major depression is not a normal part of aging. It is a serious condition that, unfortunately, some adults are reluctant to discuss with their physicians. If you notice any of the following daily manifestations of depression, make an appointment with your primary care doctor right away.

[Self-Test: Depression in Adults]

Symptoms at Home

• You notice your pants are getting very tight (or very loose), indicating a sustained change in appetite
• Cleaning the kitchen used to take an hour; now it takes all day, indicating a serious lack of energy
• No matter how early you go to bed, you never feel rested or eager to get up in the mornings
• You wake up in the middle of the night, and can’t get back to sleep
• Everything seems dull, and without vitality
• It takes a Herculean effort to get off the couch and take care of errands

Symptoms at Work

• You get a promotion, but still feel unsatisfied
• The smallest decision — like what to order for lunch — paralyzes you for hours
• Your co-workers didn’t invite you out after work, and now you feel like an outcast
• Even when you’re working hard, you feel like you could get in trouble at any moment
• You feel so antsy and agitated, it’s hard to be at your desk for eight hours
• You have broken down crying more than once this week at work

[“I Live With Both ADHD and Depression”]

If the symptoms of depression last for two years or more, the condition is called dysthymia.

If weeks-long depressive symptoms are followed and preceded by periods of “mania” that include increased energy and talking, decreased inhibitions and need for sleep, racing thoughts, and irritability, that could be a sign of bipolar mood disorder (BMD). The depressive stage of BMD may look a lot like major depression; even well-trained mental-health professionals struggle to separate them, especially in the early years of depressive symptoms. Your clinician should consider an evaluation for BMD if any of the following exist alongside the manic symptoms described above:

• A history of bipolar disorder or chronic alcoholism in the family.
• “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 with 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 therapies.
• Having ADHD as well. About 25 to 40 percent of people with bipolar disorder have ADHD. 5 to 7 percent of people with ADHD receive a bipolar diagnosis at some time in their lives, compared with 1 percent of the general population.

[How to Treat Depression]

If you experience one or more of the depressive or manic symptoms of BMD 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.