Why are the Signs of Depression Hard to see and understand?

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Everyone has heard of depression. We all kind of know what depression is. Why, then, do we miss the signs of depression either within ourselves and our loved ones?

Although we have become more understanding and aware that mental health issues surround us, many still do not know what depression signifies. If I were to ask a stranger what they thought depression was, I might get an answer ranging from “a general feeling of emptiness” to “not being able to get out of bed”.

Although these are hallmarks of depressive disorders, many other symptoms factor into a depression diagnosis and separate it from general sadness or other pathologies.

This article will go over the symptoms of depression and why it is easy to miss the signs of depression in our close ones and how to better detect depression.

Symptoms of Depression

The American Psychiatric Association’s DSM-V (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) has established criteria for a depression diagnosis. These are the tools that mental health professionals use to agree on the symptoms that must be met before they make a diagnosis.

Understanding the symptoms of depression will allow us to outline how these symptoms represent themselves and why they are more difficult to asses within ourselves and our loved ones.

  1. Depressed mood
  2. Diminished interest in activities
  3. Weight loss or weight gain / decreased appetite
  4. Sleeping too little or too much and increased difficulty falling asleep
  5. Fatigue and/or energy loss
  6. Increased physical activity without purpose (e.g., fidgeting, hand-writing, pacing etc.)
  7. Feelings of worthlessness and guilt
  8. Concentration problems, decision-making problems, cognition difficulties
  9. Thinking about suicide and/or death

The list is extensive, but you need only 5 or more of these symptoms, that last at least two weeks for a professional to diagnosis you with depression [1]. The symptoms must also affect your ability to function both at home and at work.

Depression Versus Feeling Sad

One reason depression may go unnoticed by yourself or others is that the term “depression” has become synonym with “sad”. When you are talking to your friends or family, you might describe yourself as depressed after losing your relationship or after having an awful day—you might say something like “I just feel depressed”. But feeling depressed and having the mental pathology of a depressive disorder are not the same thing. Let me explain.

Feeling sad is a human emotion we all experience; but, comparing depression with the natural human emotion is a problem. Depression is associated with much more than sadness. If you refer to the symptoms above, only a few tend to “sadness”, while the others are more intrusive and affect your ability to function properly.

When people say they feel depressed, they generally mean they feel sad.

They experience a temporary emotion and describe it as a depressed mood. But their mood does not change how they see themselves or their outlook on life. However, depression does affect a persons outlook on life – it affects persons on a deeper level.

Depression can change brain chemistry, affect our sense of self worth, and can handicap our ability to function, thus stopping us from achieving what we want. While true that sadness and loss can develop into depression, using sadness and depression to represent the same emotional turmoil is a problem.

How to Identify Depression

We have discussed the difference between sadness and depression, but how do you identify one over the other? When does sadness change to depression, and how do you see it in a loved one?

Signs-of-depression-what-you-can-do
Signs-of-depression-what-you-can-do

If you are trying to decide if a close one is depressed, start by reading over the list of depressive symptoms.

Match the symptoms from the above list to those the person is exhibiting. If they have many of the above symptoms, they may suffer from depression. Think about your last conversation with them. How did they sound? Did they mention something that is unlike them? Anything out of the ordinary should be taken into consideration when you are trying to decide if a close one suffers from depression.

What you can look for

Try identifying changes they have made in their daily activities or how they present themselves to you. The following things are the easiest to look for:

  • Changes in personality
  • Lack of interest in anything
  • Negative outlook on life
  • Negative habits (e.g., gambling, addiction, drinking, self-harm, etc.)
  • Isolation and social withdrawal
  • Lack of self-care

If you notice large changes in their personality, interests, habits and outlook towards life, this could be a sign that something is wrong. If these changes persist for a few weeks, show concern and check in with that person. Long-lasting changes and negative life habits are hallmarks of depression, and not sadness or “having an unpleasant day”.

Factors to consider

Many factors make it difficult to detect depression in those closest to us. Consider the gradual development of depression, for example. Your love one could suffer from minor depression, but only change their outlook on life over the course of a few months or even years. You would only notice minor adjustments over a long period, and so not realize that they have changed. As the depression grows stronger, you would attribute their negative emotions to their changed personality and lifestyle, but not remember the joyful and high-achieving person they once were.

Depression likes to Hide

Depression is also an elusive pathology. Depressed individuals might not show any obvious signs of depression. Fear of judgment and social pressures can make those who suffer not want to talk about how they feel. Unless you spend most of your days in proximity with that person, you can miss many of the symptoms they experience because depressed people become exceptionally good at hiding their depression and can appear to function normally.

Most of us are adept at making others see what we want them to see about ourselves—depressed persons are no different. They do not want others to see them as sad or worthless, because they feel that way about themselves. They counter their negative sense of self by showing exterior signs of happiness and love, while isolating their true self even further. When depressed persons hide how they feel and dismiss their depression, it makes it exceedingly difficult for those who love them to notice that anything is wrong. Our best course of action, when faced with elusive pathologies like depression, is to show empathy and compassion to all those around us—you never know when someone might be struggling.  

Conclusion

Depression is not a simple disorder to identify. The nature of the disorder can make it more difficult for others to see its symptoms, but there are signs of depression you can look for. Check up on those closest to you if you feel something is different about them. Watch for any signs of long-lasting sadness and lifestyle changes that happen either abruptly or over time. But keep in mind that depression is elusive, and it’s difficult to detect if the symptoms show no exterior signs. Show love, compassion, and understanding to all those around you and don’t be too hard on yourself if you do not see the signs of depression in someone you love—they most likely intended for you not too.  

As always, stay happy and reach out if you have any concerns!

References:

[1] American Psychiatric Association: (2017, January). Retrieved from https://www.psychiatry.org/patients-families/depression/what-is-depression

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