Symptoms of Major Depression

Not all people with depression will show all symptoms or have them to the same degree. If a person has four or more symptoms, for more than two weeks, consult a doctor or mental health professional right away. While the symptoms specified for all groups below generally characterize major depression, there are other disorders with similar characteristics including: bipolar illness, anxiety disorder, or attention deficit disorder with or without hyperactivity.

In Adults

• Persistent sad or "empty" mood.
• Feeling hopeless, helpless, worthless, pessimistic and/or guilty.
• Substance abuse.
• Fatigue or loss of interest in ordinary activities, including sex.
• Disturbances in eating and sleeping patterns.
• Irritability, increased crying, anxiety or panic attacks.
• Difficulty concentrating, remembering or making decisions.
• Thoughts of suicide; suicide plans or attempts.
• Persistent physical symptoms or pains that do not respond to treatment.

In Infants

It’s important to understand what constitutes normal development in infants, children and adolescents vs. what may be signs of a depressive illness.

• Unresponsive when talked to or touched, never smile or cry, or may cry often being difficult to soothe.
• Failure to gain weight (not due to other medical illness).
• Unmotivated in play.
• Restless, oversensitive to noise or touch.
• Problems with eating or sleeping.
• Digestive disorders (constipation/diarrhea).

In Children

In children, depressive illnesses/anxiety may be disguised as, or presented as, school phobia or school avoidance, social phobia or social avoidance, excessive separation anxiety, running away, obsessions, compulsions, or everyday rituals, such as having to go to bed at the exact time each night for fear something bad may happen. Chronic illnesses may be present also since depression weakens the immune system. Other signs include persistent unhappiness, negativity, complaining, chronic boredom, no initiative.

• Uncontrollable anger with aggressive or destructive behavior, possibly hitting themselves or others, kicking or self-biting or head banging.
• Harming animals.
• Continual disobedience.
• Easily frustrated, frequent crying, low self-esteem, overly sensitive.
• Inability to pay attention, remember, or make decisions, easily distracted, mind goes blank.
• Energy fluctuations from lethargic to frenzied activity, with periods of normalcy.
• Eating or sleeping problems.
• Bedwetting, constipation, diarrhea.
• Impulsiveness, accident-prone.
• Chronic worry & fear, clingy, panic attacks.
• Extreme self-consciousness.
• Slowed speech & body movements.
• Disorganized speech - hard to follow when telling you a story, etc.
• Physical symptoms such as dizziness, headaches, stomachaches, arms or legs ache, nail-biting, pulling out hair or eyelashes. (ruling out other medical causes)
• Suicidal talk or attempts.

In Adolescents

Depressive illnesses/anxiety may be disguised as, or presented as, eating disorders such as anorexia or bulimia, drug/alcohol abuse, sexual promiscuity, risk-taking behavior such as reckless driving, unprotected sex, carelessness when walking across busy streets, on bridges or cliffs. There may be social isolation, running away, constant disobedience, getting into trouble with the law, physical or sexual assaults against others, obnoxious behavior, failure to care about appearance/hygiene, no sense of self or of values/morals, difficulty cultivating relationships, inability to establish/stick with occupational/educational goals.

• Physical symptoms such as dizziness, headaches, stomachaches, neck aches, arms or legs hurt due to muscle tension, digestive disorders. (ruling out other medical causes)
• Persistent unhappiness, negativity, irritability.
• Uncontrollable anger or outbursts of rage.
• Overly self-critical, unwarranted guilt, low self-esteem.
• Inability to concentrate, think straight, remember, or make decisions, possibly resulting in refusal to study in school or an inability (due to depression or attention deficit disorder) to do schoolwork.
• Slowed or hesitant speech or body movements, or restlessness (anxiety).
• Loss of interest in once pleasurable activities.
• Low energy, chronic fatigue, sluggishness.
• Change in appetite, noticeable weight loss or weight gain, or abnormal eating patterns.
• Chronic worry, excessive fear.
• Preoccupation with death themes in literature, music, drawings, speaking of death repeatedly, fascination with guns/knives.
• Suicidal thoughts, plans, or attempts.

In the Elderly

Many people feel that it is normal for elderly persons to be depressed. This is a dangerous misconception. If you suspect an older adult is suffering from a depressive illness, a thorough medical examination should be given as soon as possible.

• Unusual complaints of aches and pains (back, stomach, arms, legs, head, chest), fatigue, slowed movements and speech, loss of appetite, inability to sleep, weight increase or decrease, blurred vision, dizziness, heart racing, anxiety.
• Inability to concentrate, remember or think straight (sometimes mistaken for dementia). An overall sadness or apathy, withdrawal; inability to find pleasure in anything.
• Irritability, mood swings or constant complaining; nothing seems to make the person happy.
• Talk of worthlessness, not being needed anymore, excessive and unwarranted guilt.
• Frequent doctor visits without relief in symptoms; all tests come out negative.
• Alcoholism, which can mask an underlying depression.
• Decreased need for sleep.
• Restless, agitated, can't sit still. Increased energy, or an inability to slow down.
• Racing, disorganized thoughts, easily distracted.
• Rapid, increased talking or laughing
• Grandiose ideas, increased creativity.
• Overly excited, euphoric, giddy, exhilarated.
• Excessive irritability, on edge.
• Increased sex drive, possibly resulting in affairs, inappropriate sexual behaviors.
• Poor judgment, impulsiveness, spending sprees
• Embarrassing social behavior.
• Paranoia, delusions, hallucinations.

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Warning Signs of Suicide

• Ideation (thinking about suicide)
• Substance use or abuse (increased or change in substance)
• Purposelessness (no sense of purpose or belonging)
• Anger
• Trapped (feeling like there is no way out)
• Hopelessness (there is nothing to live for, no hope or optimism)
• Withdrawal (from family, friends, work, school, activities, hobbies)
• Anxiety (restlessness, irritability)
• Recklessness (high risk-taking behavior)
• Mood disturbance (dramatic change in mood)
• Talking about suicide.
• Statements about hopelessness, helplessness, or worthlessness.
• Preoccupation with death.
• Suddenly happier, calmer.
• Loss of interest in things one cares about.
• Visiting or calling people one cares about.
• Making arrangements; setting one's affairs in order.
• Giving things away, such as prized possessions.

A suicidal person urgently needs to see a doctor or mental health professional.