How do you know when you’re depressed?

People experience depression in different ways

John, a software engineer in his 30s, recalls that his troubles started about the same time he quit playing basketball.

“I stopped returning phone calls. When friends asked me to shoot hoops after work, I’d always make up some excuse,” he says. “I just couldn’t imagine that anything would be fun.” Feeling more and more  isolated and out of shape, he began to believe “things would never get better.”

“Everyone feels down sometimes,” explains Evette Ludman, PhD, a psychologist who does mental health research at Group Health Research Institute. “But depression that lasts on and on is a medical condition that affects not only how you feel emotionally but also how you feel physically and how you act.  It can affect every part of your life: your work, your relationships with family or friends.

What's the difference between feeling down and being depressed?

The physical part of depression

For Jane, a 25-year-old pizza-delivery driver, depression was linked to physical pain. “I’d had some back problems before, but the pain always got better after a few days,” she explains. But when the pain lasted for more than a week, I really started to get down. I couldn’t do anything but lie around and wonder if it would ever get better.” And because Jane’s job doesn’t offer sick leave, missing work added to her stress—and seemed to make her back pain worse.

Like the “chicken or egg” story, it’s difficult to say which comes first—depression or related physical symptoms, such as:

  • fatigue,
  • headache,
  • back pain,
  • trouble sleeping, and
  • digestive problems.

But evidence has shown that depression can directly affect your body, taking away your energy and slowing you down, explains Dr. Ludman. Depression also affects how you think and feel about things so that any pain can feel more painful. Meanwhile, medical problems like arthritis or diabetes can leave you feeling discouraged and hopeless. It’s a cycle where each part feeds the other—the physical affects the mental, and the mental affects the physical.

Depression and emotions

Feeling down, sad, or even hopeless is one of the most common signs of depression. These depressed feelings often go along with loss of confidence or feeling worthless. That’s how it was for Jerry, in his 50s. “I started feeling more and more down,” he remembers. After a few weeks, he was finding it increasingly difficult to concentrate on his job as a customer service rep.  “Everything seemed like too much. I couldn’t take it when customers would get angry with me.”

For some people, feeling anxious or irritable and angry are big parts of depression. And sometimes these negative or painful feelings seem to come on for no reason.

“I was one way or the other,” says Jerry. “Either I would feel like everything was my fault, or I’d be going off on other people about everything. I started trying to cover up how little work I was getting done. My job hadn’t really changed, but it felt unbearable. I was almost ready to quit—if they didn’t fire me first.”

Depression affects your thinking

Negative thoughts are a big part of depression for some people. This may include thoughts about yourself (taking blame for everything) or thoughts about your future (feeling sure that things can’t get better). Also, negative thoughts are often extreme or exaggerated—expressed like:

  • “What’s the use?”
  • “This always happens to me,” or
  • “I can never do anything right.” 

Every success may look small and temporary

Every mistake or disappointment may look huge and permanent. And you can’t get your mind off it. It’s as if all of your mental energy goes to judging yourself—and the judgment is always that you’re not good enough.

“I always tend to be down on myself, but it got really bad when my boss told me about a written complaint a customer made about me,” says Susie, a 39-year-old grocery clerk.  “He wasn’t too critical of me. But he didn’t need to be—I really did it for him! I couldn’t stop second-guessing myself. I was thinking over and over about what I’d done wrong and remembering every mistake I’d ever made. I was so busy watching myself for mistakes that I could hardly do my job.”

Depression affects the way you act

If you’re like John—the software engineer at the beginning of the story who gave up basketball—depression makes you feel like nothing is very exciting or enjoyable. You may start to pull back from people or activities that used to be important to you. Unfortunately, the times you feel depressed are when you need positive people and activities the most. 

It’s natural to pull back when you feel down, but pulling back can make you feel even more depressed. It’s another one of those “chicken or egg” situations. You feel down, so you do less. And when you start doing less, that drags you down even more.

Know the signs

It’s easy to slip into a downward spiral where depression keeps moving you further away from feeling better. But if you can see the early signs, you can act to break the cycle and help yourself to recover more quickly.

How do you know if you’re depressed?  Dr. Ludman recommends answering these questions:

  • Do you wonder why you feel sad or discouraged—even when there’s no good reason?
  • Does it seem like nothing is very interesting or enjoyable?
  • When something negative happens, does your mind replay it over and over like a broken record?
  • Does every criticism feel huge; every compliment feel tiny?
  • Do you find yourself avoiding people or places that you used to enjoy?
  • Do you find that you have no energy and everything feels like an effort?
  • Has it seemed impossible to get a good night’s sleep?

 

by Joan DeClaire



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From Kaiser Permanente