Symptoms of depression

introduction

The collective term depression encompasses a range of symptoms with different degrees of expression. The form and course of the disease are comparable in most people, but they are different. It is also important to distinguish between a moody state, which is a normal reaction to certain events and can be managed by the person, and a full blown depression. A temporarily depressed mood occurs in most people, but must be differentiated from a pathological extent.

Signs of depression

Below are some of the typical signs of depression:

• prolonged persistence in a depressed mood
• several areas of life that are influenced by the negative mood
• Consolation and sympathy from others does not lead to an improvement and sometimes even to a deterioration
• pronounced longing for closeness and security
• general listlessness as well as listlessness and easy fatigue
• Presence of inner restlessness accompanied by nervousness and aimless drive
• increased urge for self-pity
• Presence of a constantly negative point of view with an often exaggerated and overrated assessment of one's own environment
• increased feeling of hopelessness and a pronounced disinterest, which can degenerate into complete indifference
• Often there is a lack of personal hygiene due to a lack of motivation and complete listlessness
• the person concerned is often over-sensitive, irritable and increasingly grumpy or in a bad mood for no reason, or even with an aggressive or hostile attitude
• Occurrence of feelings of inferiority and strong self-underestimation
• Memory and concentration problems
• Difficulty making decisions
• increased occurrence of feelings of guilt and shame for no apparent reason up to and including self-accusation
• Occurrence of relationship disorders due to a lack of understanding of the other individual
• Occurrence of feelings of inner emptiness combined with complete numbness
• Developing anxiety or panic attacks about one's own future
• Suffering from general distrust and paranoia
• possible development of obsessive-compulsive disorder

Read more on the subject at: Signs of depression

Diagnostic criteria for depression

Depending on the severity of a depression, there must be a different number and severity of main and secondary symptoms. Symptoms must have persisted for at least two weeks for a diagnosis of depression to be made.

Main symptoms

• depressed, depressed mood

• Loss of interests and the ability to be happy

• Drive reduction

Side symptoms

• Decreased appetite

• sleep disorders

• Impairment of self-esteem

• Feelings of guilt or worthlessness

• Brooding tendency

• Suicidal ideation

• Difficulty concentrating

• Somatic Syndrome:

  • Wake up early

  • Morning low

  • Physical over- or under-activity (inhibition or agitation)

  • Weight loss

  • Loss of libido

These symptoms can also be found in bipolar disorder. To be confused about whether or not it is a bipolar disorder, read also: What are the symptoms of bipolar disorder?

Mental symptoms

exhaustion

Exhaustion is a symptom that occurs in a large number of patients with depression. Various symptoms can cause this feeling of exhaustion. On the one hand, depression often leads to a strong reduction in drive. This means that getting involved in any activity takes a lot of effort. Even the simplest of things, like getting to the kitchen or bathroom, can be extremely arduous. Getting up in the morning can be very difficult. In addition, there is the severe tiredness that often occurs in depression. This comes about on the one hand from the frequently occurring sleep disorders with problems falling asleep and staying asleep as well as very early awakening, but also from an inner emptiness that causes permanent tiredness and exhaustion. The constant feeling of being a burden to others with their bad mood and lack of joy or interest adds to a feeling of utter exhaustion. The occurrence of suicidal thoughts and constant brooding can also make you feel very exhausted.

fatigue

Tiredness, like permanent exhaustion, is a common symptom of depression. The tiredness can come as a feeling from within, because a depressive episode can be very stressful in itself, but it can also be caused by frequently occurring sleep disorders. Those affected often complain that they have difficulty falling asleep or that they keep waking up at night. Waking up very early in the morning without being able to fall asleep again contributes to the symptom of fatigue in depression.

Listlessness

Feeling listless is one of the three main symptoms of depression. It means that those affected often feel an oppressive heaviness that makes it extremely difficult to do even the simplest of activities. Getting up in the morning can already be a torture, as can simple daily activities such as brushing your teeth or preparing breakfast. Most current antidepressants aim to increase drive, so they should significantly reduce the decrease in drive and thus ensure that those affected are relieved of the oppressive severity and they can more easily go back to everyday activities.

Brooding

Brooding is a fairly common symptom of a depressive episode. Brooding means that the person concerned thinks about the same things over and over again, the thoughts in the head go round in circles and are negative in nature. There is usually a kind of compulsion to brood. This means that those affected cannot not brood, it cannot be switched off and is therefore particularly agonizing. Brooding means a kind of unwanted thought circles around the same topics. Those affected do not come to a solution by pondering.

Read more on the subject at: Compulsion to brood

Inner unrest

Depression can show up in a number of ways. In many patients there is a crippling inhibition of drive with inner emptiness and deep sadness. But despite the outward lack of exercise, many patients also experience inner restlessness, even if it sounds like a contradiction at first. Those affected have the feeling that they cannot come to rest. Often this is also a reason for the pronounced sleep disorders that occur frequently.

Also read the article: The nocturnal unrest.

fear

Anxiety can also be a symptom of depression. Fear can arise, for example, from the fact that those affected have the feeling every day that the day cannot be made because even the simplest everyday activities such as shopping or brushing teeth cost an enormous amount of effort due to the reduced drive. Also due to the sad and not lightened mood, those affected often fearfully ask themselves in the morning how they should get through the day. There are also types of depression that involve psychotic thoughts. So those affected develop delusional ideas. One of the most common delusions is a pronounced and unfounded fear of impoverishment.

Joylessness

Joylessness is one of the main symptoms of depression. Things that otherwise gave the person concerned joy, that might have made them laugh or that they simply enjoyed doing, no longer have this effect. Everything becomes exhausting and a tormenting duty. Joy can hardly be felt at all by those affected in a moderate or severe depressive phase. An example of this are the children or grandchildren with whom we enjoyed spending time so much. Suddenly, the depressive patient strains terribly to spend time together, they can no longer enjoy the children and wish to be alone. In addition, they often feel guilty because they feel such joylessness and because they notice that they are putting a lot of strain on their relatives.

sadness

Sadness or depressed mood is also one of the three main symptoms of depression. People who are suffering from depression are in a sad mood, have negative prospects for the future and cannot be happy about anything. The sadness is described by many affected as almost paralyzing, there seems to be no way out.

pessimism

A negative or pessimistic view of the future is relatively typical for patients with depression. The agonizing thing about the disease is precisely the fact that those affected cannot imagine that they will feel better again in a few weeks or months. They also have a negative and pessimistic self-image.

aggression

Aggressive behavior such as strong irritability with rapid outbursts of anger can also occur in the context of depression. In the last few years it has been shown that especially men who suffer from depression react more with such aggressive behavior and outbursts of anger. The typical symptoms of depression are also present in them, but they are more in the background than the aggressive component with which they try to counter the feelings of inner emptiness and deep sadness.

burnout

Burnout and depression are two different illnesses. Burnout is not yet a separate diagnosis in the classification of illnesses. Burnout and depression can occur at the same time, so burnout can also be accompanied by depressive symptoms. Basically, however, it currently applies that burnout usually results from excessive demands in everyday working life and above all affects this area while depression affects all life situations. Nonetheless, the two diseases depression and burnout have a lot in common that do not always make a distinction easy.

Read more on the subject at: Burnout syndrome

Hypersensitivity

Hypersensitivity in the sense of increased perception of touch stimuli is not a typical symptom of depression. The so-called high sensitivity is also referred to as hypersensitivity. Certain people react to a wide range of stimuli (not just touch stimuli) much more sensitively than others. So far, however, there is no scientific evidence that highly sensitive people are more likely to develop depression or vice versa. In the last few years, however, the question of whether there might not be an essential connection has arisen more and more, especially from the side of alternative medicine. This idea stems from the fact that highly sensitive people, according to current alternative medicine opinion, are also significantly more susceptible to mood swings. This in turn could increase the risk of developing depression.

listlessness

Listlessness is a symptom that can occur in the context of depression. In the guidelines, however, there is no talk of listlessness but of loss of interest, loss of joyfulness and lack of drive. Depressed people can no longer enjoy things that they would otherwise have been happy about. Old interests suddenly no longer exist and every day-to-day activity becomes difficult. These complaints are considered to be the main symptoms of depression.

Difficulty concentrating

Concentration disorders are also common in the context of depression. Affected people have great difficulty concentrating on something. In severe depression, they can no longer concentrate on even the simplest things. Reading, for example, is extremely difficult for many depressed people, even if they enjoyed reading before the onset of the illness. Often they only manage a few lines and here, too, it can happen that they were so unfocused that they cannot remember what they have read immediately afterwards. After the start of drug treatment, the success of the therapy can also be recognized by the fact that the ability to concentrate slowly increases again. However, it often takes months before the ability to concentrate is as good as it was before the onset of the disease.

Suicidal ideation

Thoughts of suicide are a central issue in depression. Many depressed patients sooner or later think about suicide as a way out of their depression. By no means all who have these thoughts put them into practice, nevertheless the thoughts are very tormenting. It is often difficult to confide in other people, as suicide is still a kind of taboo subject today. Depression is by far the most common cause of suicide attempts in Germany. The sick see no other way out, have the feeling that they can no longer or do not want to live like this or are very afraid of causing their relatives to suffer too much with their illness. Thoughts of suicide as a symptom of depression can also be treated well in most cases with antidepressants. Drug and psychotherapeutic therapy is therefore the most important step in getting suicidal thoughts under control in depression before it is too late.

Also read our article: What can be signs of suicide?

Physical symptoms of depression

The physical symptoms of depression are as extensive as the psychological signs listed above. Of the sleep is most often affected: it comes to Difficulty falling asleep and staying asleep, Early waking and stressful dreams. As a result, one is often very sleepy and very exhausted during the day. The appetite is also affected, either unusually decreased or increased, which can lead to weight gain or loss. In addition, an indefinite nausea or Indigestion occur. You can also a headache without a specific place of origin and with varying strength.

There may be a weakening of sensory impressions like odor, taste, See and Listen come; sometimes also to a generalized hypersensitivity. Chest pain, especially in the Heart region, respiratory or Circulatory disorders can also occur. They are also not uncommon Tension in the musclesthat particular too Move- and Joint pain lead whose exact place of origin is often not localizable. Also can Bladder disorders, Burning tongue and Dry mouth as well as skin hypersensitivity and physical indolence. In addition, there are hot flashes, cold showers and a disturbance of sweat and sweat Tear secretion. Also worth mentioning are the decline in sexual desire and performance; both are more common in connection with depression.

sleep disorders

Sleep disorders are a symptom that often occurs in the context of depression. Those affected complain of different types of sleep disorders. Problems falling asleep and / or difficulty staying asleep play a role. Also very typical for depression is waking up very early in the morning without being able to go back to sleep.

In the treatment of depression, in addition to psychotherapeutic and drug therapy, sleep deprivation also plays a role as a form of therapy. A distinction is made here between partial and total sleep deprivation, with partial sleep deprivation the patient usually goes to bed in the evening and is then woken up at night. He should then stay awake until the next evening. Total sleep deprivation means being fully awake for one night. The effect of sleep deprivation therapy is in many cases a mood improvement. However, this usually disappears after the next night with normal sleep, so that the sleep deprivation therapy has to be repeated regularly. Sleep deprivation therapy is usually carried out under inpatient conditions. Combined with other forms of therapy such as light therapy as well as psychotherapy and drug therapy with antidepressants, sleep deprivation therapy can have a supportive effect.

Pain

Depression can be associated with numerous physical (somatic) symptoms. Pain in various parts of the body can also appear as such somatic symptoms. Especially when unspecific pain in various parts of the body is described by the patient as one of the leading symptoms at the beginning, the diagnosis can be difficult.

Weight loss

Weight loss is a typical physical symptom of depression. Weight loss is one of the somatic syndrome that can occur in the context of depression. Depressed people often have no appetite at all. They lack interest in and enjoyment in everything, including food. The decrease in appetite usually means that affected people eat significantly less and can thus lose considerable weight. This can be a serious problem, especially for people who were slim before the onset of the disease. In the worst case, it must be decided whether intravenous calorie intake (high calorie infusion solutions via the vein) is necessary. Especially with seasonal depression, i.e. depression that mainly occurs in the darker seasons, the opposite can happen. Those affected often have cravings and gain weight significantly. A weight gain or an increase in appetite does not automatically speak against the presence of depression.

dizziness

Dizziness is a very unspecific symptom that can have numerous triggering causes. In addition to physical causes, mental problems can also lead to dizziness. One then speaks of a somatoform vertigo. The most common cause of this type of dizziness is anxiety disorders. But depression can also be the reason for somatoform dizziness. Somatoform vertigo is one of the most common types of vertigo. How the vertigo feels varies from person to person. Some described vertigo, others vertigo. The duration also varies greatly. Dizziness that occurs with depression usually benefits from combined drug and psychotherapeutic treatment, like most other symptoms of depression.

Flu-like symptoms

Depression often leads to severe listlessness, tiredness and a feeling of weakness. Pain can also occur. As such, the symptoms of depression can in some cases suggest the flu for the first few days, especially if there is a pain in the limbs. Symptoms such as (sub) febrile temperatures, sore throats or coughs and runny nose are not typical symptoms of depression.

Feeling of pressure in the chest

A feeling of pressure in the chest is not a typical symptom of depression. It can have a variety of causes, including serious heart or gastrointestinal disorders.Pressure on the chest can, however, also occur as a physical symptom in psychological stressful situations. For example, panic attacks are more common. In this respect, a feeling of pressure on the chest is a possible symptom even with depression, for example as a symbolic symptom that those affected can only breathe with difficulty or are very afraid.

Visual disturbances

Depression can trigger many symptoms. However, visual disturbances are not a typical symptom of depression. This does not mean that vision disorders cannot occur in exceptional cases in the context of depression. Such a newly occurring visual disturbance should definitely be clarified by an ophthalmologist before it is viewed as an accompanying symptom of depression and not specifically treated.

Typical symptoms in men

The basic symptoms of depression are relatively similar in women and men. In the classification for diagnosing depression (ICD-10), certain symptoms must be present so that a diagnosis of depression can be made. No distinction is made here between men and women. The main symptoms are usually present in both sexes, they can just show up differently.
The main symptoms of depression include low mood, loss of interest, and joylessness, and decreased drive. Depending on the severity of the depression, there are either two or all three symptoms.
In addition to these main symptoms, there are numerous possible secondary symptoms, at least two of which must be present in order to be able to diagnose depression. These include insomnia, difficulty concentrating, decreased self-esteem, feelings of guilt, thoughts of suicide, decreased appetite and restless behavior. From this classification, which applies to both sexes, it becomes clear that the symptoms themselves cannot be that different in men and women.
The big difference, however, can be in how men and women deal with these symptoms and what they are externally showing. It is described that many men who are suffering from depression often stand out for their aggressive, reckless behavior and significantly increased irritability. They often show an attitude of reproach, so in many cases male depressives initially blame their environment for their condition. It can lead to increased risk-taking and anti-social behavior. Men also have an increased tendency to consume alcohol during depression. Physical symptoms such as dizziness, pain or sleep disorders can also occur. Unfortunately, men and women alike often have suicidal thoughts during a depressive episode. Since men often choose more aggressive or harder variants of implementation, about three times as many depressed men as women die from suicide.

Erectile dysfunction

Erectile dysfunction can have numerous physical or psychological causes. Psychological causes in particular play a major role in younger men. Men who suffer from depression can be mentally tense due to symptoms such as sadness, loss of interest, joylessness or anger towards the environment. This or a complete feeling of emptiness and the feeling that currently nothing is really enjoyable or meaningful are of course reasons why the psyche closes itself off to sexuality, erectile dysfunction occurs. Here, too, these problems often recede significantly after a few weeks after starting effective drug and psychotherapeutic therapy.

Typical symptoms in women

As already described above, the basic symptoms of depression differ only slightly between men and women. What is very different, however, is how the disease is dealt with and what men and women say to the outside world. While men tend to be more aggressive and risk-taking during depression, women are more likely to experience other symptoms.
Due to the depressed mood and the loss of happiness, affected women often show reduced emotions, withdraw from other people and are increasingly tired. Feelings like hopelessness and guilt towards others arise. You can no longer react adequately to happy events, an agonizing inner emptiness occurs. The drive is missing, getting up in the morning becomes torture. Everything becomes exhausting and exhausting. The look to the future is shaped by pessimistic thoughts, there is often loss of appetite and weight loss.
Women also often have suicidal thoughts during depression. The rate of suicide attempts is even significantly higher in women than in men. Since women often choose "softer" methods such as taking an overdose of tablets, suicide attempt leads to actual death less often than in men. Women often complain about a morning low during a depressive episode, which means that the symptoms are most pronounced in the morning. Waking very early is also a typical symptom of depression.

Depression as a response to traumatic experiences

Depression can and will occur as a reaction to profound life events reactive depression called. It is important here to differentiate reactive depression from a healthy grief reaction, even if the transitions are fluid. In contrast to depression, at the end of the mourning process there is the Conclusion with the loss and the setting of a new equilibrium. The loss of a loved one, job, physical integrity - all of these can trigger symptoms of depression. It is often about things that are needed for physical and emotional well-being - if these factors are lost, grief naturally follows. On the contrary, it is even unhealthy in emotional stressful situations emotionless to react. A depressive mood due to emotional distress can last different lengths of time and is characterized by the typical symptoms of grief such as depressed mood and listlessness.

By overcoming this upset, the person suffering from it can even be strengthened. The person can gain greater independence and space is created for new (emotional) bonds and relationships. Self-confidence can also be strengthened, so that, among other things, Feelings of guilt and shame can be reduced as part of the processing process. If the transition from the depressive mood to the healthy grief reaction cannot take place, the healing process is delayed and a chronic i.e. develop prolonged depression. The predominant symptoms in most cases include prolonged depressed mood, Loss of appetite, Exhaustion, sleep disorders, Difficulty concentrating, low self-esteem and an inability to enjoy things that have always been pleasurable. The latter in particular can have a negative effect on the relationship with friends, family and relationship partners, as their attempts to cheer up fail because of the joylessness of the suffering person, which is perceived as unpleasure.

Feelings of guilt and the feeling of worthlessness can also affect those affected. Both can be triggered and reinforced by thoughts that appear oversized and false to an outside view. Feelings of guilt towards family members and friends who try to help can add to the strain on the relationship. In addition, the view into the future is negatively influenced. The person concerned sees little perspective for himself or his illness and has the feeling that he cannot escape the depressed mood. The feeling of being trapped in a suction or a black hole and being pulled down by it is often described.

Symptoms of winter depression

The layman term winter depression is referred to in technical jargon as seasonal depression. It occurs mainly in the dark autumn and winter months, the cause is most likely a lack of daylight which can upset the neurotransmitter balance in the body in more susceptible people and thus cause depression. The symptoms are similar to those of non-seasonal depression. There is a feeling of low spirits, a lack of interest in activities that would otherwise have been enjoyable, a lack of cheerfulness, fatigue and exhaustion, a significant reduction in drive and difficulty concentrating. In contrast to non-seasonal depression, winter depression tends to increase appetite with weight gain rather than weight loss, and sleep behavior in seasonal depression tends to shift towards an increased need for sleep rather than sleep disorders. Moodiness and inner tension also occur.

Read more on the subject at: Winter depression

Symptoms of pregnancy depression

The symptoms that can occur in the context of pregnancy depression are similar to those of depression in non-pregnant people. It can lead to a depressed mood, severe listlessness and constant fatigue. In addition, there can be a lack of interest or a lack of enjoyment in things that would otherwise have given you pleasure. Concentration problems, excessive irritability, feelings of helplessness and eating disorders with either little or excessive appetite also occur. Feelings of guilt or inferiority can also occur. In addition, those affected often complain of severe mood swings and frequent crying. Feelings of anxiety can also play a role during pregnancy depression.

Read more on the subject at: Pregnancy depression

Recognizing Depression

Obviously, not everyone can be identified as depressed. Even if the symptoms described are omnipresent for the person concerned and encroach on their life in an all-encompassing way, to outsiders it can appear as if this person is at the center of life, is successful and happy. Sometimes a breakdown only occurs after years or the person has to struggle with the depression for the rest of his life, but looks unaffected on the outside. Depression can also hide behind addictions, e.g. Alcohol and gambling addiction. Frequent partner changes can also be signs of depression or a depressed mood. Such a hidden form of depression is also called latent depression designated.

The severity of the full picture of depression must be clearly distinguished from other possible forms. Often the person affected is no longer able to lead his or her own life. He cannot distance himself from his negative feelings and is absorbed by them. The diagnosis of severe depression can be made according to the current diagnostic schemes if the following criteria are met, at least 5 of which must apply over a period of two weeks:

• Depressed, depressed or irritable mood over a long period of time and continuously
• significantly reduced interest or pleasure in almost all activities
• significant weight gain or weight loss without diet (more than 5% of body weight in one month) or significantly decreased appetite
• Insomnia or increased sleep almost every day
• internal tension or restlessness, which can be expressed in jerky, nervous movements
• Fatigue or loss of energy
• Feeling of worthlessness or excessive or disproportionate guilt
• decreased ability to concentrate and make decisions

Read more on the subject at: How can you recognize depression?

Forms of depression

Manic depression or bipolar disorder, on the other hand, is characterized by an alternation of strongly positive and strongly negative moods, which in some patients can follow one another directly. If the person concerned is full of zest for action and optimism in the manic phase, wasteful and often also unrestrained, in the depressive phase they lapse into discouragement, a depressed mood and emotional indifference.

Further examples are depression that can occur after a successful birth, exhaustion depression after long-term stress (burnout) or the form of depression that occurs more frequently in old age (senile depression).

Read more about this under: Depression or Burnout - What do I have?

Last but not least, the severity of depression also depends on age and gender. Children suffer similarly to adults, but their inner tension can increasingly turn into irritability and insubordination. They are also increasingly afraid - of monsters under the bed, but also embarrassing events or being abandoned and the future. They often don't like to play with others, preferring to spend their time alone in their room at home. In particular, the proportion of men suffering from depression has long been underestimated and depression was treated as a “women's disease”. On the one hand, this is due to the fact that women go to the doctor far more often than men (especially with psychological problems) who often do not want to admit weakness.

On the other hand, the symptoms in men are also expressed differently and therefore more difficult to recognize because they do not fit into the usual pattern of depression. Even if the basic symptoms, such as depression, listlessness, negative circles of thought and self-underestimation as well as sleep disorders are comparable, the bad mood in men is much more often linked to aggression. Male patients are often irritable, uncomfortable and uncomfortable with their skin. Their ability to withstand stress is reduced, they can run out of their skin at the slightest cause and are often not able to stop these attacks, even if they themselves find them unsuitable.

The body also reacts to such attacks with reddening of the face, increased sweat production, rapid heartbeat, shortness of breath, and tremors and dizziness can occur. In general, it is more common for men to experience depression as a physical complaint. The stomach or other parts of the body can hurt without a fall or other causative event preceding it. If no physical cause can be found, depression should also be considered and this possibility clarified.

Read more on the subject at: What types of depression are there?

Tests to diagnose depression

There are numerous tests available for depression. Many of these are carried out by doctors in order to be able to assess whether and to what extent depression is present. But even for people themselves who fear that they are suffering from depression, there are now questionnaires that can be used to roughly check whether depression might be present.
Deutsche Depressionshilfe, for example, provides such a questionnaire on its website. Here nine questions must be answered, each with one of five possible answers, followed by the evaluation of the test. A reliable diagnosis is not possible on the basis of this test, but it serves as a rough guide. If the test indicates the presence of depression, the treating family doctor should first be consulted in order to initiate further diagnostic and therapeutic steps.

Read more on the subject at: Test for depression