Signs and Symptoms of Depression

Depression vs ordinary sadness

Everyone feels sad, low or flat at times. Sadness is usually tied to an event, comes in waves, and still leaves room for moments of pleasure, humor and hope. Depression is more persistent and pervasive.

Signs and symptoms of depression

Emotional symptoms

• persistent sad, empty or numb mood
• loss of interest or pleasure in hobbies, friends, food or sex
• hopelessness about the future
• feelings of worthlessness or excessive guilt
• irritability, frustration or a short temper, especially in men and teenagers
• tearfulness, or being unable to cry
• thoughts of death or suicide

Physical symptoms

Depression is not only a mood problem. Physical symptoms are often what people notice first:

• tiredness and low energy, even after rest
• sleeping too little, waking very early, or sleeping much more than usual
• appetite and weight changes in either direction
• moving or speaking more slowly, or feeling restless and unable to sit still
• unexplained aches, headaches or stomach problems
• low sex drive

Thinking symptoms

• trouble concentrating, remembering or making decisions
• slowed thinking
• negative thoughts about yourself, the world and the future that are hard to shake

Signs other people may notice

Withdrawing from friends, cancelling plans, neglecting appearance or home, drinking more, falling behind at work or school, and speaking negatively about themselves.

Symptoms in different groups

• Women: depression is about twice as common. It may be linked to the premenstrual phase (PMDD), pregnancy, the year after giving birth (postpartum depression) and perimenopause.
• Men: more likely to show irritability, anger, risk-taking, overwork or heavy drinking than sadness, and less likely to seek help.
• Teenagers: irritability, falling grades, withdrawal from family, self-harm and changes in sleep.
• Older adults: physical complaints, memory problems, loss of interest and withdrawal, sometimes mistaken for dementia.

What can cause depressive symptoms

Depression usually results from a mix of factors:

• Life events: bereavement, relationship breakdown, job loss, money problems, isolation, abuse or trauma.
• Family history and personality traits such as perfectionism or high anxiety.
• Physical illness: chronic pain, heart disease, stroke, diabetes, cancer and hypothyroidism can cause or mimic depression.
• Hormonal changes: childbirth, menopause, low testosterone.
• Substance use: alcohol, cannabis and withdrawal from stimulants.
• Medicines: some steroids, beta-blockers, isotretinoin and hormonal treatments in some people.
• Season: seasonal affective disorder causes low mood each winter.

Low mood can also be part of bipolar disorder, grief or an anxiety disorder.

A quick self-check

Over the past 2 weeks, how often have you been bothered by:

1. little interest or pleasure in doing things?
2. feeling down, depressed or hopeless?

These two questions are the PHQ-2. If either has been present on more than half the days, talk to a doctor, who may use the longer PHQ-9 questionnaire. A questionnaire is a screen, not a diagnosis.

What helps

Things you can do now

• Tell someone you trust how you are feeling.
• Keep a basic routine: get up at the same time, eat regular meals, and get outside in daylight.
• Move your body: regular moderate exercise, even a daily walk, has a real antidepressant effect.
• Do one small thing you used to enjoy, even if you do not feel like it. Activity often comes before motivation returns.
• Cut back on alcohol and drugs, which deepen low mood.
• Protect sleep: a regular bedtime, limited caffeine and screens before bed.

Professional treatment

A primary care doctor can assess you, check for physical causes with blood tests if needed, and discuss treatment. Effective options include talking therapies such as cognitive behavioral therapy, and antidepressant medicines. For moderate to severe depression, the combination works best. Our depression condition page covers diagnosis and treatment in detail.

Frequently asked questions

What are the first signs of depression?

Early signs often include losing interest in things you usually enjoy, feeling flat or irritable, sleeping badly, feeling tired all the time, withdrawing from people, and finding it hard to concentrate. When these last most days for two weeks or more, it is worth talking to a doctor.

What are the physical symptoms of depression?

Depression commonly causes fatigue, sleep problems, appetite and weight changes, slowed movement or restlessness, headaches, back pain, stomach upsets and low sex drive. Physical symptoms are sometimes the main complaint, especially in older adults and in men.

How do I know if I am depressed or just sad?

Sadness usually follows an event, comes and goes, and still allows enjoyment. Depression lasts most of the day nearly every day for at least two weeks, takes away pleasure, affects sleep, energy and concentration, and makes it hard to function. A doctor can help you tell the difference.

Can depression go away on its own?

Mild depression sometimes lifts on its own, especially when the trigger resolves. But untreated depression often lasts months and tends to come back. Treatment shortens episodes and lowers relapse risk, so it is worth getting help rather than waiting it out.

What should I do if I have thoughts of suicide?

Reach out right away. In the US, call or text 988 to reach the Suicide and Crisis Lifeline, available 24 hours. If you are in immediate danger, call 911 or your local emergency number. Telling someone you trust and removing means of harm also helps keep you safe.