Symptoms

You don't have to have all the symptoms to qualify you for a depressive disorder. If you suspect you might have one, see your doctor immediately for diagnosis and treatment. Do not treat yourself with herbal remedies.

Symptoms

• Prolonged sadness or unexplained crying spells.
• Significant changes in appetite.
• Sleeping too much or not being able to sleep.
• Irritability, anger, worry, agitation, anxiety.
• Pessimism, indifference.
• Loss of energy, persistent lethargy.
• Feelings of guilt, worthlessness.
• Inability to concentrate, indecisiveness.
• Inability to take pleasure in former interests.
• Withdrawal from friends and family.
• Unexplained aches and pains.
• Recurring thoughts of death or suicide.

For major depression, symptoms need to be present for at least two weeks and include at least five of the depressive symptoms. Dysthymia, the more chronic form, has to have two or more of the symptoms of depression for at least two years (or in the case of children and teenagers, for one year), and the person should be depressed more days than not.

Depression in women

Women are twice as likely to become depressed as men. Hormones may play a role. Such factors may include menstrual cycle changes, pregnancy, miscarriage, after giving birth, pre-menopause and menopause. Many depressed women may carry the weight of work and home, dealing with single parenthood and caring for children and aging parents.

Depression in men

Men are less likely to admit to depression, and doctors are less likely to look for it. However, the rate of suicide deaths in men is four times higher than in women.

Men's depression is often disguised by alcohol or drugs, or by working long hours. Depressed men appear irritable, angry and discouraged rather than sad and hopeless, complicating the diagnosis of depression. Men are less likely to get help even if they realize they are depressed.

The elderly

Depression may be dismissed as a normal part of aging. However, it is not and should not be treated as such. Many older people enjoy their lives and have a sense of satisfaction in their relationships. Symptoms may go unnoticed by the doctor, especially if the person just complains of the physical problems such as the lack of sleep and low energy. Depressed older people are less forthcoming about feelings of despair and sadness, mostly because they have been conditioned to believe that depression is a character flaw and not a real illness that can be treated.

Sometimes depression in older people is misdiagnosed as dementia, which is not the same as depression. Someone with dementia (and not depression) may ask the same questions over and over, get lost in familiar places and be unable to follow directions. They may also get confused about time, people and places. They may also neglect their physical health.

Depression in children

Only in the past two decades has depression in children and teenagers been taken seriously. Symptoms of depression in children may be different than in adults: The child pretends to be sick, refuses to go to school, clings to a parent or worries the parent may die. Older children sulk, get into trouble at school and their grades decline. They may become moody and feel misunderstood. You may have a tough time deciding if this is just a phase or something to be worried about. If you're in doubt, talk to your child's teachers and see the pediatrician or family doctor.

What is bipolar disorder?

Bipolar disorder, formerly called manic-depressive disorder, is a condition where periods of depression alternate with periods of unusually high energy with feelings of elation or irritability. Sometimes doctors may mistake bipolar with depression. When you are in a manic phase, it does not mean your depression has improved. Rather, it could mean you have bipolar, which must be treated.

You may be bipolar if you have depression along with these signs:

• Excessive feelings of euphoria (being overly happy).
• Rapid or pressured speech.
• High energy, activity and restlessness.
• Decreased need for sleep.
• Feelings of moodiness and irritability.
• Increased sexual drive.
• A sustained period of unusual behavior.

People with bipolar disorder can have mild to severe manic or depressive phases. For example, some people do not have extreme "high" periods but may have periods of more energy. Some people go in and out of manic or depressive periods very rapidly.

More on Depression

In the Encyclopedia:

This article was reviewed and updated June 2007.