symptoms of depression

The 2021 National Survey on Drug Use and Health found that about 21 million adults (8.3% of U.S. adults) in the U.S. have experienced at least one major depressive episode (Substance Abuse and Mental Health Services Administration).

It can be easy to dismiss some of the symptoms of depression as just feeling off, but it is a serious mental health condition that requires dedicated care. Depression affects millions of people worldwide, and unfortunately, not all cases are easy to spot, especially for family members and close friends. In this blog post, we will be discussing the most common signs and symptoms of depression to help you identify it and seek help for yourself or your loved one.
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Core symptoms of major depressive disorder include:

  • Feeling sad or having a depressed mood
  • Loss of interest or pleasure in activities once enjoyed
  • Feeling worthless or guilty
  • Difficulty thinking, concentrating or making decisions
  • Changes in appetite — weight loss or gain unrelated to dieting
  • Trouble sleeping or sleeping too much
  • Loss of energy or increased fatigue
  • Increase in purposeless physical activity (e.g., inability to sit still, pacing, handwringing) or slowed movements or speech (these actions must be severe enough to be observable by others)
  • Thoughts of death or suicide

Risk factors associated with developing depression:

Depression can affect anybody and usually has multiple risk factors. Below are some biopsychosocial risk and prognostic factors for depression:

  • Biological: Imbalance of dopamine, serotonin, and other neurotransmitters; chronic pain and conditions such as diabetes or hypothyroidism
  • Genetics: if a biological a parent or sibling has depression, you’re 3x more likely to develop it
  • Psychological: (e.g. low self-esteem, low distress tolerance, people who are generally more pessimistic)
  • Social: difficulties such as death of a loved one, trauma, divorce, isolation, lack of support, trauma
  • Environmental: chronic exposure to violence, neglect, abuse, or poverty
  • Prescription medications or non-prescribed substances (such as alcohol)
    (Cleveland Clinic, Depression); (American Psychiatric Association, What is depression?)

The different types of depression:

  • Anxious distress: depression with feeling keyed up, restlessness, difficulty concentrating, worrying, and fear of losing control of self
  • Mixed features: depression with mania, including elevated self-esteem, excessive talking, expansive mood, racing thoughts, and increased goal-directed activity
  • Melancholic features: loss of pleasure in most activities, lack of reactivity to usually pleasurable stimuli (doesn’t feel better, even temporarily, when something good happens), despair, depression worse in the morning, waking up early, agitation or sluggishness, low appetite/ weight loss, excessive/inappropriate guilt
  • Atypical features: depression where one can be cheered up by happy events, have an increased appetite, hypersomnia, sensitivity to rejection, heavy feeling in arms/legs
  • Psychotic features: depression with delusions/hallucinations
  • Catatonia: depression that includes uncontrollable/purposeless movement OR fixed/inflexible posture
  • Peripartum onset: occurs during (prenatal depression) or after pregnancy (postpartum depression)
  • Seasonal pattern: symptoms come and go with the seasons, usually beginning late fall / early winter and ending in the spring/summer

(National Institute of Mental Health); (Mayo Foundation for Medical Education and Research); and (American Psychiatric Association, 2022)

There are other disorders that include depression as a symptom, such as:

  • Persistent depressive disorder: less severe symptoms of depression that last for about 2 years; chronic
  • Bipolar I and II: mood swings that range from mania to depression.
  • Cyclothymic disorder: milder mania and depression than those seen in bipolar
  • Disruptive mood dysregulation disorder: in children, including severe irritability and anger as well as temper outburst. This disorder eventually becomes a depressive disorder or anxiety disorder in teen years or adulthood
  • Premenstrual dysphoric disorder: depression associated with hormone changes that begin about 1 week before and improve within a few days after the onset of menstruation. Depression is minimal or gone after menstruation.

(Mayo Foundation for Medical Education and Research, 2022)
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How to effectively treat depression

Depression should never be self-diagnosed. A diagnosis can only be made by a licensed mental health or psychiatric clinician. Individuals should seek professional help if they are struggling with signs or symptoms of depression. Professional support can help rule out underlying medical conditions (e.g. hypothyroidism, vitamin deficiency) that may mimic depression symptoms.

  • Behavioral therapy identifies short and long term goals, and to address barriers to engagement (e.g sense of incompetence, isolation, feeling like a burden)
  • Cognitive behavioral therapy raises awareness about the intertwined relationship between thoughts, behaviors, and feelings
  • Interpersonal psychotherapy fosters effective communication of needs and emotions.
  • Mindfulness-Based Cognitive Therapy: identifies rigidly held negative beliefs about self and others; teaches people how to notice and refocus attention to the present moment.
  • Psychodynamic therapy focuses on early developmental experiences to understand conflicts and improve self-awareness
  • Supportive therapy centers the relationship between therapist and client; empathy, affirmations, and unconditional support.

For more intensive symptoms of depression, the following treatments can be offered:

  • Brain Stimulation Therapies (National Alliance on Mental Illness)
  • Transcranial Magnetic Stimulation (TMS)
  • Vagus Nerve Stimulation
  • Deep Brain Stimulation

(American Psychological Association)

Medications that can treat depression

  • Selective Serotonin Reuptake Inhibitors (SSRI)
  • Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)
  • Tricyclics
  • Atypical Antidepressants
  • Monamine Oxidase Inhibitors (MAOIs)

(U.S. Food and Drug Administration)

If you or a loved one are showing signs of depression, you would likely benefit from these therapies. PCI offers intensive, and non-intensive therapy for depression in our mental health treatment program. We also understand that depression is often tied to the use of substances, which is why we also have a dual-diagnosis treatment program. Visit our contact page to send us a message or give us a call. A care coordinator will walk you through our programs and determine if treatment is right for you.



1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).

2. American Psychiatric Association. (n.d.). What is depression?. American Psychiatric Association.

3. American Psychological Association. (n.d.). Depression treatments for adults. American Psychological Association.

4. Cleveland Clinic. (n.d.). Depression. Cleveland Clinic.

5. Cleveland Clinic. (n.d.). SSRIs (Selective Serotonin Reuptake Inhibitors). Cleveland Clinic.

6. Substance Abuse and Mental Health Services Administration. (n.d.) 2021 National Survey of Drug Use and Health (NSDUH) releases.

7. Mayo Foundation for Medical Education and Research. (2022, October 14). Depression (major depressive disorder). Mayo Clinic.,for%20food%20and%20weight%20gain

8. National Alliance on Mental Illness.(n.d) ECT, TMS and other brain stimulation therapies.

9. National Institute of Mental Health. (n.d.). Depression. National Institute Health.

10. National Institute of Health. (n.d.-b). Major depression. National Institute of Mental Health.

11. RU.S. Food and Drug Administration (n.d.). Depression Medicines. FDA Office of Women’s Health.

12. World Health Organization. (n.d.). Depressive disorder (depression). World Health Organization.