What are the signs of depression?

There are many symptoms of depression. Individuals may have some or all of them. The intensity, duration and combination of symptoms are also highly variable from person to person. When thinking about whether you or your loved one is suffering from depression, keep in mind that what separates depression from the ordinary blues is that depression symptoms tend to be pervasive, persistent and impact people’s lives in significant ways. Common signs of depression include:

  • Feeling sad or empty: People who are depressed may feel that there is no pleasure in life. They may feel like nothing could make them happy, not even an all-expense paid trip to the islands.
  • Loss of interest: Individuals with depression lose interest in activities that used to have meaning. This may include hobbies, exercise, work or relationships. One of the most painful aspects of depression is that people can also seemingly lose their ability to enjoy time with family, children and friends. The love is still there of course; it is just buried under the pain of depression.
  • Feeling hopeless: The old saying, ‘This too shall pass’ doesn’t ring true to people with depression. Depression can make people feel like these sad and negative feelings will never go away, and that there is no hope for them to be happy. Individuals with depression can be extremely pessimistic about all aspects of their lives. Feelings of hopelessness can lead to suicidal thoughts or suicide attempts, so take these symptoms very seriously.
  • Worthlessness and guilt: Depression makes people feel bad about themselves and their lives. They may focus on their failures, their losses or the things that have gone wrong, and not be able to see the things that have gone right. They can also feel guilty and angry at themselves for being depressed. They recognize that depression is harming their relationships, their careers and their lives, but they can’t change how they feel.
  • Feeling Irritable: Negative emotions can weigh a person down and make them irritable, much in the way that physical pain can make people cranky or impatient. The psychological pain of depression can cause the same effect.
  • Feeling constantly tired: When someone is depressed, daily routines and tasks that were once a breeze may seem too hard to tackle. Fatigue for no apparent reason, lethargy and not feeling like you have the energy to do much of anything are common signs of depression.
  • Difficulty concentrating or focusing: Making decisions, reading or even watching TV can seem like too much to a depressed mind. People with depression sometimes feel that they can’t think clearly, focus or remember details. Even small or trivial decisions may seem overwhelming.
  • Physical pain: Psychological pain can have an impact on the body. Headaches and body aches are often associated with depression. The stomach is another area of the body often impacted by depression. Many depressed individuals complain of cramps, nausea, upset stomach and other digestive problems.
  • Increase in alcohol or drug use: People with depression may drink or use drugs to alleviate their symptoms or escape negative feelings. Substance use and depression often go hand in hand.
  • Changes in sleep: Depression may cause individuals to sleep too much or too little. Some people may have a hard time getting out of bed, while others have insomnia. They may have difficulty falling asleep or staying asleep, and wake up feeling anxious.
  • Changes in appetite: Overeating or having no appetite may also be a sign of depression. Food can lose its appeal and the person may feel like they have to force themself to eat. On the other hand, food can also be a source of comfort for individuals with depression and they may overeat when they didn’t before. Depression often leads to weight gain or weight loss.

Types of Depression

The National Institute of Mental Health defines several types of depression.

Persistent depressive disorder is a depressed mood that lasts for at least two years.

Postpartum depression is a major depressive episode during pregnancy or after delivery. It is more severe than the “baby blues,” which occurs when mothers feel a little down and anxious during the couple of weeks after a baby’s birth. Postpartum depression is extreme sadness, anxiety, and exhaustion that make it difficult for a mother to care for herself and her infant.

Psychotic depression occurs when a person has severe depression plus psychosis, such as having outlandishly false beliefs (delusions) or auditory and/or visual hallucinations.

Seasonal affective disorder is the onset of depression during the winter months, when there is less natural sunlight. This depression typically lifts during spring and summer.

Bipolar disorder is characterized by extremely low moods (depression) that alternate with extremely high moods (mania or less severe form of abnormally elevated mood called hypomania.)


Depression is an extremely complex disorder, and researchers are still working to uncover the underlying biology. Genetic predispositions almost certainly play a role. But environmental factors are also important. Stressful life events, grief, trauma, medications and medical illnesses are also known to trigger depression.

Genes: Studies have identified genes that cause individuals to be more susceptible to mood disorders, including depression. Depression often runs in families. However, that doesn’t mean the person will develop depression just because others in their family have experienced depression. And it’s very possible to have depression even if there is no family history of the disease.

Brain structure abnormalities: Research has also uncovered specific areas of the brain involved with regulating mood. Abnormalities in the functionality of certain nerve pathways or circuits may impact depression. Researchers have also used imaging technology such as functional magnetic resonance imaging (fMRI) and PET scans to compare the brains of people with depression to those without. One study found the hippocampus is smaller in depressed women than those who weren’t depressed. Other studies have found a difference in brain activity in the amygdala, an area deep in the brain associated with core emotions such as anger, fear and pleasure. Smaller volume in the thalamus, also an area of the brain which regulates mood, has been associated with bipolar disorder by multiple studies.

Stressful life events: The loss of a loved one, difficulties in an important relationship, or stepping into a caregiver role for someone you love are all associated with raising the risk of depression. Financial stress, the loss of a job or a home, becoming an “empty nester” or even retiring can contribute to depression.

Traumatic experiences: Traumatic experiences such as emotional abuse, sexual abuse or witnessing violence during childhood may make people more vulnerable to depression later on in life. Sexual assault, domestic violence or other traumatic events can also contribute to depression in adulthood. Military personnel, police, emergency responders, and firefighters may also experience or witness trauma while on the job, raising their risk of depression.

Substance abuse: It’s not always clear whether the substance abuse itself triggers depression or if people use drugs and alcohol in an attempt to soothe or relieve the symptoms of depression. But a high proportion of those with substance use disorders also suffer from co-occurring depression.

Physical illness: There are many diseases associated with higher rates of depression, including dementia/Alzheimer’s disease, Parkinson’s, AIDs and cancer. People who have had strokes or head injuries are also at higher risk. People with pain disorders are also more likely to have depression.

Understanding Alcohol and Depression

Drinking is one of the most common ways that people deal with depression. Alcohol is a form of self-medication – a few drinks can boost the mood and make someone who feels sad or stressed feel better. But those mood enhancing effects are fleeting. Alcohol and depression can be a dangerous combination.

Heavy drinking is correlated with triggering depression, memory loss and suicide. Studies suggest that 30 to 50% of people with alcohol use disorder also have depression. And alcohol has the potential to do tremendous harm to people suffering from depression. Alcohol can interfere with sleep, which can already be an issue for depressed people. Heavy drinking can make symptoms of depression worse. Drinking also raises the risk of suicide, by impairing judgment, lowering inhibitions and causing people to act impulsively. Alcohol may also ease the distress associated with committing suicide, making people more likely to go through with it. Alcohol can also interfere with antidepressants.

When seeking rehab for drugs or alcohol, it’s essential that depression is treated at the same time as the addiction. Treating alcohol and depression helps people sleep better, feel more energetic and feel hopeful about the future, which are all important in recovery. When people are no longer depressed, they have the energy and the confidence to make positive changes.

When depression and substance abuse are combined, it makes it extremely difficult to see through the fog of despair that a better life is possible, and that there are concrete steps individuals can take to get there. When depression is treated, people are able to see that a happier existence free of alcohol and drugs awaits them.

Selecting Bluff as an Inpatient Depression Treatment Center

Bluff is an addiction, dual disorders and depression treatment center. Bluff offers patients suffering from substance abuse and depression a beautiful, peaceful setting to reset their way of thinking and allow the body, mind and soul to heal. Bluff has also assembled a team of psychiatric providers, nurse practitioners, registered nurses, and therapists to effectively and compassionately treat depression in those who are in recovery from substance use disorders.

As patients detox from alcohol and drugs and remove toxic substances from their bodies, symptoms of mental illnesses such as depression can also change. Detox is a time when it’s especially important for psychiatric providers to pay close attention to any changes in a patient’s symptoms or mood, adjusting medications as needed.

Our caring and experienced therapists include licensed marriage and family therapists (LMFT) and licensed clinical social workers (LCSW). They use proven techniques such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) to help patients find new ways of thinking about themselves and their behavior as well as develop the motivation and the skills to make positive changes. Antidepressants and other medications are important aspects of treatment for depression. So is learning to take care of oneself physically and mentally.


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