Depression: Know the Signs
Oct 08, 2017 Cedars-Sinai Staff
Depression is more than just feeling sad or blue, or falling into a funk.
And it's more common than you think.
Worldwide, over 300 million people are estimated to suffer from depression. It can be challenging to treat or even identify, as people struggling with depression often turn inward and withdraw, leaving them less likely to reach out for help or even talk to someone about their symptoms.
Fight the stigma
One big barrier to recognizing and treating depression is the stigma around mental health. Many people keep silent about their depression. Our culture emphasizes self-reliance, which can make people too ashamed to ask for help.
There's also a myth that physical problems happen to our bodies while mental problems are character defects that have to do with our identity. Nothing could be further from the truth.
"Depression is a biological condition—a medical problem like any other."
"Depression is a biological condition—a medical problem like any other," says Dr. Margaret Haglund, medical director of the Cedars-Sinai Outpatient Mental Health Program. "There's no blame or shame in hypertension. Why should it be different for depression? It's just a condition that develops and has to be managed over time. We treat depression with medications or talk therapy. And yes, there are observable symptoms."
Clues that may point to depression
When someone's behavior or reactions to everyday events change, and they seem different to their family, friends, and co-workers, depression may be the cause. Anger and irritability can also be signs.
"You might think that someone is just in a bad mood or is an unpleasant person," says Dr. Haglund. "But being angry and irritable can be a symptom of depression. When the condition is treated, we're often surprised to see the surliness go away. There was an underlying cause."
People who withdraw from friends and family might be suffering from depression. If they're also irritable, it can be difficult to reach out to them. But individuals with depression usually do want someone to notice and care about them, even when they turn inward and shy away from parties and social events.
Disruption in sleep and appetite can also indicate depression. "Some people sleep more than before and some sleep less," says Dr. Haglund. "The same goes for eating." As always, seeing a healthcare provider is important to disentangle other medical causes from mental health issues.
Starting the conversation
The signs of depression can also resemble symptoms of other illnesses, so it's important to encourage someone who might be depressed to see their primary care physician for an assessment and possible referral. But how do you start that conversation?
"When depression is severe, it can be hard to work, play, and love—all things that are so vital to a fulfilling life."
Dr. Itai Danovitch, chair of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai, suggests asking an open-ended question.
"Express your concern in a supportive way," he says. "'I've noticed that you seem really down or depressed lately. How are you doing?' Then, if your family member or friend is coping with something that seems outside the scope of ordinary problems, ask them to go to their doctor."
A widespread problem that can make other illnesses worse
Depression is a serious enough problem that every patient at Cedars-Sinai is screened.
"We're on top of this because depression is so under-recognized and disabling," says Dr. Danovitch. "In fact, the World Health Organization ranks it the leading cause of disability among medical conditions. Depression actually exacerbates the symptoms of other health problems."
"About two-thirds of patients with depression have significant symptoms of pain or aches across their body," says Dr. Danovitch. "There is a decrease in function, and they often have trouble taking care of themselves. When depression is severe, it can be hard to work, play, and love—all things that are so vital to a fulfilling life."
The goal is to treat depression before it can make illness worse. When an initial screening suggests a person is depressed, a clinician will assess whether it's a new development or if the patient has a history.