How Do I Know if I'm Depressed?

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Jacki entered my office sullen and mystified. She said she had every reason to be happy. She had a loving husband whom she adored, two healthy young sons, a pretty house in the suburbs, a job where colleagues treated her well, and financial stability. But she had trouble getting out of bed in the morning, didn't feel like going out with friends, and lost interest in having sex. She told me she couldn't figure out why she was so miserable.

David, another patient, confessed to me that he entered into therapy only because his wife threatened that she would divorce him if he didn't do something to improve his mood and behavior. He complained that his wife just didn't take the sources of his stress seriously. His business was facing enormous competition. He was worried about the future of his company. Plus, running to and from his elderly parents' apartment to care for them, driving them to doctor visits, and ensuring that their aide was properly caring for them took every last ounce of his energy. In the little time he had to relax at home, he sat in front of the TV, not making conversation, and snapped at his wife if she made any requests. He just wanted to be left alone.

When I met with David and his wife together, her perspective was different. She said his business was going fabulously well, and even shared some details about the company's revenue. She was nervous though, that David's constant distractions with worries would have a negative impact on his employees, his decision making, the success of his business, and their family's financial stability. There seemed to be a total disconnect between David's very convincing view of what was going on and the reality of the situation—a hallmark of depression. One thing was clear to both of them: David's wife was exasperated. She was experiencing the ripple effects of depression.

Distinguishing between the blues, the "blahs," and depression

Jacki and David were both demonstrating typical signs of depression. But like many people who suffer from the condition, they didn't realize it. For Jacki, there was a chronic underlying sadness and emptiness that she couldn't explain. David pointed to his business worries as the rationalization for his moodiness and behavior. What he didn't recognize is that his negative thinking and persistent work concerns were his depression "talking."

It's common, of course, for people, to experience the blues and the :"blahs." Life is not always exciting. There are challenges that inevitably present themselves, It can be tough sometimes to muster positive energy when the weather has been consistently gray or rainy or you feel overwhelmed with work responsibilities or are dealing with a tough boss. So how can you know when what you're going through fits the medical definition of depression?

Depression manifests in three ways: physically, emotionally, and cognitively.

• Physical symptoms of depression include having sleep problems, eating too much or too little, and experiencing a decrease in or loss of sexual desire.
• Emotional symptoms include irritability, sadness, anxiety, and not taking pleasure in activities or people you once enjoyed.
• Cognitive symptoms include having constant negative and ruminating thoughts, problems concentrating, difficulty making decisions, and an inability to think clearly.

Everyone experiences some of the symptoms I outlined above at different points in their lives. There is almost always a reason someone can point to in order to rationalize their feelings and behaviors, After all, life presents difficult challenges, illness, and loss and mourning—and these affect each of us. So how can you know if you're depressed?

The answer lies in the intensity, frequency, and physicality of your symptoms. If your symptoms last longer than two weeks. If you can't snap out of your irritable mood at home or at work, if you're so anxious that you can't enjoy happy occasions or so bitter that you can't be thankful for the good things in your life, if you're frequently indecisive or have trouble focusing, if you are tired all the time and have low libido—you are exhibiting classic signs of depression.

Unfortunately, some people feel ashamed about being depressed. The stigma associated with mental health challenges is not just unfortunate, it is dangerous. It prevents many people from seeking help. It also has a ripple effect—hurting marriages, friendships, and how you perform at your workplace. Depression is a very common health issue. According to the National Institute of Mental Health, in 2023, 21 million adults experienced a major depressive episode. A 2023 Gallup poll reported that 29 percent of Americans report having been diagnosed with depression in their lifetime.

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The good news is that if you have depression there is an excellent chance that your condition can be resolved with psychotherapies, like cognitive behavioral therapy (CBT), and/or pharmacological agents, of which there are many and which can be mixed and matched to target your individual symptoms.

Are you skeptical about overcoming your depression? That is typical of the way depressed people think. They are certain that nothing will and nobody can help them. After all, negative thinking is a classic sign of depression! The solution is this: Get thee to a healer! Schedule a consultation with a psychiatrist. Give CBT a go, and if that doesn't seem to work, keep in mind that there are excellent psychiatric medications.

The chances of a successful recovery from depression are superb. Depression is never inevitable. Not after the loss of a job, a loved one, or a marriage. Sadness is normal, yes. But when one is paralyzed by despair, chances are it's a biological depression and the symptoms being experienced are a part of it. There are always going to be situations that elicit moodiness, worry, sleeplessness, and other depressive symptoms But, generally, these symptoms come and go. If they begin to rule your life, please seek help. If you are thinking that depression is something you can just snap out of, think again. This is not a bad mood. This is not about you being weak and needing to work to cure yourself. Just like you wouldn't ignore having a diabetic, cancerous, or heart condition, don't ignore signs of depression. As I have seen over and over in my practice, people not only survive depression but, when treated well, they thrive!

Do you have these signs of depression?

Check off all that apply to you:

• Have you experienced significantly diminished interest in things you used to enjoy?
• Have you experienced changes in your sleep—had trouble falling asleep or staying asleep, or are sleeping all the time?
• Have you had changes in your appetite or weight not due to intentional weight loss or gain?
• Have you been feeling fatigued or lacking energy most of the time?
• Have you had a reduced ability to concentrate and focus most of the time?
• Have you been feeling irritable most of the time?
• Have you been feeling down and anxious most of the time?

If you've checked off any of the above, schedule an appointment with a psychiatrist. You deserve to lead your best life.