Depression is one of the most common mental health disorders in Australia. More than 14% of Australians will be diagnosed with depression in their lifetime. Today, that’s over 3.5 million people.

Rates of depression are also on the rise. The World Health Organisation (WHO) estimates that the number of people with depression increased by around 18% between 2005 and 2015. Depression symptoms are also debilitating – they impact a person’s physical health, relationships, overall wellbeing, and performance at work and school. Depression is already a leading cause of disability worldwide and is predicted to be the number one international health concern by 2030.

Fortunately, depression is also very treatable. There are many effective treatments for depression, and most people are able to find a treatment that suits them. As with many other conditions, early intervention is the most effective. So, it’s important to know what depression is, what the symptoms of depression are, and what help is available.

Understanding Depression

Depression, also called ‘clinical depression’, ‘major depression’, or ‘major depressive disorder’, is a mental health disorder characterised by persistent low mood, low energy, and repetitive, negative thinking. People with depression feel constantly down and unmotivated, find it hard to enjoy activities that normally interest them, and are often very self-critical.

Unsurprisingly, depression impacts every aspect of a person’s life. People with depression have trouble concentrating, which can impact their performance at work. They generally have low self-esteem and sometimes see themselves as worthless, which can lead to relationship breakdowns. Depression also increases a person’s risk of having anxiety or a substance use problem, and some people with depression think about suicide.

Suicidal thoughts can be very distressing and can lead to suicide attempts. Suicide is the most common cause of death in Australians aged 15 to 44, and 9 Australians die of suicide every day. Men are three times more like to die by suicide than women, and Indigenous Australians are twice as likely to die by suicide than non-Indigenous people.

Many people with depression don’t seek help. However, depression responds well to treatment; most people who have treatment get better. If you think you could have depression, or if you’ve been experiencing some symptoms of depression, it’s important that you reach out for support.

The Difference Between Clinical Depression and Low Mood

Depression is very different from ‘feeling low’. It’s normal to feel sad, tired, down, and bored from time-to-time. Everyone has moments where they just can’t be bothered, and everyone has self-critical thoughts – especially when we’ve gone through something stressful. Humans are wired to feel painful emotions like sadness in response to difficult situations.

Depression, however, is characterised by abnormal low mood. Here, the term ‘abnormal’ means not normal for you. This could be low mood that’s more intense or long-lasting than usual, or low mood that feels out of proportion to the situation. It can also be low mood that’s difficult to explain or doesn’t have a clear cause or trigger.

Depression is also more than low mood. People with depression also experience a cluster of clinical depression symptoms, like intense feelings of hopelessness, unjustified guilt, or difficulty experiencing moments of happiness. Unlike low mood, depression also has a physiological component, such as fatigue and changes in weight or appetite.

What Are the Main Symptoms of Depression?

Depression is a complex mental health condition that has behavioural, emotional, physical, and cognitive symptoms. Depression can look slightly different in each person, and depression can also be expressed differently in different cultures.

Overall, however, the main symptoms of depression are:

• Persistent and intense negative feelings, such as sadness, numbness, emptiness, or hopelessness.
• Persistent and significant loss of pleasure or interest in nearly all activities.

In other words, people with depression feel down, have difficulty feeling positive emotions, and find it hard to enjoy things that they normally like.

For a person to be diagnosed with depression, these symptoms:

• Need to be present nearly all day, every day, for at least two weeks.
• Must be severe enough to impact a person’s work, relationships, or quality of life.
• Can’t be caused by a medical condition, a substance or medication, or another psychological disorder (e.g. schizophrenia).

Physical Symptoms of Depression  

Depression can have a significant impact on the body and a person’s overall sense of physical wellbeing. This is because depression impacts a person’s energy and appetite.

Specifically, the physical symptoms of depression include:

• Significant change in appetite (either eating much more or much less than normal)
• Significant weight loss or weight gain (a change of more than 5% of your body weight)
• Difficulty falling asleep (insomnia) or sleeping too much (hypersomnia)
• Persistent fatigue

In severe cases, depression can also cause intense and persistent restlessness, or very slowed movements.

For these signs to be classified as ‘depression symptoms’, they can’t be the result of a purposeful change in behaviour. For example, weight loss would not be considered a symptom of depression if you’ve recently joined a gym and changed your diet.

Cognitive Symptoms of Depression

Depression can also cause changes in the way someone thinks. Many of these changes worsen a person’s mood, and, by extension, their depression, resulting in a vicious cycle. As a result, the cognitive symptoms of depression are a primary target of CBT.

The cognitive symptoms of depression include:

• Repetitive and unrealistic negative thoughts
• Excessively self-critical thoughts
• Thoughts of death or suicide
• Difficulty concentrating
• Difficulty making decisions

Emotional Symptoms of Depression

As depression is a mood disorder, many people consider emotional changes to be the hallmark symptoms of depression. However, many of these symptoms are also shared with anxiety disorders, as well as other mental health disorders.

The emotional symptoms of depression include:

• Persistent feelings of sadness, numbness, emptiness, or hopelessness
• Difficulty feeling (or an inability to feel) positive emotions, like joy, happiness, or curiosity
• Excessive feelings of worthlessness or guilt

The physical, cognitive, and emotional symptoms of depression interact. Part of overcoming depression is learning what symptoms of depression you experience and how they interact with each other. This way, you can learn to effectively change these patterns, so that you can break the cycle and start to feel better.

The Different Types of Depression

Many people are surprised to learn that there are different ‘types’ of depression. The most common types are major depressive disorder (MDD) and persistent depressive disorder (PDD).

Major depressive disorder is what most people mean when they use the terms ‘depression’ or ‘clinical depression’. Major depressive disorder is characterised low mood and loss of interest in activities, as well as the physical, cognitive, and emotional symptoms described above.

Persistent depressive disorder, sometimes called dysthymia, is a less severe but longer lasting type of depression. To be diagnosed with major depressive disorder, a person must have significant depression symptoms for at least two weeks. To be diagnosed with dysthymia however, symptoms can be milder but must be present for at least two years.

Perinatal depression is another well-known type of depression. Perinatal depression refers to depression experienced by a person whilst pregnant (antenatal) or up to a year after they’ve given birth (postnatal). Perinatal depression is very common, occurring in up to 17% of people who become pregnant.

Episodes of depression can also occur in other psychiatric conditions, like bipolar disorder and post-traumatic stress disorder.

How to Identify Depression Symptoms

Many symptoms of depression, like fatigue and low mood, are normal, everyday experiences. Other symptoms, like excessive guilt or feelings of worthlessness, can be difficult to identify – especially in other people. As a result, it can be difficult to know whether or not something might be a symptom of depression.

Here are some guidelines that might help you know whether it’s time to reach out for help, or check in with the person you’re worried about:

Firstly, symptoms of depression generally occur in clusters and are a change from a person’s normal behaviour. For example, difficulty falling asleep isn’t a sign that someone has a mental health disorder. However, if a person seems more down than usual, is withdrawing from their normal activities, and starts having trouble falling asleep, then further investigations could be worthwhile.

Depression symptoms also interfere with important aspects of life, such as work, relationships, physical health, or overall wellbeing. For example, some people with depression can find it difficult to get out of bed to get to work, which could result in them being fired. Other people have trouble connecting with loved ones, which can lead to a relationship breakdown. Other times, people with depression might turn down important medical treatment, because they don’t have energy or don’t feel worthwhile.  

Symptoms of depression are also persistent, occurring nearly all day, every day, for at least two weeks – often much longer.

Finally, depression symptoms can develop without a clear cause or trigger. It’s normal to experience intense and long-lasting sadness after a significant loss, such as the death of a loved one. Depression symptoms, however, can be difficult to explain. People with depression often think or say things like, “I don’t know why I feel like this” or “Why do I feel so empty when my life is so good?”.

What to Do If You’re Experiencing Symptoms of Depression

If you think you could have depression, or if you’re dealing with symptoms of depression, one of the best things to do is tell someone how you’re feeling. Depression symptoms can be difficult to cope with, but they’re easier to manage when you have support. Telling someone you trust about what you’re going through can alleviate feelings of guilt and help you feel more hopeful. It also means that these people can check-in with you, help you challenge your self-critical thoughts, and help you have fun!

Exercise is also one of the effective ways to reduce symptoms of depression. Regular cardiovascular exercise can improve your sleep, energy, and mood. It can be difficult to start exercising when you’re feeling fatigued and down, so start small and do exercise that you enjoy.  

It’s also important to check-in with a healthcare professional. If you’re in Australia, your GP is a good place to start. GPs are trained in mental health assessment, and can refer you to specialised mental health professionals, such as counsellors, psychologists, and psychiatrists. GPs can also prescribe antidepressant medications, which are generally recommended in the treatment of moderate to severe depression.

If you’re experiencing thoughts of suicide and are feeling overwhelmed call Lifeline on 13 11 14, the Suicide Call Back Service on 1300 659 467, or your state’s Mental Health Line, shown below. These free, 24/7 support services can talk you through intense thoughts and feelings, help you stay safe, and help you get you connected with mental health support if you need it.

If you’ve made a plan to hurt or kill yourself, and are feeling so low that you’re thinking of going through with it, resist your thoughts and dial triple zero (000) immediately – people there know what to do and how best to help you. If you live outside of Australia, call your local emergency services straight away.

How to Help Someone Who is Showing Depression Symptoms

If you’re worried that someone you know is experiencing depression symptoms, check in with them and ask them how they’re feeling. Use gentle and supportive language, for example, “I’ve noticed you seem a bit down lately, is everything okay?” or “I’ve been a little worried about you, how are you feeling?”. Don’t use accusatory language, like “What’s wrong with you?” or “You’re no fun to be with anymore”.

If this person opens up to you, listen quietly and try not to offer solutions at first. Empathy is often more helpful than an answer. Similarly, although you also might be tempted to encourage this person to “be positive” or “cheer up”, these kinds of statements can feel dismissive. Instead, try offering some validating statements like, “You must feel so tired” or “You’ve dealt with this alone for so long, I’m glad you told me.”

It can also be helpful to ask the person what you can do to support them. If the person isn’t able to think of anything, then you could ask if specific things might help, like, “Would it be helpful if we had dinner more often?” or “Would you like me to help you find a therapist?”. Remember however, don’t offer something that you won’t be able to provide.

If you feel comfortable, check in with the person more often over the following weeks, asking them how they feel, encouraging them when they make progress, and listening when they have setbacks. Try to organise a few social events or fun activities for you to do together.

Learn practical strategies for managing persistent sadness and low mood with our clinically-proven Online Course for Depression.

References

• Australian Bureau of Statistics (ABS). 2018. National Health Survey: first results, 2017–18. Canberra: ABS.

• Australian Bureau of Statistics (ABS). 2008. National Survey of Mental Health and Wellbeing: summary of results, 2007. Canberra: ABS.

• World Health Organization (WHO). 2017. Depression and Other Common Mental Health Disorders: Global Health Estimates. Geneva: WHO.

• Australian Institute of Health and Welfare (AIHW). 2014. Australia’s Health 2014. AIHW: Canberra.

• National Institute for Health and Care Excellence (NICE). 2009. Depression in adults: Recognition and management clinical guideline [CG90]. https://www.nice.org.uk/guidance/cg90/resources/treating-depression-in-adults-pdf-316004588485