Can you be depressed and not know it? A look into the subtlety of depression

Right now, millions of people are suffering from depression—and some might not even know it. Despite being one of the more well-known mental health conditions, not everyone knows the signs. 

You may ask yourself: “How can I be depressed and not know it?” That question has many answers, but the truth is that depression feels different to everyone. If you think you might be depressed, here are some reasons why you may not have realized it before now, as well as some treatment options to help you overcome it.

How Could I Not Know That I’m Depressed?

Depression can come on slowly, sometimes with no identifiable reason. There is a multitude of reasons why someone doesn’t realize they’re depressed, unique to each individual. However, here are some common factors that could be making your depression hard to identify.

  1. Co-occurring conditions: One of the things that makes depression easy to miss is if you have a co-occurring condition. There are many conditions that frequently happen alongside depression, or even cause your depression to be confused for something else. If you’re told you have conditions like an anxiety disorder or ADHD, you likely wouldn’t assume that you’re also depressed, since they share many of their symptoms.
  2. Stress: Another common reason for overlooking depression symptoms is everyday stress. “Pushing through” in order to reach our goals can cause us to ignore stress or sadness in favor of being “strong” or “tough.” However, pushing down or ignoring stress can lead to depression. Not everyone knows how to destress and unwind when they’re overworked, causing people to continue to bear their stress and ignore the warning signs of depression in order to keep functioning as they are.
  3. Stigma: This can cause people to refuse to acknowledge their depression. Depression can seem like something far-off, like a problem that only certain people deal with in specific, maybe stereotypical ways. In reality, depression is very nuanced and can look different to you than it would to someone else suffering from it. 

Also, if you have never been diagnosed with depression, you could be missing the signs that are pointing to it.

Logically, it might seem like feeling this way for the first time might make the symptoms more noticeable, but in fact, it can be easier to pinpoint red flag behaviors if you know what you’re looking for. Depression symptoms can vary and develop very slowly, so it might not be clear that these new behaviors are signs of a larger problem. 

It might start with negative self-talk, or evolve into a lack of joy and loss of motivation. Especially if work, school, or life expectations are high and you have never been diagnosed with depression, symptoms like pessimism, negativity, or exhaustion might not seem that out of the ordinary. They might even convince you that what you’re feeling is valid and deserved.

Depression can quickly become isolating. You might feel resentful, or perhaps feel like a burden. Talking about how your emotions might seem overwhelming or too vulnerable, making it hard for those around to know how you’re feeling or realize what’s going on. In children and adolescents, depression might make them seem more irritable than sad.

Many people see depression as intense sadness or dejection, but in reality, sadness is not a required feeling in order to be depressed. In fact, the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-5, only requires feelings of sadness or diminished interest or pleasure in order to consider someone depressed. To you, it might feel more like loneliness, or simply a lack of joy and pleasure.

However you’re feeling, it’s not your fault. Depression is pervasive and subtle, with symptoms that compile on themselves and make it hard to seek help.

This is why it’s so important to check in with yourself. It can be easy to not register how you’re feeling, especially if you’re someone who shies away from feelings like anger, frustration, or sadness. When everything feels like it’s falling apart, when even small things feel like too much, it can be hard to do anything beyond function, to see or feel anything beyond what’s right in front of us. 

Be mindful of your self-talk, and try to notice any patterns that come up with your depressive behaviors. This can help you gauge how you’re feeling and make depression easier to spot if it troubles you again in the future.

How Do I Know If I Have Depression?

As we’ve stated, it can be difficult to know whether you have depression. However, there are simple ways to check with yourself and discern whether you might be depressed. Here is a list of standard depression symptoms:

  • Changes in appetite; gaining or losing interest in food
  • Trouble falling asleep, staying asleep, or sleeping too much
  • Headaches or back aches
  • Digestive problems
  • Anxiety
  • Shift in mood: agitation, anger, sadness
  • Lack of energy or tiring easily
  • Forgetfulness or difficulty concentrating, struggling in work or school
  • Low sex drive
  • Hopeless outlook on life, like there’s nothing to be happy about
  • Feelings of guilt or helplessness
  • General apathy and lack of interest or pleasure in activities or people you enjoy
  • Thoughts of suicide
  • Using alcohol or drugs or food to help you cope, wanting to numb your feelings
  • Finding it hard to deal with everyday tasks
  • Low self-esteem, constant negative self-talk

You may have varying combinations of these symptoms depending on your situation and personality. If this is your first time dealing with depression, take note of which symptoms seem the most familiar to you and how they may have started. You can use these as future indicators when you’re feeling off that you may be starting to feel depressed again.

It’s important to know what your own depression’s red flags are so that you can take preventative steps, rather than waiting until your depression is worse and it could be more challenging to motivate yourself and take action. Checking in and gauging your emotions will also help you realize earlier on that you’re feeling depressed.

What Causes Depression?

Causes for depression can definitely play a part in masking what’s actually happening. After all, if you have a good reason to be sad, it can be difficult to notice when that sadness might be sinking into depression. Despite similar feelings being involved, depression and sadness are not necessarily the same thing. 

Depression can make you feel many different versions of sadness: hopelessness, helplessness, low self-esteem. Feeling sad due to a person or event is somewhat separate, though—it doesn’t usually leak into feelings like self-loathing or lethargy on its own, as it’s not quite as pervasive as depression.

That being said, sadness can be a starting point for depression. Circumstantial factors, like relational troubles, job loss, or loss of a family member or loved one are very common reasons for depression.

Medical issues like chronic illness or pain, nutritional deficiencies, and conditions like cancer or hyperthyroidism can also lead to depression. If one of these health issues is causing depressive symptoms, you might not notice at first. Since you’re struggling with your health, you might already feel frustrated or scared, which could be masking deeper symptoms of depression.

Even something as common as stress, when it builds up over time or becomes chronic, can lead to depression. Since stress can become worse over time, much like depression, it can be hard to differentiate the two. 

How Prevalent Is Depression?

Depression is the most prevalent mental health condition. Around the world, approximately 280 million people have depression. According to the World Health Organization, a total of 5% of adults are diagnosed with depression worldwide.

However, there’s more to the statistics than that. Depression affects people differently by gender as well, as women are twice as likely as men to suffer from depression, which can partially be attributed to hormonal shifts due to menstruation, giving birth, and menopause.

There are also many people who never get diagnosed with depression. Depression can be hard to identify for a number of reasons, and whether they don’t know that they have depression or they are reluctant to acknowledge it, a number of people never seek treatment for their depression.

Is Depression Difficult to Diagnose?

Yes, it can be hard to diagnose. Not knowing you are depressed is a common phenomenon, so it can take longer to get a diagnosis than it might for those with different conditions or disorders, if they get diagnosed at all.

Depression can also be hard to diagnose because its symptoms tend to be nonspecific and are shared by other disorders like anxiety or bipolar disorder. However, this in no way means that it’s impossible to get diagnosed with depression, or, on the other side, that it is self-diagnosable. 

If your depressive symptoms continue for more than two weeks, talk to a doctor about getting diagnosed and discussing treatment. If you’re looking for other resources, the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Helpline is available 24/7.

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What Conditions Can Be Mistaken for Depression?

There are a number of conditions that can be confused for depression, since depression shares symptoms with many different conditions. If you have one of these conditions, it may be very difficult to tell if you might have depression alongside it.

Conditions that are commonly mistaken for depression include: 

  • Anxiety
  • Anemia
  • Bipolar disorder
  • Chronic fatigue syndrome (CFS)
  • Diabetes
  • Hypercalcemia
  • Cyclothymic disorder
  • Premenstrual dysphoric disorder (PMDD)
  • Post-traumatic stress disorder (PTSD)
  • Fibromyalgia
  • Hypothyroidism
  • Vitamin D deficiency
  • Attention-deficit/hyperactivity disorder (ADHD)

Does Anemia Mimic Depression?

Yes, symptoms of anemia do mimic symptoms of depression. Anemia causes your blood to struggle with carrying oxygen throughout the body due to a lack of healthy red blood cells, so it can feel like you constantly lack energy or that it takes more energy to do menial tasks than it does for other people—a common sign of depression. However, they are not the same thing.

What GT Characteristics Might Be Confused With Depression?

GT (Gifted and Talented children) characteristics can be similar to those of depression. Kids that are considered “gifted” can feel larger amounts of pressure to perform and succeed, which is not always healthy for them. This can cause them to experience drastic mood swings, and they can start to feel isolated from others. They can also seem pessimistic, being quick to point out problems. 

These are all symptoms of both depression and bipolar disorder. The similarities in symptoms may not mean that your child is depressed, but their GT characteristics also do not rule out the possibility. If you think your child may be depressed, it’s best to take them to a doctor for a diagnosis.

Treatment Options for Depression

Treating depression starts with diagnosis, and from there, doctors suggest either psychotherapy, medication, or a combination of the two.

Each method’s effectiveness depends on the patient. Talk therapy can be just as effective as medication, and vice versa. 

Talk therapy works to treat depression by addressing patterns, relationships, or feelings that could be causing depression symptoms and working through them. Therapy can even help just by giving you a personal connection to someone. Having someone to talk to regularly can help you feel less isolated or lonely.

The function of antidepressants isn’t fully understood, but they work to balance brain chemicals called neurotransmitters that have been adjusted by the patient’s depressive state.

One thing that needs to happen alongside any treatment that you choose is taking care of yourself. When you’re depressed, this can seem like a gargantuan task. Whether or not you knew you were depressed, you may even have a number of everyday tasks that you feel behind on, like cleaning, work, or catching up with friends. 

Even though it might feel like they’ve been stacking up over time, doing these tasks as a form of self-care can take you out of a cycle of guilt that you might not have realized was there, and can go a long way to take away some stress and fill yourself up.

Checking in with yourself is another important method of self-care. Especially if you didn’t realize you were depressed, gauging how you feel is an integral part of measuring your progress and assessing how best to help yourself.

Other good tactics for taking care of yourself are getting the right amount of sleep, avoiding substances like alcohol or drugs, eating healthier, and, especially, exercise. Even just going for a short walk every day can do wonders for your mood.

It is extremely possible to suffer from depression without knowing it. It’s easy to mistake depression for something else, or even to be so stuck in it that you don’t see how much your life has changed. Many people suffer from depression unknowingly, but you do not have to continue that way. 

If you think you might be depressed, or even if you’re unsure, talk to a medical professional about your symptoms and see what treatment options are available to you. It could change your life for the better.

Table of contents

How Could I Not Know That I’m Depressed?

How Do I Know If I Have Depression?

What Causes Depression?

Is Depression Difficult to Diagnose?

What Conditions Can Be Mistaken for Depression?

Treatment Options for Depression

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  • Medical reviewer
  • Writer
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Zubair Haq

Zubair Haq (“Z”) is a Psychiatric Mental Health Nurse Practitioner (PHMNP) who has been in the field of nursing for over 10 years with teens, adults, and seniors. He specializes in depression, anxiety, life counseling, stress management, and ADHD.

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Hannah DeWitt

Hannah is a Junior Copywriter at Thriveworks. She received her bachelor’s degree in English: Creative Writing with a minor in Spanish from Seattle Pacific University. Previously, Hannah has worked in copywriting positions in the car insurance and trucking sectors doing blog-style and journalistic writing and editing.

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