Depression symptoms: How to recognize the signs and what to do next

How Does It Feel to Be Depressed?

Depression is a mood disorder that affects both your mind and body. The two main symptoms that define major depressive disorder (MDD) are:

1. Depressed mood: feeling sad, hopeless, or emotionally empty
2. Loss of interest or pleasure (anhedonia): no longer enjoying things you used to love

Depression often feels heavy and all-consuming. It can make activities you once enjoyed seem pointless or not worth the effort of getting out of bed. Your emotions might swing between feeling completely numb and feeling overwhelmed by hopelessness—often with no clear reason for these low moods.

These feelings can convince you that there’s no way out or that things will never get better. The emotional pain frequently has no obvious cause, which can make it even more confusing and isolating.

What Depression Feels Like: Real Descriptions

Bruce Springsteen described his experience with depression in his autobiography Born to Run:

“My depression is spewing like an oil spill all over the beautiful turquoise-green gulf of my carefully planned and controlled existence. Its black sludge is threatening to smother every last living part of me.”

Artist Vincent Van Gogh wrote about one of his depressive episodes:

“One feels as if one were lying bound hand and foot at the bottom of a deep dark well, utterly helpless.”

These descriptions capture something clinical lists often miss: Depression doesn’t just affect your mood, but it can feel like it’s taking over your entire sense of self and your ability to function in the world.

Core Emotional Symptoms of Depression

The two core emotional symptoms of depression form the foundation of any clinical diagnosis. Understanding how these symptoms actually feel can help you recognize them in yourself or others.

Depressed Mood

In clinical terms, a depressed mood means that someone feels “sad,” “hopeless,” or “empty.” To outside observers, they might seem “tearful,” “sensitive,” or even “numb.”

“It’s not uncommon for folks to feel numb,” says Evan Csir, a licensed professional counselor at Thriveworks. “Depression is a complex feeling, and many people feel sad for a long period of time, sometimes with no reprieve for months. A lot of folks also say that they feel lonely and they struggle to connect with others.”

These feelings can appear without explanation and completely overwhelm all the positive aspects of one’s life and identity. They go far beyond normal feelings of sadness or disappointment. They can feel all-encompassing, making it extremely difficult to get out from under them without love, support, and professional guidance.

Loss of Interest or Pleasure (Anhedonia)

In clinical terms, anhedonia means that someone experiences “markedly diminished interest or pleasure in all, or almost all, activities.”

Do you normally take pride in your appearance? Do you like to call your best friend at the end of the day, or enjoy planning vacations or birthday parties? Depression can erase all those simple, familiar pleasures. You’re suddenly wandering from room to room, looking for any little thing that can spark happiness. And worse, you often can’t access those old positive feelings, even in your memory.

Signs of Depression in Daily Life

A depressed mood and anhedonia are both deeply felt emotional symptoms, but internal symptoms can also manifest externally, sending up red flags for loved ones. For example, a depressed person might:

• Stop taking care of themselves
• Quit showering or exercising routinely
• Start eating junk food more frequently, or rarely consume anything nourishing at all, causing weight fluctuations
• Change their sleep habits—instead of getting eight hours a night, they’re sleeping during the day, or experience insomnia
• Be more irritable or agitated
• Stop having sex with their partner because what used to feel good doesn’t feel good anymore

These new behaviors can cause a negative feedback loop that worsens someone’s depressive symptoms.

And worst of all, depression symptoms can be deadly. People with depression are at higher risk of having suicidal thoughts or attempting suicide. They may become so desperate to end their mental suffering that they see suicide as their only option, never giving themselves the chance to feel better.

If you or someone you love is struggling with their mental health and are showing signs of suicidal ideation or self-harm, crisis hotlines such as the 988 Suicide and Crisis Lifeline or the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline at 1-800-662-HELP are available with qualified, knowledgeable experts on call 24/7. However, if someone’s life is in immediate danger, call 911 right away.

Physical and Cognitive Symptoms of Depression

Depression affects more than just your emotions—it can impact your body and mind in ways that might surprise you. Many people don’t realize these symptoms are connected to depression.

Physical Symptoms

• Depression symptoms can be physical, with some people feeling:
• Restless or agitated
• Sluggish
• Excessively tired
• In pain
• “Depression can make people feel physically sore and exhausted, making it difficult to get up and do things. This can often be because people are laying in bed frequently,” Csir states.

They might go to their doctor seeking help for their mysterious headaches or stomachaches, only to be told that there’s nothing physically wrong with them.

Cognitive Symptoms

Depression symptoms can affect cognitive functioning, impacting concentration, memory, and decision-making. For example, a depressed person may:

• Stare for hours at the coffee maker, unsure whether to start it or not
• Find it impossible to focus on simple tasks at work
• Space out while driving home or getting dressed in the morning due to their dark ruminations
• Take a long time to get their words out

“People with depression may report intrusive thoughts that are negatively charged, or tend to remember experiences to be more negative or challenging than they actually were,” Csir tells us. “Due to how rigid depression can make a person (e.g., difficulty seeing alternatives to situations), sometimes folks can also get stuck in their routines or struggle to adapt to a change of plans.”

DSM-5 Criteria for Depression

The Diagnostic and Statistical Manual of Disorders (DSM-5), published by the American Psychiatric Association (APA), provides the official criteria that mental health professionals use to diagnose major depressive disorder (MDD).

To receive a diagnosis of major depressive disorder, you must meet these specific requirements:

You must experience at least five of the following symptoms for at least two weeks (one of which MUST include the first or second symptom listed):

1. Depressed mood
2. Loss of interest in activities that used to be enjoyable
3. Significant appetite changes or unintentional weight loss/gain
4. Sleep issues such as insomnia or hypersomnia
5. Extreme/observable restlessness or sluggishness
6. Excessive fatigue, low energy
7. Feelings of worthlessness or profound guilt
8. Impaired ability to think, concentrate, or make decisions
9. Suicidal ideation or thoughts of death (do not need to be present every day)

Additional requirements:

• Your symptoms must be causing significant problems in your life and ability to function
• You must be able to rule out other causes (like medication, substance abuse, grief/loss, or another mental health condition) for these mood changes

Taken together, the above signs of depression also comprise depressive episode symptoms.

The DSM-5 provides further ways to classify MDD by severity. A clinician will often code major depression as mild, moderate, or severe depending on the intensity and frequency of symptoms.

Depression Severity: Mild, Moderate, and Severe

Depression symptoms can range from mild to severe, based on someone’s degree of functioning. Understanding these different levels can help you recognize where you or a loved one might fall on the spectrum and what kind of support might be most helpful.

Understanding Each Level

Mild Depression: If someone has mild depression, their symptoms might not be as noticeable to an outside observer. Their functioning may appear relatively normal, with others not recognizing how much extra effort is required to maintain that appearance. Someone with mild depression might also dismiss their symptoms as just being “the blues” or normal sadness. But if they meet the DSM-5 criteria for a depressive disorder, then they have depression and could benefit from treatment.

Mild depression symptoms are less intense versions of those standard DSM-5 diagnosis criteria and may include: lack of motivation, increase in maladaptive coping behaviors like drinking or gambling, withdrawal from friends, irritability, daytime sleepiness, and flu-like symptoms.

Moderate Depression: The next level of depression symptoms tends to have a greater impact on functioning, affecting multiple areas of someone’s life simultaneously. These symptoms can affect a person’s social life, romantic life, productivity, self-esteem, weight, and energy levels.

Severe Depression: On the far end of the symptom spectrum, someone with severe depression might wrestle with the most intense feelings of darkness and despair. Severe symptoms can include hallucinations or delusions, complete inaction (stupor or catatonia), reckless behavior, and suicidal thoughts or plans.

Someone with severe depression symptoms may pose a danger to themselves. In order to get treatment at this point, they may need the support of friends or family. Severe depression can render someone virtually helpless, unable to make that first phone call to a mental health professional.

How Depression Looks for Different People

Depression symptoms are both individual and dimensional. They can be affected by age, gender, cultural norms, and much more. And they can range from mild to severe. Here are some notable differences in how depression symptoms may manifest across demographics.

In Men

Men with depression may be more reluctant to talk about their feelings of sadness due to perceived gender roles, often causing them to downplay their symptoms or resist professional treatment. These sad feelings can manifest as increased irritability, frustration over minor matters, or angry outbursts. Depression symptoms in men may also include the following:

• Escapist behavior
• Physical complaints
• Risky or reckless behavior
• Alcohol or drug use (sometimes used as a maladaptive coping strategy)

In Women

Women are nearly twice as likely as men to be diagnosed with depression. They are also uniquely susceptible to the following:

• Premenstrual dysphoric disorder
• Perinatal depression
• Perimenopausal depression

In Children

Children with depression can also express irritability rather than sadness. Parents and caregivers may also see the following depression symptoms:

• Drop in grades at school
• Failure to meet expected weight gains
• Separation anxiety or clinginess
• Refusal to go to school
• Worry and anxiety
• Body aches and pains

In Teens

Teenagers with depression may have poor attendance at school, or their grades may suffer. They can also exhibit any of the following signs of depression:

• Hypersomnia (sleeping too much)
• Hyperphagia (abnormally increased appetite)
• Personality disturbances
• Extreme sensitivity
• Drug and/or alcohol use
• Social avoidance
• Apathy
• Self-harming behaviors

In Older Adults

Older adults and the elderly may exhibit memory difficulties in addition to a melancholy mood and psychomotor disturbances. This is why depression in older adults can sometimes be mistaken for dementia (pseudodementia).

Treatment Options for Depression

Depression is highly treatable, especially with early intervention. Talk therapy can help from the very first sessions—having a mental health professional accurately identify what’s going on in your life and give you a name for your symptoms can provide a sense of control and often relief.

“Therapy can help people process their feelings and understand that what they’re going through is normal,” Csir says. “Just having someone listen, support them, and hold them accountable can be very powerful, as depression can be very isolating.”

There are several effective treatment approaches available:

Therapy

Here are some of the main evidence-based psychotherapy treatments that therapists, psychiatrists, counselors, clinical social workers, and other mental health professionals might utilize to address the signs and symptoms of depression:

• Cognitive behavioral therapy (CBT): CBT is a very common approach used in depression therapy. The goal of CBT is to assess thoughts, emotions, and behaviors and make healthy adjustments and improve well-being. The process involves identifying distorted thoughts and emotions, connecting them to the behaviors that they cause, and working through the thoughts and feelings to then change the unhelpful behavior. This can help people with depression change their mindsets, helping them find hope and happiness again.
• Dialectical behavior therapy (DBT): Dialectical behavior therapy helps a person accept their reality while working to change their lives and unhealthy behaviors through identifying emotions and thoughts (mindfulness), learning to withstand unpleasant emotional responses (distress tolerance), coping with and decreasing unwanted feelings (emotional regulation), and improving relationships and social skills (interpersonal effectiveness skills).
• Interpersonal therapy (IPT): IPT focuses on the relational aspects of a person’s well-being, specifically assessing and improving their relationships with others. IPT helps individuals with depression strengthen their connections with others, seek appropriate support, and examine how one’s emotions impact their relationships.
• Psychodynamic therapy: Psychodynamic therapy is a form of psychotherapy that delves into the unconscious processes and inner conflicts of an individual to address emotional and psychological issues. It aims to uncover deep-seated, often unconscious, emotions and beliefs to promote insight and self-awareness, which can lead to long-term changes in behavior and emotional well-being.

Medication

The two most common types of medications used to treat depression are antidepressants called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). (We break down the difference between these two medications in detail here.)

• SSRIs: The most commonly prescribed type of antidepressant, SSRIs treat depression by increasing the amount of serotonin in the brain. This can help improve mood, appetite, sleep, and other symptoms of depression.
• SNRIs: Similar to SSRIs, SNRIs increase serotonin levels as well as norepinephrine, both of which influence mood.

Not everyone with depression requires medication, but if symptoms are intense and persistent, taking medication can make symptoms more manageable while talk therapy treats the root emotional causes.

Other Treatments

• Transcranial magnetic stimulation (TMS): TMS is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain, targeting areas that control mood. This can be performed multiple times (repetitive TMS), depending on the efficacy, to lessen symptoms of depression over time.
• Electroconvulsive therapy (ECT): ECT involves being put under anesthesia and causing slight, intentional seizures by passing small electrical currents through the brain. Though there can be some side effects (as with other treatments), these procedures are controlled and targeted at altering brain chemistry to improve mood. This can be effective for people whose depression has resisted other treatments.
• Esketamine: For cases of treatment-resistant depression, the FDA approved a prescription version of ketamine named esketamine, or Spravato. Taken as a nasal spray, this medication is only prescribed once two standard types of depression treatment have been tried with unsuccessful results.

Recovery from depression might take weeks, months, or years. Mastering the symptoms of this disorder often requires pharmacological and/or therapeutic interventions. And it may feel daunting to ask for help. But just like any other serious health issue, depression shouldn’t be ignored. Even if your life isn’t at stake, your well-being is. You deserve a better life than what depression dictates. You deserve to feel joy again, and by prioritizing your care, you will.

When and How to Seek Help for Depression

If you think you may be depressed, consider seeking guidance from a mental health professional. Whether or not you have clinical depression, they can help you process your emotions, work through past and current challenges, and identify ways to improve your health and well-being.

“A lot of folks will wait for their depression symptoms to be at their worst before seeking help,” Csir says. “I really encourage people to come in sooner than later. The longer depression goes untreated, the more difficult it can be to work through it.”

Signs It’s Time to Seek Professional Help

Consider reaching out for support if you’re experiencing:

• Symptoms lasting two weeks or longer that interfere with daily functioning
• Persistent feelings of sadness, emptiness, or hopelessness most days
• Significant changes in appetite or unintentional weight loss/gain (5% of body weight in a month)
• Sleep disturbances (insomnia, early morning awakening, or sleeping too much)
• Difficulty concentrating, making decisions, or remembering things
• Loss of interest in activities you previously enjoyed
• Increased irritability, restlessness, or feeling slowed down
• Excessive guilt or feelings of worthlessness
• Fatigue or loss of energy nearly every day

How to Get Help

Mental health professionals: The experienced clinicians at Thriveworks are here to help you work through the challenges you’re facing. You can work with someone who specializes in depression, anxiety, trauma, or another condition you’d like help with and receive treatment from an empathetic, knowledgeable professional willing to work with you at your own pace.

Crisis support: If you need immediate help, resources like the 988 Suicide and Crisis Lifeline have qualified professionals who are always available to talk through your challenges and emotions.

The Bottom Line

Depression is more than sadness; It’s a serious medical condition that affects your emotions, thoughts, and physical health. The key symptoms to watch for are persistent low mood and loss of interest in activities you once enjoyed, along with changes in sleep, appetite, energy, and concentration that last at least two weeks.

The most important thing to remember: depression is highly treatable. Evidence-based therapies like cognitive behavioral therapy (CBT), medications such as SSRIs, and other proven treatments can significantly improve your quality of life. Early intervention leads to better outcomes, so don’t wait until symptoms become overwhelming to seek help.

If you’re experiencing depression symptoms, reaching out for professional support is a sign of strength, not weakness. With the right treatment and support system, you can manage your symptoms, regain your sense of well-being, and rediscover hope for the future.

Frequently Asked Questions

How do I know if I’m depressed or just sad?

Depression differs from normal sadness in duration, intensity, and impact on daily functioning. While sadness is typically temporary and linked to specific events, depression involves persistent symptoms lasting at least two weeks that interfere with work, relationships, and daily activities. If you’re experiencing low mood, loss of interest in activities, sleep changes, or difficulty concentrating for two weeks or more, consider consulting a mental health professional for an evaluation.

How long do symptoms have to last to be considered depression?

According to the DSM-5 criteria, depression symptoms must persist for at least two weeks to meet the diagnostic threshold for major depressive disorder. However, the symptoms must also occur most of the day, nearly every day during this period, and significantly impact your ability to function in daily life.

When should I see a therapist for depression symptoms?

You should consider seeing a therapist if you’re experiencing persistent sadness, hopelessness, or loss of interest in activities for two weeks or longer, especially if these symptoms interfere with work, relationships, or daily functioning. Other signs include sleep disturbances, appetite changes, difficulty concentrating, thoughts of death or suicide, or feeling overwhelmed by daily tasks. Early intervention often leads to better treatment outcomes, so don’t wait for symptoms to become severe.