5 Early Signs of Depression

Disclaimer: This article is not a tool for self-diagnosis. If you suspect that you or someone you know suffers from depression, please consult a professional for a proper diagnosis and treatment. 

Sadness and depression are not the same. It is difficult to have a specific explanation for how depression feels like. For some, it feels like a black hole while for others it feels like living a stranger’s life. Some say it feels like an elephant sitting on their chest or like drowning. For me, it’s like it sailing. It feels like I am drifting in a vast ocean on a tiny unstable plank of wood. 

The weather I experience in my sea of emotions changes daily. There are days of torrential downpours, the kind where the rain pelts violently and I feel cold. Other days, are muggy and the atmosphere feels charged and heavy. But most days, the weather is fine. Normal. Yet, I’m always watching the clouds–waiting for any sign of change. 

What is depression? 

The clinical definition for depression is a mood disorder that causes persistent feelings of sadness, hopelessness, and apathy with symptoms present for more than two weeks. According to the DSM-5 criterion, these are the symptoms that someone must show to be diagnosed with depression:

• marked diminished interest in all or almost all activities all day, nearly every day
• significant weight loss or gain without dieting
• loss or increased appetite 
• slow cognition or physical movement 
• fatigue or loss of energy nearly every day
• persistent feelings of worthlessness or excessive guilt
•  diminished concentration
• recurrent thoughts of self-harm or suicidal ideation.

However, depression is complicated. It’s messy and it does not look the same in everyone. Sometimes it is triggered by an event and other times it washes over like an unexpected tide. Despite its unique manifestations, here are five signs to look out for that signal depression or a depressive disorder. 

• Changes in sleep patterns 

There is a complex association between the number of hours you sleep and your mood. Despite the many studies investigating the relationship, researchers have not found a reason for it. Some hypothesize that disruption in biochemical pathways causes insomnia/hypersomnia. 

Biochemical evidence suggests that an increase of cholinergic agents causes a disruption of monoamine neurotransmitters like serotonin, dopamine, and norepinephrine. Meaning, the increased release of certain neurons during REM sleep can cause insomnia. What brings about this reaction is unknown. However, this study elucidates the importance of treating sleep as well as mood. It states that while most antidepressants focus on improving moods, they ignore REM sleep activity. A focus on brain activity during sleep could help psychologists better understand treatment options. 

Sleep patterns can also be disrupted by fatigue which can cause over-sleeping. At least 27% of patients with depression reported suffering from hypersomnia. Despite sleeping sufficient hours, patients reported that their sleep was not restorative. Fortunately, studies show that improved sleeping patterns decrease depressive episodes. 

A way to improve your sleep is to practice sleep hygiene or set a bedtime alarm. If your insomnia persists, talk to your doctor or psychologist about doing a sleep study and discuss possible solutions.  

• Food

Change in appetite is common for those with depression, but this symptom is not shared by all patients. According to the American Psychiatric Association, approximately 48% of depressed adults exhibited a depression-related decrease in appetite and only 35% reported a depression-relation increase in appetite. 

Neurological empirical data can further elucidate the relationship between appetite and depression. In those with increased appetite, researchers found more activity in the orbitofrontal cortex, a region responsible for encoding value to stimuli. However, those with decreased appetite showed no change. This was a significant finding because the large volume and blood flow towards the orbitofrontal cortex may be linked to the development of depression. In those with decreased appetite, they noticed abnormal activity in the interoceptive cortex and the dorsal mid-insula, hence lesser food pleasantness. 

There is no doubt that there is a link between mood and food. Food is often used as a way to socialize and your mood can impact your disposition to do so. Also, food can be a way to cope with unresolved emotions. Because depression can exist comorbid with eating disorders, please feel free to reach out to a licensed professional to discuss treatment. 

• Indecisiveness 

Depression has a surprising effect on your cognition. It makes it harder for you to focus and make decisions. For those with severe depression, antidepressants may help but it usually doesn’t. Studies have shown that under normal circumstances, our decision-making is based on a computational value of high utility.  

However, in a depressed state, strong emotions and incorrect predictions about the future disrupt our decision-making process. Emotions like hopelessness effect increase aversion to risk, make us more cautious and increase anticipatory regret making us passive decision-makers. Additionally, since you are more pessimistic in a depressed state, every decision feels riskier and like an end-all and be-all. 

When you are depressed, pessimism kills any opportunity. This compounded with the belief that failure looms on the horizon urges you not to choose. In a way, you are absolving yourself of any responsibility. Sometimes, not choosing is fine if you feel like choosing is causing you anxiety. But, eventually, there will be moments where you will have to choose. When these moments come, have a toolbox of techniques that can help you make decision-making easier. Talk with your therapist and come up with techniques.  

• Pain 

A surprising sign of depression is physical pain. Common symptoms are joint pain, limb pain, back pain, muscle ache, and gastrointestinal problems. There is a lot of research in this field, specifically the relationship between depression and fibromyalgia. 

Most research points to an imbalance of serotonin and norepinephrine as the possible causes of pain and depression.  

But, depression causes pain, and pain causes depression. Studies show that pain slows recovery from depression. One can not be treated without the other. Unfortunately, most patients only report the physical symptoms; hence physicians ascribe the symptoms to somatic illnesses leaving depression untreated. This is an incomplete treatment plan that does nothing to address the mood disorder causing pain. A holistic treatment of pain and depression can help improve a patient’s life and improve the likelihood of remission.

Though psychopharmaceuticals are used to treat both pain and depression, it is a good idea to couple treatment with other techniques such as talk therapy or stress reduction techniques. If you experience this pain as part of depression, discuss with your physician about possible treatment. 

• Lethargy

When we talk about depression, we often think about fatigue being a defining trait. However, fatigue is not just physical. It can also manifest through apathy, emotional distancing, or impaired concentration. Its manifestations are so varied that it is hard to tell whether you are depressed or just tired. However, what distinguishes normal fatigue and depression-related fatigue is will or desire. Most people dealing with depression-related fatigue have low-motivation and experience a loss of interest. They withdraw from daily activities and are often mislabeled as “lazy.”

On the other end, people are suffering from depression who are high functioning individuals. Though they seem productive, they experience all of the symptoms associated with depression. Regardless of how someone behaves, never assume what they are going through. Depression is an internal battle that a lot of people are not privy to. 

Remember that weather is different from climate– it always changes. There may be seasons, but they always pass. If you notice the winds are picking up and there is a storm looming on the horizon, find your crew. People who are are supportive and who will be there for you when the storm comes. Reach out to your doctor or therapist if you are experiencing or have experienced any of the symptoms mentioned above. 

Take care! 

Additional Sources

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