Content

• To step
• Part 1 of 3: Learning about the signs of depression
• Part 2 of 3: Finding the cause of depression
• Part 3 of 3: Treating your depression
• Tips
• Warnings

Depression is a long-term problem that usually goes on for months or years if left untreated. You can suffer from it if you have trouble functioning in your daily life, or if you regularly experience negative emotions, whether or not you know the immediate cause. No two people with depression are alike, so don't expect to have every symptom on this list; read the entire article to learn how closely each is linked to depression. If, after reading the signs, you expect to be depressed, continue reading to determine possible causes you can work on and find ways to recover from this condition.

To step

Part 1 of 3: Learning about the signs of depression

1. Understand the relationships between depression, anxiety and bipolar disorder. Most people with depression or an anxiety disorder also experience some of the symptoms of the other condition, but identifying the primary problem can treat that as well. Bipolar disorder, on the other hand, is another condition that is easily confused with depression, but requires specialized medication. Please read these descriptions carefully before continuing:
   • Depression is a medical condition characterized by overwhelming negative emotions that last longer than ordinary sadness and intervene in your life. If left untreated, it can persist in mild or moderate form for years ("dysthymic disorder"), or for severe periods of about six months ("major depression").
   • People who suffer from an anxiety disorder feel overwhelmed with worry and fear. The symptoms below include signs that could also be a sign of an anxiety disorder. Additionally, panic attacks, cold or sweaty hands, or obsessive thoughts are symptoms of an anxiety disorder, not depression. If you have a mix of both, the treatment section still applies.
   • Bipolar disorder causes major depression to occur for several weeks or more, but then gradually changes to a manic period instead, with reckless behavior, racing thoughts, and lots of energy. If you experience this cycle, you should report it to a doctor immediately. Bipolar disorder must not being treated with antidepressants.
2. Investigate your persistent showers. Depression is a medical condition that prevents the brain from regulating its emotions. Everyone feels down from time to time, but people who suffer from depression regularly experience one of the following emotions or moods, or a combination of these.
   • Sadness. Are you often sad or despondent?
   • Emptiness or numbness. Do you feel like you have no emotions at all, or are you having trouble feeling anything?
   • Hopelessness. Have you felt tempted to "give up," or had trouble imagining an improvement? Have you become more pessimistic since you started to suspect depression?
   • If these are your most common moods, or if they prevent you from functioning in your daily life, then you will likely benefit from treating your depression.
   • If you are trying to diagnose other people, realize that they can hide these emotions or not even admit them to themselves. In that case it may be appropriate to give more weight than normal to the external symptoms as described further below, especially mood swings and irritability.
3. Identify thoughts of death, self-harm, or suicide. Severe depression or anxiety often causes gloomy thoughts about fantasies, but different patients often show this in different ways. If any of the following applies to you, you should start treating your depression:
   • You wish you were dead.
   • You think the world is better off without you.
   • You intentionally hurt yourself.
   • You fantasize about hurting or killing yourself, or planning how you would do it. People with fears sometimes have similar experiences, imagining a death that they fear or worrying about becoming suicidal.
4. List activities that you have given up or no longer enjoy. Depressed people often give up their hobbies, stop spending time with friends, or feel like having sex. If your friends have stopped inviting you, they may respond to your lack of interest or repeated rejection.
   • If you are not sure if this applies to you, make a list of the activities you participated in regularly before you started to feel worse, and estimate how often you did each activity. For the next few weeks, make a note of when you do any of these activities and see if it is significantly less.
5. Identify other changes in your energy level and state of mind. Depression can have opposite effects in different people. Are you restless, unable to concentrate and extra touchy? Or have you become tired, unable to perform routine tasks and tend to avoid active movement?
   • Do you snarl at people or get into arguments for no good reason? A shorter fuse is another example of a mood shift that is sometimes triggered by depression, especially among men and teenagers.
6. Be on the lookout for crying and changes in taste. Sudden weight gain or weight loss can be a sign of many medical conditions, but even if depression is not the cause, you should still make an appointment with a doctor. Frequent crying, combined with some of the above symptoms, can indicate depression, especially if you are not sure why you are crying.
7. Consider whether your feelings of guilt or worthlessness are proportional. It can be difficult to be objective about your own emotions, but compare your behavior to that of the people around you. Do you feel a lot of guilt about small mistakes, events that no one blames you for, or things that you have no control over? Do daily activities make you feel worthless or useless?
   • If you answered "yes" to these questions, but the symptoms do not describe you well, consider asking a doctor for advice about anxiety disorders instead.
8. Have mysterious aches and pains investigated. If you have unexplained headaches or other pains on a regular basis, ask a doctor for advice. A medical condition is likely to blame for this, and depression is a likely possibility if you are a (young) teenager to which some of the other symptoms also apply.
9. If you are still unsure, look at these other symptoms. If you are still unsure whether you have depression, these other problems could be additional signs. However, these symptoms can have many other causes as well, so don't worry too much if they are mild or your only symptoms:
   • Difficulty sleeping or waking up earlier than usual, especially when combined with restlessness and touchiness.
   • Sleeping too much, especially when combined with low energy and avoiding activity.
   • Difficulty making small decisions, especially if the attempt already leaves you feeling overwhelmed and hopeless. This can also manifest itself as not being able to focus long enough to make the decision.

Part 2 of 3: Finding the cause of depression

1. Understand the typical causes of depression. Depression is a complicated condition, and there are no simple tests that doctors can do to see if you have it. However, if anything on this list applies to your life, that information can help you, your friends, or your therapist work on your recovery:
   • Trauma and grief. Abuse or other violent experiences can cause depression, whether they have occurred recently or otherwise. Grief after a friend's death or other traumatic event can progress to full-blown depression.
   • Stressful events. Sudden changes, even positive ones such as getting married or starting a new job, can be responsible. Longer-term stress from caring for a sick person or going through a fighting divorce are also common causes.
   • Health status. Chronic pain, thyroid disease, and many other medical conditions can cause depression, especially if you have a long battle with an illness.
   • Medication and substances. Read the package insert for any medication you are taking. Avoid alcohol and other drugs to see if your symptoms improve depressed people often misuse substances, which makes the problem worse.
   • Heredity. If your biological relatives are or have been suffering from depression, you are more likely to get it too.
2. Know how different groups typically respond to depression. Certain demographics are more at risk for depression than others and show different signs. Learn about how depression manifests itself in these categories of similarly affected people. Especially if you are trying to identify it with someone else by external signs:
   • Women are twice as likely to become depressed as men, in part due to more extreme hormonal changes. Keep track of your symptoms of depression to see if they are related to your period, menopause, pregnancy, or delivery.
   • Men have a lower risk of depression, but a higher risk of suicide. In many cultures, they are less likely to recognize emotional changes and may need to be diagnosed by other symptoms, especially increased irritability and violence, drug abuse, and sleep problems.
   • Teens will also be less likely to show or admit grief. More often they will respond to depression with anger, touchiness and / or drug abuse.
   • Older people are more likely to complain about physical problems than mental or emotional problems and as a result, depression can be hidden for a long time. Be aware of physical changes, death of friends, and loss of independence that can cause depression.
3. If you recently gave birth, find out when the depression started. New mothers often experience mood swings, touchiness, and other symptoms that can range from mild to severe. If your depression started after birth or at some point in the next few months, you could have postpartum depression.
   • Most new moms experience "baby blues" symptoms for a few days, and then recover on their own. This is likely due to hormonal changes and postpartum stress.
   • If you are having suicidal thoughts, or if the depression is preventing you from looking after your baby, or if the symptoms persist for more than two weeks, see a doctor right away.
   • Postpartum psychosis is a rare condition that can develop within two weeks of giving birth. If your depression symptoms are severe and are accompanied by extreme mood swings, thoughts of harming your baby, or hallucinations, go to a hospital right away.
4. See if your depression is related to fall or winter. If your symptoms develop as the days get shorter and darker, your depression could be winter depression caused by too little sunlight. Exercise outdoors during daylight hours to see if you improve, or ask a doctor for light treatment.
   • Not all temporary depressions are winter depressions. Many people have periods of depression that occur every few weeks, months or years.
   • If you are extra manic and energetic when you are not depressed, tell a doctor you may have bipolar disorder.
5. Don't dismiss your depression if none of these causes apply. Many periods of depression have a primarily biological or hormonal cause, or one that is difficult to identify. This does not make it any less serious or less worthy of treatment. Depression is a real medical condition, not something to be ashamed of because you don't think you have a reason to be sad.

Part 3 of 3: Treating your depression

1. Ask for help. Realize that your feelings of helplessness are part of your affliction, not reality, and that isolation carries those feelings. Friends and family can help by listening to your problems, encouraging you to do something about them, and supporting you through the most difficult moments.
   • If you are having trouble being active or leaving home, let your friends know that you are depressed and encourage them to keep inviting you to activities that you enjoy, even if you don't make it every time.
2. Nurture good friendships. If you don't have anyone in your life to support you, learn how to connect and make friends with people. If someone in your life is making you stressed or unhappy, avoid them.
   • It's important to find a support group, so make this your priority. If you wake up feeling like you're having a better day than usual, cancel your plans and spend the day at a social event or reaching out to old friends.
   • Try to join a club of people who share an interest with you, or even a group you have never thought of before. A regular appointment such as a weekly dance night or book club can make it easier to get into the habit of attending.
   • If you're too shy to talk to strangers on any of these occasions, a smile and eye contact can be enough to start a conversation. Find a smaller group or one with people you are comfortable with if you have serious anxiety about it.
3. Make healthy lifestyle changes. Getting plenty of sleep, regular exercise, and a healthy diet are all vital for lowering stress and encouraging a healthy emotional state. Consider meditation, massage, or other relaxation methods.
   • Use your support network. Seek exercise advice from the professionals at your sports club, discuss relaxation methods with your faith counselor, or ask a friend or roommate to help you create and stick to a schedule.
4. Address the cause. If any of the steps in the finding the cause of the depression section match your experiences, try to address them directly and treat your depression at the same time. Eliminating the underlying cause can be an extremely effective way to treat depression.
   • When you are grieving, talk about your grief with friends, family, and mentors. Seek counseling to help you through the process.
   • If you've recently undergone a major change, try to find out which parts of the change made you unhappy and reverse them. If you've moved to a city where you don't know anyone, call your old friends, try to find new friends, or move again to an area that you feel more connected to. If you thought you would like the change and are unsure why you react with depression, talk to a counselor.
   • If you suspect your depression is related to your menstrual cycle or menopause, speak to your doctor and ask about treatment options.
   • Consult a doctor, counselor, or specialist support group if you have a chronic illness or a drug or drug abuse problem.
5. Get a diagnosis - or two. Try to be open and honest with your doctor about your symptoms and contact him again if there are any changes. If he is prescribing medication to treat your depression, it is wise to see a second specialist, especially if he seems distracted or spends little time with you.
   • Your doctor will not necessarily prescribe medication. If she thinks there is a specific cause for your depression, she will recommend an action plan or lifestyle change instead. Referral to therapy is also common, and does not mean the doctor thinks you are crazy.
   • If your depression lasts for only a few weeks and is gradually replaced by "high" bouts of reckless energy, ask your doctor to consider bipolar disorder before taking any prescription medication.
6. Get therapy or counseling. There are many types of therapists or counselors who can help you recover. If you don't have a counselor at the moment or if his efforts aren't helping, find a cognitive behavioral therapist or ask a doctor to recommend one. This style of therapy has the best evidence for successful depression treatment.
   • Try to ignore the stigma on therapy. It is an effective option to aid in your recovery, not a sign of weakness.
   • Cognitive behavioral therapists work to identify the thought processes and behaviors that keep your depression going, and then teach you how to adjust them. The process can take several sessions but will be faster and more effective the more open and willing you are about participating.
7. Take antidepressant medications. Once you are sure of your diagnosis and have started taking steps to fight the depression, ask your doctor if medication is a good idea. Your doctor can prescribe antidepressants even if he thinks your main problem is an anxiety disorder, as they can also be effective in treating these conditions.
   • Give the medication time to work. If you do not experience changes after a few weeks, or if you cannot cope with the side effects, ask your doctor for a different medication.

Tips

• Be prepared to improve in "baby steps". Don't expect it to improve immediately after identifying your problem, but spot small improvements and performance along the way.
• Depression is no small matter. It is a real disease that needs to be treated and cared for just like any other disease such as thyroid disease or the flu. Just because depression isn't always physical doesn't mean it's something you get over by sheer willpower. Seek help and treatment.

Warnings

• If you are depressed, some of your friends may try to put your symptoms aside or tell you that you can handle it. Explain to them that you have a medical condition and are not in full control of your emotions. And avoid them if they persist.
• If you suspect a friend is considering suicide, don't be afraid to talk directly to him about it.
• If you're considering immediate suicide or serious self-harm, check this website for help in the Netherlands or this one for suicide hotlines in other countries.