What Depression Looks Like: Signs, Symptoms, And Treatments

Depression is a mental illness that is often misunderstood. Advertisements for depression medication and movies that touch on this illness often portray individuals living with depression as all experiencing the disorder in the same way. In reality, however, depression can look different in different people. Below, we’ll explore depression, the various ways it can manifest, and some evidence-based treatment options to consider if you’re experiencing symptoms. 

What is depression?

Depression is a term that is often used in multiple contexts—sometimes casually—which can make it difficult to determine if someone is really experiencing or referring to diagnosable, clinical depression or not. 

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lists several types of diagnosable depression, including the following:

• Major depression
• Persistent depressive disorder
• Postpartum depression
• Seasonal affective disorder
• Disruptive mood dysregulation disorder
• Premenstrual dysmorphic disorder
• Substance/medication-induced depressive disorder

Some people may also think of depression when bipolar disorder is mentioned. While some people living with bipolar disorder may have depressive episodes, this isn’t the case for everyone—and regardless, depression and bipolar disorder are distinct illnesses.

What depression looks like: key diagnostic criteria

Many people may believe they can recognize depression in others, but this assumption is incorrect and can even be dangerous. Only a licensed mental health care professional or doctor can diagnose depression, as there are specific criteria that have to be met for a person to receive such a diagnosis. 

That said, people who are concerned about a loved one’s mental health might benefit from becoming familiar with the official criteria for major depression as listed in the DSM-5. If they notice some of these signs in their loved one, they might encourage them to seek a depression evaluation and mental health help.

The following list of depression criteria from the DSM-5 includes notes that are intended to guide clinicians as they assess a person’s symptoms: 

“A. Five (or more) of the following symptoms have been present during the same 2-

week period and represent a change from previous functioning; at least one of

the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do not include symptoms that are clearly attributable to another medical condition.

1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).

3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)

4. Insomnia or hypersomnia nearly every day.

5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

6. Fatigue or loss of energy nearly every day.

7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for dying by suicide.

B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

C. The episode is not attributable to the physiological effects of a substance or another medical condition.”

These guidelines refer to symptoms of a major depressive episode. They go on to state that these symptoms must not be attributable to another mental health condition or a physical health condition or as a response to a significant life event like the death of a loved one.

How can depression symptoms vary?

For example, some people may experience more of a depressed mood, whereas others may experience anger or more cognitive symptoms like trouble concentrating. Still others may not have many symptoms that are noticeable to others. Some people living with depression might also dive into their work and remain highly productive, which can make it difficult for friends and family to notice that they are experiencing signs of depression.  

What are mental health treatments for depression symptoms?

If you’re living with signs of depression, it’s recommended that you seek professional care. Treatment for depression symptoms may involve a combination of medication and therapy, depending on the individual. If one treatment doesn’t work for one person, it may work well for another. There are multiple options that a physician, therapist, or psychiatrist may recommend to help someone find a personalized way to treat depression that works for them.  

Medication for symptoms of depression

In some cases, a person living with depression may be prescribed one of several medications, typically in conjunction with talk therapy. Some people may benefit from selective serotonin reuptake inhibitors (SSRIs). Other people may benefit from serotonin and norepinephrine reuptake inhibitors (SNRIs). If one medication doesn’t work, another may work better depending on the individual. Remember to not start, stop, or change any medication without consulting your doctor.

Therapy for signs and symptoms of depression

Most people living with depression may benefit from talk therapy, either alone or in tandem with medication. Many therapists use the cognitive behavioral therapy (CBT) methodology to help clients learn to identify and challenge distorted thoughts. Interpersonal therapy and psychodynamic therapy are some other modalities that may be recommended for people experiencing depression. Keep in mind that a person doesn’t have to have severe depression to benefit from therapy for this condition. Therapists can help with many types and grades of depression as well as a variety of other mental health disorders, symptoms, and challenges. 

Exploring online therapy for depression symptoms

Some people living with depression may not feel well enough to leave home at times. Others may not feel comfortable speaking about their symptoms with a professional face to face in an office setting. In these cases, online therapy can serve as an effective alternative to in-person therapy. Online therapy allows people living with depression to connect with a licensed mental health professional via phone, video call, live chat, or a combination of these methods—all remotely, from home or anywhere they have an internet connection. Online therapy also tends to be more affordable than conventional in-person therapy without insurance. 

Does online therapy work for depression and other mental health conditions?

Over the last decade, many studies have looked at the effectiveness of online therapy for addressing various mental illnesses, including depression and anxiety disorders. Among others, one meta-analysis published in 2020 suggests that online therapy may be even more effective than traditional in-person therapy for treating symptoms of these conditions in many cases.