It is possible to have only one episode of major depression in a lifetime. However, most people who experience depression have multiple episodes. These depressive symptoms are often very apparent to friends and family members. In spite of that, most people are not treated for a first episode of depression, and sometimes fail to receive treatment until the most pronounced symptom of depression, attempted suicide, presents itself.
Behavioral Changes Mark the Onset of Major Depression
Is your normally cheerful teenager suddenly sullen? Is your husband (or wife) more withdrawn, less inclined to share stories of home, work, or activities? Does he or she no longer enjoy former activities that used to bring great pleasure or contentment? Or has your child or life partner lost his/her appetite for food as well as enjoyment? Is there insomnia, changes in affect (slowed thinking, speaking or acting), or unexplained aches and pains? If so, you may be witnessing the onset of depression, though more than likely it’s actually the first visible episode of depression.
Teen Depression Symptoms
The most obvious symptoms of teenage depression include:
• Irritable, angry or hostile behavior
• Sadness and/or tears for no apparent reason
• Physical and emotional withdrawal
• Loss interest in former hobbies or interests
• Visible, sometimes dramatic, changes in eating and sleeping habits
Parents and professionals need to remember that many of these distinguishing characteristics of depression can also indicate drug or alcohol use.
Adult Depression Symptoms
Adult symptoms of depression include some of the above (i.e., loss of interest, sadness, change in eating habits, and irritability), as well as difficulty concentrating, remembering and making decisions. Depressed adults may also experience feelings of guilt or failure, lose interest in sex, and avoid intimacy. Depressed individuals of either sex may exhibit a marked decrease in energy (sleeping a lot) and demonstrate excessive fatigue even in the absence of physical exertion. This last, however, is also a clear symptom of illness.
Depression in the Elderly
In addition to some of the depression symptoms experienced by teens and younger adults, older people may develop drug or alcohol dependencies that did not exist before. Depressed seniors may also experience significant sleep disturbances, ranging from oversleeping to an inability to fall asleep, stay asleep, or stay awake during meals and other absorbing activities.
In all groups, thoughts of suicide will eventually dominate, and the greatest risk is that severely depressed individuals may not even express the wish to kill themselves. In many teenagers, and some adults, highly aggressive “terroristic” behavior may signal states of depression with so few symptoms (or such guarded behavior) that no one suspects until some trigger provokes an event like the Columbine school shooting of 1999 in Littleton, Colorado.
The final, telling symptom of depression in older people is increasing physical pain, either from already-present illnesses like arthritis, or from newly voiced physical complaints like headaches, shortness of breath, stomach distress and the like. Always consider whether these pains may be related to depression, or whether they signal a disease process.