Depression is a common emotion experienced by all types of people. Young and old, male and female, rich and poor, depression hides from no one. However, recognizing depression is often difficult because it can look completely different from one person to another. Here are some of the ways you might recognize depression.

Depression in Men

Men are more likely to become irritable and agitated when depressed. They often have a difficult time experiencing and talking about their emotions. Most men will not recognize when they are depressed. Their loved ones and those around them may notice that they are short tempered, less willing to do things they normally do, more likely to become isolated and develop a “don’t care” attitude. They can experience a lack of energy, sex drive, and creativity. Also, they may exhibit disdain toward even the most important elements of their life. There are often changes in sleeping patterns, weight and personal appearance/hygiene.

In many cases, it is difficult for men to seek help for their depression. Males either think they can handle their emotions themselves, or they simply don’t recognize or acknowledge that there is an issue at all. Men frequently become defensive when told something is not right, or asked by love ones if they need help.

When talking to men about depression, it’s important to assure them that this doesn’t make them weak or in any way imply that they are less masculine. I often explain to men that depression is just like any other medical disorder. For instance, most men can identify that high blood pressure is a common medical problem that requires medication. “If you don’t take the medication for your blood pressure,” I explain, “it can lead to more severe consequences such as kidney failure, heart disease, and sometimes even death.” I go on to explain that depression is no different. It is not something you’ve caused. It’s not something you can hide from and without treatment depression can lead to potentially lethal consequences.

Depression in Women/Post-Partum Depression

Women are more likely than men to be diagnosed with depression in part because they are more willing to seek help for their emotions. Hormonal changes in women do not directly cause depression, but do correlate with changes in mood and emotions. In women depression presents in a more typical fashion. Most women will complain of low energy, fatigue, poor concentration, depressed mood, low interest and motivation, feeling the need to isolate from everyone, and will more easily endorse suicidal thoughts. To qualify for a major depressive episode these types of symptoms must be present for 2 weeks.

Pre-Menstrual Dysphoric Disorder (PMDD)

Pre-menstrual dysphoric disorder (PMDD) is a condition where women have severe depressive symptoms leading up to their menstrual cycles. Symptoms usually occur around 5-11 days prior to menstruation and resolve when or shortly after menstruation begins. Medications that can help treat depression (such as Selective-Serotonin Reuptake Inhibitors) can be used during part of the month or during the entire month given the severity of symptoms. Other medication that might help these symptoms are birth control pills, diuretics (for women with fluid retention), and pain relievers. Women with PMDD present very similarly to women with depression (as mentioned above), the main difference is the duration of symptoms, with PMDD having a shorter duration.

Post-Partum Depression

Post-partum depression is a unique type of depression occurring after a woman gives birth. This can happen in mothers who have a history of depression, but can also occur without any prior history. Pediatricians and OB-GYN’s provide regular screening of mothers for Post-partum depression at most clinics in the first few months after delivery. New moms will often have symptoms of increased crying, irritability, depressed mood, and feelings of inadequacy that could be concerning for post-partum depression, but could also be normal hormonal changes post-partum.

One of the most frequently used tools – The Edinburgh Postnatal Depression Scale – is used to screen mothers during what is usually a joyous time, but can be a horrific emotional experience. On this scale, a score of ten or higher is considered a positive screen. Close attention must be paid to question number ten which focuses solely on thoughts of harming oneself. In fact, even if the screen is completely normal, I also ask this one, important question to all new moms. It’s also important to educate these mothers on the safety of their newborn. I have come across moms whose depression is so severe that they have thoughts about hurting their newborns. It’s important to be aware of this serious complication and to talk to loved ones around you if you are concerned that they may be sad and/or lonely.

Depression in Teens

Depression can be difficult to diagnose in teenagers because we often think of them as “moody,” and they typically have a difficult time expressing their emotions. Teens are not experienced with new emotions and don’t know that they are depressed. Warning signs for teens include poor school performance, withdrawal from friends and activities they previously enjoyed, overreaction to criticism, agitation, changes in sleep or eat, substance abuse, and problems with authority.

Teens will often suffer silently. They do not want to be known as awkward and want to fit in with their peers. If they are feeling depressed or suicidal, they will most likely express themselves in unusual ways. These include new obsessions with death, poems and/or songs related to death and dying, giving away belongings, and changes in personality. Special attention should be paid to social media posts that suggest finality or saying goodbye. Facebook has started a page for reporting concerns for suicidal content that they then reach out to the person suspected of being suicidal.

Depression in Children

Depression in children is by far one of the most difficult conditions to diagnose because children are unique in the ways they express themselves. Depressed children might be easily irritated, annoyed, and shy. Many times they will present with physical complaints (such as abdominal pain, back pain, or headaches), refusing to go to school, easily argumentative, and overly tired.

Most parents are able to recognize a change in their child’s behavior. If you become concerned that your child is depressed, don’t wait. Bring your child to their pediatrician for evaluation.

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