Warning Signs of Depression
Most people can identify the common symptoms of depression, including (but not limited to) a depressed mood, tearfulness, withdrawal, irregular sleep patterns, loss of interests, and loss of energy. When you think of an example of a person who is depressed, you probably imagine the friend who stops returning your phone calls, ignores your texts, passes on invitations to get together, looks disheveled, rarely leaves their house, and has no energy when you see them in person. You are able to recognize that this person is withdrawing and may be on the verge of spiraling out of control. These are the people that you check on, you encourage them to seek help, and you realize your support is necessary for their well-being. However, are you able to recognize less common symptoms of depression? Has someone you know become more irritable, angry and hostile, or even started verbalizing their perceived shortcomings regularly?
The presentation of depression is often confusing because it is often masked by anger, hyperactivity, pain (e.g., headaches, stomachaches), fatigue, and/or irritability. Depression is often perceived as an expression of weak emotions. Many individuals do not want to admit that they are experiencing these emotional symptoms. So, they inadvertently switch this ‘weak’ emotion into a perceived ‘strong’ emotion, such as anger or irritability. Sometimes it is easier to become angry than to reveal the deep sadness that you are experiencing. Unfortunately, when an individual becomes angry at others, they create a vicious cycle of pushing people away (those who could offer support), questioning their actions (e.g., why did I do that?), developing self-deprecating thoughts (e.g., What is wrong with me? I can’t do anything right. No one wants to be around me), and then pushing people away again. Expressing anger towards others effectively protects the person from exposing and dealing with true depressive emotions.
Often when we come across someone who is irritable, we are less patient and may even avoid being around that person. Irritability is a more common symptom of depression in adolescents and males. A person who in the past was a pleasant person to be around, who is now constantly irritable and difficult to be around, may likely be experiencing a depressive episode. Similar to a person who is constantly angry, people who are irritable also drive those closest to them away. Even accepting family members and close friends have difficulty spending time with individuals who have a bad temperament. It can be exhausting but if you can understand that these symptoms are masking an extremely difficult circumstance that the person is having a hard time coping with, then maybe, you can demonstrate a little more patience.
Another less noticeable symptom of depression involves low self-esteem. Sometimes when a person is experiencing a period of depression that they are not effectively coping with, their attitude changes. You may notice that they are verbalizing negative feelings about themselves, such as “I’m terrible at this. I’m the worst mother ever. I’ll never be able to finish this. I’ll never get into college. I’ll never get a job. I should never have done that.” These negative statements may seem like harmless socializing between friends, but they may reveal some inner turmoil and a decline in self-esteem that may lead to increased symptoms of depression. In extreme circumstances, attitudinal symptoms may lead to suicidal ideation.
The onset of depression often follows stressful life events, trauma, or loss. Many youth and adults have experienced extreme stress in the past six months as a result of the pandemic that they may never have encountered before. Many people have not had their emotional regulation and coping abilities pressed to their individual limits. Current stressful life events may induce symptoms of depression in many individuals. Recognizing the obvious and not so obvious symptoms will help you be a better family member and/or friend. If you do identify warning signs of depression, the first step is to offer support to that person – listen. Let them acknowledge they need help and the ways that you can be supportive. If a person is angry and irritable, you may need reinforcements to get them the help they need. You can do this by searching local psychologists and therapists in your area and providing a contact list to the person in need. Also, recognize that people with any type of mental health disorder grow so accustomed to their symptoms that they assume that the way they are feeling is normal and do not seek help. The earlier the interventions begin, the more likely that symptoms will recede and/or become manageable. Reducing the atypical, interpersonally challenging symptoms of depression, such as anger and irritability, can lead to improved relationships and thus likely continued relational support for the individual coping with symptoms of depression.