Depression affects different people in different ways. Some people may present predominantly with physical symptoms such as backache, headache or stomach complaints that do not respond to treatment.

Others may complain mostly of disturbed sleep, loss of energy and appetite changes. Not everyone experiences all the symptoms of a depressive or manic episode. The severity of symptoms may also be different in different people.

These many different presentations can sometimes make it difficult to recognise and diagnose a depressive disorder. A sufferer may not seek medical help because they may not realise that they are suffering from depression and that it is a legitimate medical illness.

The most commonly reported symptoms are as follows:

 
• a depressed or low mood or feeling of sadness;  
• increased irritability;  
• increased anxiety or a feeling of nervousness;  
• loss of interest or pleasure in activities that were previously enjoyed;  
• tearfulness or a feeling of wanting to cry but possibly an inability to do so;  
• decreased sexual interest or other sexual problems;  
• changes in appetite resulting in either weight gain or weight loss when not dieting;  
• changes in sleep pattern with either difficulty falling asleep, frequent waking during the night or waking up unusually early in the morning and not being able to return to sleep. Sleep may also be increased with a desire to be asleep most of the time;  
• a feeling of being chronically tired and energyless or amotivated;  
• a slowing down or speeding up of physical activity (including speaking very softly or slowly);  
• feeling worthless, useless and helpless;  
• feeling inappropriately excessively guilty (and possibly blaming oneself for being depressed or unable to “snap out of it”) ;  
• difficulty thinking, concentrating or remembering;  
• difficulty making decisions, even over simple matters;  
• a feeling that life is not worth living and frequently thinking about death and/or suicide;  
• becoming increasingly socially withdrawn and feeling reluctant to entertain or go out visiting;  
• not bothering to dress properly/self-neglect;  
• multiple physical complaints e.g. frequent headaches; backaches/stomach aches or constipation;  
• alteration in menstrual cycle;

Anxiety symptoms are also often experienced by persons suffering from a depressive disorder (in up to 90% of cases) and these include nausea, dizziness, breathlessness, heart palpitations, feeling worried and fearful, being tremulous or shaky, feeling sweaty, experiencing pins and needles in the hands and around the mouth or frequently having a runny tummy and passing urine often.

If you have been feeling low or irritable together with several of the above listed symptoms for at least two weeks you may wish to complete a self-evaluation questionnaire to see whether or not you are depressed.