Doctors begin to talk about depression once several of the following symptoms manifest during most of the day for a period of at least two weeks:
- intense sadness (emotional pain);
- diminished or absence of interest or pleasure in usual activities;
- diet issues: loss of appetite and weight, increased appetite and weight gain, bulimia;
- difficulty sleeping: insomnia or, the opposite, the tendency to sleep too much;
- loss of libido;
- fatigue and loss of energy characterised by sluggishness, even without particular exertion;
-feelings of guilt or of worthlessness;
- difficulty concentrating or memory problems;
- cognitive decline;
- dark or suicidal thoughts.
Other symptoms may arise in certain patients, such as:
- anxiety of varying intensity and duration, often present upon waking up, and which may get better over the course of the day;
- “functional” symptoms: palpitations, headache, generalised or localised pain, soreness, cramps, muscle tension, digestion problems etc.;
- personality problems: irritability, aggression, temper tantrums, touchiness, hypersensitivity to rejection;
- withdrawal, avoiding others and personal contact;
- excessive consumption of alcohol or drugs.
Sufferers of depression can become occupied with endless brooding, which can cause them to have the same thoughts over and over again throughout the day. They might feel useless, have no desire to do anything, not show any interest in their loved ones, feel powerless and, in the worst case scenario, may want to withdraw from society and might even have suicidal thoughts.
The medical approach to depression is a delicate issue, as it is often a hidden illness. The diagnosis is often taken badly by the patient, with this lack of acceptance and refusal to have to “change” or control their life by taking medications meaning that they potentially do not comply with their treatment regimen. Globally, depression is underdiagnosed and insufficiently treated, despite effective psychological and pharmaceutical treatment strategies being available.
DEPRESSION: DIFFERENCES IN MANIFESTATION AT DIFFERENT AGES
The symptoms of the illness differ depending on the age of the patient. In children or adolescents, personality problems often occur, such as irritability, aggression or difficulty concentrating. There are sometimes diet issues, for example food restriction or, the opposite, episodes of bulimia. Adolescents with depression are at increased risk of taking drugs.
In elderly patients, the symptoms of depression are often tricky to recognise. The apathy, lack of enjoyment in doing things they used to enjoy or even apragmatism (lack of motivation) observed in elderly patients are often accredited to ageing and the diminished capacity to do the tasks and activities they did before. In addition, elderly sufferers of depression wanting to end their life is relatively common but difficult for others to spot, especially in patients who live in an institution or who are isolated.