Five things to know about depression, and symptoms you may be overlooking

If you've struggled with depression, you're not alone. It's the most common mental health issue facing adults, and, as of 2021, it affects nearly one in three in the United States—a prevalence rate that has more than tripled in the last two years.

This dramatic increase in diagnoses has clear links to the COVID-19 pandemic's beginnings in the early months of 2020. But a glimmer of hope cuts through the darkness depression can bring: 80% of those who seek treatment experience an improvement in their symptoms within four to six weeks.

As promising as treatment can be, roughly two-thirds of those experiencing depression symptoms do not seek help. To encourage all members of the Case Western Reserve University community to take inventory of their own mental health, and to promote more informed conversation on the topic, The Daily sat down with two experts from University Health and Counseling Services (UHCS). Naomi Drakeford, Ph.D., associate director for diversity, equity and inclusion, and Hillary Jones, associate director of counseling services and a licensed professional clinical counselor with supervision designation, gave insight on depression symptoms so those potentially unaware of their diagnosis can, after treatment, experience life to the fullest.

Follow along to learn what Drakeford and Jones consider five of the most common misconceptions about depression—and what you need to know.

1. Depression is more than just sadness

A depressed mood is the most common symptom of depression—you might be feeling down and tearful, and it may be difficult to get out of bed. However, it is also very common for an individual suffering from depression to appear high functioning and still perform daily tasks, but it takes more energy—and events and hobbies may not offer the same enjoyment they once did.

Normally, an individual may be able to get through their work day and then go to the gym, make dinner, meet with friends. Someone experiencing depression, however, may get through their work day and feel like they just can't do one more thing. Or, they may muster up the energy to go to that dinner with friends, but they just can't seem to have a good time like they usually do.

2. Depression can cause one to isolate

A symptom that can show up often in students is withdrawal or isolation. For students who are extroverted and very social, this symptom is easier to recognize. But, for those who might not be as outgoing, or who identify as introverted, this is sometimes a harder piece to identify. Something that can help expose this symptom is to ask yourself: What is my alone time doing for me? Is it actually recharging me or is it draining?

3. It might be more than just fatigue

Often depression can show up as fatigue and folks don't know to recognize this as a symptom. They will head to the doctor's office to get their thyroid checked, or assume they are just not getting enough sleep when, in reality, they might be experiencing depression. Combine this fatigue with difficulty concentrating and difficulty making decisions, and life gets to be just too overwhelming.

For example, an individual may make decisions all day at work or work hard to focus in class, and then finally get home—only to decide what to have for dinner. Decisional fatigue caused by depression can mean that this person is so exhausted from their day that they skip dinner because they couldn't make one more decision.

4. Depression is physical, not just mental

As mentioned earlier, depression can cause fatigue and difficulty concentrating. There can also be changes to sleep and appetite. For some people, depression can cause insomnia while others may sleep 10 to 12 hours a day and still feel tired. And, those suffering from depression may experience an increase or a decrease in appetite.

Depression can also manifest in a slowness, either cognitive or physical—walking more slowly, feeling as if you are weighed down or moving through water. Some people even describe it as if they have weights on their feet.

5. Depression exists on a spectrum

When discussing major depressive disorder, the clinical term for depression, it is important to recognize that individuals can experience it as mild, moderate or severe. Though someone may not be experiencing severe symptoms, this doesn't mean that those symptoms are not worth addressing. And, an individual's experience of depression can fluctuate on this spectrum—making it even more important to address mild symptoms as soon as they arise.

Depression, as with almost anything, can be experienced very individually. One person's manifestation of depression may be completely different from another's. Layers of identities, experiences and cultural pieces affect not only an individual's depression symptoms but also how they communicate those symptoms.

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