The Main Characteristics and Symptoms of Depression
Depression is one of the most common psychopathological conditions. However, feeling sad or down isn’t enough to diagnose depression, as there are other criteria that are also important, such as anhedonia or loss of interest, as well as a vision of the world that’s full of negativity or pessimism. The truth is that the symptoms of depression can be very varied, depending on the person affected.
On the other hand, it’s important to differentiate depression as a symptom, present in most psychopathological pictures and other medical conditions, and depression as a disorder. Let’s go deeper.
Symptoms of depression
Depression is a very complex reality that can manifest itself through the following symptoms.
Emotional symptoms
Sadness is one of the most frequent symptoms, although frustration and irritability also tend to appear. In the most serious cases, the person denies that they’re like this, but, in turn, states that they’re unable to feel anything.
Another characteristic emotional symptom is the feeling of emptiness, of loss of meaning. Nothing fills or satisfies you.
Motivational symptoms
People with depression are usually in a state of inhibition in which symptoms such as apathy, indifference, and lack of interest or motivation, among others, predominate. They have stopped enjoying activities that used to be pleasant, losing interest in everything. For them, doing simple things, like getting out of bed, are impossible tasks to do.
For this reason, it’s common for them to drop out of school, work, or have serious difficulties in making decisions. With such low energy levels (central catecholamines and serotonin) the cost per unit of effort is so great that it takes so much energy to carry out any activity.
Cognitive symptoms
The depressed person’s assessment of themselves and their environment is negative due to the presence of negative cognitive biases to interpret reality. In this way, their self-esteem is also affected.
Hopelessness (a pessimistic vision of the future) is always present, which can lead to suicidal ideas in some cases. Paradoxically, the greatest risk of suicide doesn’t occur during the most serious moment of the depressive episode, but a few months after the remission of symptoms.
Physical symptoms
These are very common and are usually one of the main reasons for seeking professional help.
Among the most common are insomnia (especially terminal), hypersomnia (excessive sleepiness), fatigue or loss of weight and appetite. A decrease in sexual desire can also occur as well as alterations in the sexual response, such as impotence in men or anorgasmia in women, among others.
Diffuse complaints like headaches, constipation, or nausea are quite common in depression. These symptoms mean that, on many occasions, general practitioners are the first to receive these patients.
It seems that the symptoms in people who see a specialist are different from those who don’t. So, while the mood in both groups is similar, those who go to a health professional have greater somatic symptoms. Therefore, the presence of these types of symptoms could be considered as the dividing line between “normal” depression and “clinical” depression.
Many professionals, especially psychiatrists, argue that approximately half of depression disorders can appear in a masked way in the form of a somatic illness. However, the concept of masked depression is confusing and difficult to prove empirically.
Psychomotor symptoms
Depression is usually accompanied by a decrease in general activity. Severe forms are usually accompanied by psychomotor retardation. It’s a generalized slowing down of motor responses, speech, gestures, etc.
In some cases, states of almost total silence or inactivity (depressive stupor) may appear similar to the catatonic states of schizophrenia. Although states of agitation and restlessness may also appear.
Discover more here: How to Help a Person with Depression
Other symptoms
Anxiety can appear as a symptom in depression, making it difficult in some cases to differentiate whether it’s an anxiety or mood disorder, since their symptoms overlap and they both respond to the same drugs (SSRIs).
Therefore, it can be difficult to make a differential diagnosis between the two. Furthermore, the most common psychopathological condition in the community setting is mixed anxiety-depressive disorder, included in the WHO’s ICD.
Attention and memory biases
Attentional problems prevail in anxiety and memory problems in depression. Specifically, people with anxiety have a great facility to associate neutral or ambiguous signals with alarm-fear reactions. This is partly due to their great attentional hypervigilance and sensitivity to danger.
People with anxiety have an attentional bias that operates automatically in the processing of information. In fact, they perform better in attention-based tests (surveillance, selection, etc.).
In depression, the person tends to remember and interpret reality in terms of their negative mood, hence it’s more related to memory problems. On the other hand, the lack of positive affection typical of depression has its cerebral correlation in the left frontal activation deficit.
So far, the differentiation between anxiety-depression is problematic, but let’s see what happens in the posterior brain areas. Depression suppresses the parietotemporal right hemispheric function, which is what is activated in states of emotional processing (eg, involved in the face processing), while anxiety increases the activation of this area.
Interpersonal functioning
Interpersonal and social relationships are disturbed. Depression is associated with rejection of others and a worsening of social behavior.
Some people with depression have prior deficits in this area, and, in others, interpersonal efficacy decreases as a result of this disorder. This low social ability makes interactions unsatisfactory for others, being associated with negative responses on their part.
If we take into account the perspective that affirms that interpersonal relationships are maintained by an exchange of reinforcers, then in the case of people with depression, others lose the motivation to interact with them because they contribute so little with no reinforcers.
This causes a decrease in their social behavior and creates a vicious circle that worsens relationships and favors rejection behaviors.
An important aspect is that inadequate interpersonal functioning is considered a predictor of a worse course of depression.
Final comments about depression
Depression is associated with an increased risk of morbidity and mortality (in some studies up to four times higher) from various diseases, leading to more early deaths.
The risk of suicide is 21 times higher in people with depression. Specifically, in Europe, it represents more than 7% of premature mortality, in addition to being considered the main cause of disability in the world by the WHO.
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