Manifestations of Depression Steve's Articles

Manifestations of Depression

Manifestations of Depression

Steven G, Rise, PhD, LCSW-R

Why is it so important that we understand the dynamics of this issue?

  • About 5% of the total US population is medically diagnosed with depression, and many times that number experience depression but will never get the help that they need.
  • The majority of all Americans will experience serious depression at one time or another in their lives.
  • Depression is the #1 mental health problem in America.
  • Depression strikes women twice as often as it does men.
  • Depression is three times more prevalent in higher socioeconomic classes than in lower socioeconomic classes.
  • Depression has much more to do with anger than it has to do with sadness.[1]

Chances are, even if this deep, dark, silent, painful, assumed shameful burden does not fall upon you, it will probably be experienced by someone close to you.  The more that one knows about depression, the more he or she can recognize the symptoms, recover from its effects, grow from the experience, and prevent it from returning.[2]


This section will highlight some of the ways in which people show their depression. See if you can identify any of these symptoms as your natural response or the symptoms you can recognize in others.

~Moodiness. Moodiness is the category of symptoms that most people associate with depression: a sad facial expression, frequent crying or moping about, downcast features (they look sad, have slumped posture, look down, etc.), and a look of discouragement and exhaustion. Depressed people often lose interest in their personal appearance, and the more seriously depressed individual often appears unkempt and un-bathed.

~Painful Thinking. Painful thinking often causes a depressed person to be introspective in a very self-defeating, self-blaming way. The individual may agonize over past mistakes and focus on “what-if” and “if-only” thinking patterns, and may wallow in guilt even if he or she is innocent of the self-accusations. The depressed individual also tends to take an exaggerated view of his or her problems; and will bitterly condemn him or herself, or others, for those problems that they are experiencing.

Painful thinking often centers around guilt. This guilt is sometimes authentic (the result of actual mistakes and sin) and sometimes it is false guilt (blaming oneself for actions or consequences of which one is innocent or that could not be helped). If the depressed individual could think realistically and objectively, he or she would realize that the situation was outside of his or her control.

Furthermore, this person is angry about the past, negative about the present, andgloomy about the future. It seems as thought the problems and pain will go on forever. The depressed person who is caught up in painful thinking usually loses motivation and interest in previously enjoyable activities. He or she may begin to avoid people, and this self-imposed isolation serves to increase the pain and depression; which may cause an emotional, spiritual, social, and physical downward spiral.

~ Physical Symptoms. Negative mental and emotional activity in the brain stimulates the production of brain chemicals that affect body functions. Sleep is affected; sometimes individuals have trouble falling asleep, but more often, the person awakens during the night and has difficulty falling back to sleep. During waking hours, body movements usually decrease, and signs of physical exhaustion are often visible; appetite and body weight are affected too; the person may over or under eat. Digestion may also be affected; this may be to either extreme, constipation or diarrhea. Additional physical manifestations of depression may

include a lack of sexual interest, tension headaches, dry mouth, irregular heartbeat, and anxiety.

An important point to remember is that depression manifests itself differently in children. Depression in children is common following a major loss or disruption in life as with the loss of a parent, a pet, or a beloved object; or a move to a new house. The depression may take the form of withdrawal, prolonged sadness, and a marked increase or decrease in the child’s activity level. During adolescents, the teenager may become hostile, irritable, and rebellious. They may also experience significant feelings of guilt because of their poor choices in responding to the social pressures that they are faced with, in addition to the depression itself.

Depression in the elderly may have a few special considerations as well. Even though the more mature are marked by the same symptoms as other adults, there may be special issues that center around the issues of loss which are common with advancing age. Losses tend to cluster together and tend to take on symbolic meaning for a person who is approaching the end of his or her own life.

Finally, special consideration needs to be given to women who are experiencingpostpartum depression. This is most easily defined as the “blue” feeling or emotional letdown that affects the vast majority of mothers within the first week or so of delivery. It is caused by many factors including: hormonal imbalances, familial and social pressures, emotional stress, and physical exhaustion. When all of these elements combine, the overwhelmed mother often experiences temporary depression

[1] Minirth, Meier, & Arterburn.  (1995).  The Complete Life Encyclopedia

[2] The context of this study is, in many regards, limited to mild and moderate forms of depression, but it does apply as a partial curative factor even in severe depression.  It is in no way the intention of this study to eliminate or minimize the importance of psychotropic medication therapy in situations when deemed necessary.
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