Signs of depression

We all experience deep sadness and anxiety every now and again, especially when faced with a particularly challenging or painful situation in life. Everybody feels helpless and unable to cope sometimes. But in some people this leads to depression. Depression is a common medical condition. It is estimated that 15 out of every 100 adults (15%) in Germany are affected by depression at least once in their lifetime.

But it can be difficult to determine exactly when depression sets in. Depression is more than simply feeling blue or having a bad day. It is associated with deep sadness, listlessness and a loss of interest. People no longer enjoy things they used to enjoy, find it difficult to work or study, and neglect their friends and family.

How depression is diagnosed

To find out whether someone is depressed, doctors ask about symptoms that could be signs of depression. They also try to rule out other illnesses or health problems that could cause similar symptoms.

There is no accurate test for diagnosing depression.

If someone has several of the following symptoms over a longer time period (at least two weeks), they could be depressed:

• Feeling down all the time
• Listlessness
• Being less active
• Lack of enjoyment and general loss of interest (even in hobbies and other activities that used to be fun)
• Low self-esteem and a lack of self-confidence
• Feeling guilty about things you cannot help
• Tiredness
• Sleep problems
• Loss of appetite
• Concentration problems

In some people depression mainly manifests itself in physical symptoms such as weight loss, sleep problems, inexplicable pain, constipation or a loss of sexual desire. Depression not only causes listlessness, it can also make people more irritable.

As well as these symptoms, other problems such as an increase in alcohol consumption or an addiction sometimes play a role too. Depression can also be accompanied by other psychological problems, such as anxiety disorders.

Symptoms in children and young people

Which symptoms of depression occur and how strong and frequent they are varies from person to person, and is different in the various age groups, too.

Pre-school children probably do not get depressed very often, and it can be hard to tell if they are. Pre-schoolers who are depressed cry a lot, do not have any interest in play and are very anxious. They try hard to be nice and obedient. In some children it can set back their development.

School-aged children who are depressed often lose interest in their leisure activities and can be hostile to others. They can lose their temper, get upset quickly over little things and have low self-esteem.

With teenagers it can be hard to tell the difference between "normal” mood swings and when the person is really depressed. Healthy young people are sometimes defiant, aggressive, uninterested, have low self-esteem or retreat into themselves - without being depressed. Weight changes, drug and alcohol use, extreme tiredness and thoughts of suicide can be, among other things, a sign of depression in a teenager.

Severe depression

Doctors differentiate between mild, moderate and severe depression. The number and strength of symptoms can indicate how severe someone’s depression is. People who have severe depression may seriously consider suicide: if so, they need urgent help.   

Bipolar disorder (often called manic depressive disorder or manic depression) is a specific form of depression. It is a lot less common than depression. People who have bipolar disorder go through alternating phases of being depressed and being extremely energetic and euphoric (“manic”). They may lose touch with reality and get into difficult situations.


Author: German Institute for Quality and Efficiency in Health Care (IQWiG)

© IQWiG (Institute for Quality and Efficiency in Health Care) Last update of this website: 02/03/2012