The Story:

A young couple I have treated for some time came into my office recently. Lisa was angry with Justin because he had been (in her opinion) distant and unloving towards her in recent weeks. No matter how hard she tried to please him, nothing seemed to work, and she began to wonder whether he had lost interest in her. After I asked Justin certain key questions, it became clear that he had gradually become depressed and, in doing so, had lost interest in pretty much everything that had previously given him pleasure – including Lisa. Once Justin’s depression was adequately treated, he became the warm, loving and attentive man with whom Lisa had fallen in love and chosen to spend her life with.



There are some important lessons to this story.

First, depression is not always obvious. It can masquerade as something else (in this case, lack of interest in your partner).

Second, it is valuable for friends or loved ones to learn the tell-tale signs of depression so that they can offer help as early in the process as possible because depression is a painful condition, both for the person suffering from it and his or her loved ones.

So, here are seven tell-tale signs of depression that will help you determine if your friend or loved-one is developing depression:

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1. Loss of interest in things that were previously pleasurable. Sometimes this loss of pleasure – also known as anhedonia – may not be complete. So your loved one may gravitate only to those things that are easily enjoyed and require the least amount of effort, such as playing video-games, sitting in front of the TV or surfing the Web. This readily leads to thoughts or comments such as “You have plenty of time and interest for surfing the Web, but not when it comes to spending quality time with me.” Engaging with another person and meeting that person’s needs require more effort than surfing the Web and therefore may be an early sign of depression.



2. Sleep difficulties. This may take the form of trouble falling asleep, or waking up during the night or the early hours of the morning. You may find your loved one in another room, trying to while away the time. This may disrupt your own sleep and may feel like abandonment, leading you to say things like, “Not only isn’t he/she available for me during the day, but even at night.” Again, it’s important not to take the symptom personally, but recognize it as what it is.





3. Eating changes – too little or too much – with corresponding weight changes in the expected direction. A husband (for example) can readily become angry with his wife and blame her for eating too much and gaining weight, misinterpreting the symptom as a sign that she no longer cares as much about their intimate life and is therefore “letting herself go.”



4. Anger and irritability. A depressed person struggles to get through the day. Ordinary obstacles and challenges become more difficult and can lead to frustration and the feelings that go along with that. This is another tell-tale sign of depression that is easy to take personally.

5. Expressing negative thoughts. You might feel enthusiastic about something and your friend or loved one might come back with a “downer” of a response, such as “I don’t think that will amount to anything,” or “What does it matter? It makes no difference.” Such negative thoughts are a cardinal symptom of depression, yet sometimes they feel almost calculated to throw a dampener on things. The depressed person is not trying to make life difficult for others even though that is often the effect of depressive thoughts and utterances.



6. Suicidal ideas. These may take a passive form such as, “I don’t care if I live or die” or a more active form, such as “Sometimes I feel like driving the car off the road.” Always take such statements very seriously. There is a common myth that if a person is really suicidal, they don’t tell others about it; they do it. By this ererroneous logic, if the person is telling you about it, you might mistakenly conclude that they won’t actually do it. Nothing could be further from the truth. Not only are such statements key elements of depression (which warrants treatment in its own right), but they suggest that such treatment is urgent.



7. Loss of confidence in oneself and optimism about the future is sign of a depression. Depressed people feel poorly about themselves and their future. If your friend or loved one is usually more self confident and optimistic and this then changes, suspect depression.

If you detect one or more of these signs in a friend or loved one, you may want to look up a more comprehensive list of symptoms for major depression in the standard manual for psychiatric conditions, the DSM-IV.

Once you suspect depression, do encourage your friend or loved one to seek consultation and treatment with a qualified person, not only for his or her sake, but for yours. Sometimes it can also be helpful and comforting for you to offer to accompany the person to the consultation.

Wishing you Light and Transcendence,

Norman

