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Some people describe depression as a feeling of looking through a dark veil. Senses seem dulled and even activities that once brought pleasure are cast aside. But the early symptoms of major depression may be hard to pinpoint, so subtly does it manifest. Major depression doesn’t always make a dramatic entrance but instead makes itself known gradually and insidiously. What are the early symptoms of depression?
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The Early Symptoms of Major Depression are Often Subtle
It’s important to recognize the early symptoms of major depression since the diagnosis is based exclusively on signs and symptoms. There are no blood tests, x-rays or imaging studies that show whether a person is suffering from major depression. These tests are used only to rule out physical causes of a depressed mood such as anemia, thyroid disease, vitamin deficiencies or dementia.
The early symptoms of major depression vary with age. In adults, symptoms can be both mental and physical. The most common symptom adults with major depression experience is an inability to feel pleasure. Activities they previously enjoyed no longer bring them happiness. This often leads to social isolation and the desire to “be alone".
On the inside a person with major depression feels useless, sad, and helpless and has an overwhelming sense of pessimism about the future. They may think about dying or have suicidal, which some act on. They may also have problems concentrating and find it difficult to make a decision or focus on tasks.
Physical symptoms often go along with the mental symptoms of major depression. Two of the most common are changes in sleep and appetite habits. People with major depression often have problems falling asleep or staying asleep. At the other extreme, they may use sleep as an escape from their sense of hopelessness and stay in bed most of the time. Loss of appetite is more common than overeating, but either can occur. Not surprisingly, most people with major depression lack energy and have a low sex drive, although some may be restless and irritable.
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Early Symptoms of Major Depression in the Very Young and Old
Kids get depressed, although fewer kids than adults experience major depression. Children may have many of the same psychological and physical symptoms as adults with depression, but these symptoms are more likely to be dismissed as a “part of growing up". Kids who have major depression are more likely to be irritable, restless and demanding than a depressed adult and may show a decline in school performance or conduct issues.
Sometimes children with major depression become insecure and unsure of themselves and withdraw into their own little world, which they can control. Sadly, some attempt to harm themselves.
The early symptoms of major depression in the elderly are often even more subtle. Older people may still have the symptoms previously discussed, but it’s more common for them to talk about physical problems such as problems sleeping or eating – or they may be more forgetful. Major depression in older people can masquerade as physical problems - including dementia. An elderly person with depression may neglect their home or their physical appearance and show very little motivation to care for themselves or others.
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The Bottom Line?
The early symptoms of major depression are often subtle, especially in children and the elderly. Being aware of these early signs and symptoms ensures that a person with major depression gets the help they need to emerge from the darkness.
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American Psychiatric Association. Physician Med Guide for Depression.
Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition. American Psychiatric Publishing. 2000.