Depression in Disguise

Many people think of depression as an intolerable sadness or a deep gloom that just won't go away. Yet depression can also be sneaky, disguised in symptoms that can be hard to identify. If you've had unexplained aches or pains, often feel irritable or angry for no reason, or cry at the drop of a hat -- you could be depressed.

Fortunately, you can be proactive with depression. Learn how these less obvious symptoms can reveal themselves and when you should seek out depression treatment.

Common Depression Symptoms

Common symptoms of depression include feeling sad, hopeless, empty, or having lost interest in the things that previously gave you pleasure. But other, less obvious symptoms also may signal depression, including:

• Anger, irritability, and impatience. You may feel irritated and angry at family, friends, or co-workers, or overreact to small things.
• Sleep problems. You may have trouble sleeping, or you may wake up very early in the morning. Or you may sleep too much and find it hard to get up in the morning.
• Anxiety. You may have symptoms such as anxiety, worry, restlessness, and tension. Anxiety and depression often occur together, even though they are two separate problems.
• Crying. Crying spells, crying over nothing at all, or crying about small things that normally wouldn't bother you may be signs of depression.
• Inability to concentrate. If you are depressed, you may be forgetful, have trouble making decisions, or find it hard to concentrate.
• Pain. If you have aches and pains that don't respond to treatment, including joint pain, back pain, limb pain, or stomach pain, they could be signs of depression. Many people with depression go to their doctor because of these types of physical symptoms, and don't even realize that they are depressed.
• Substance abuse. Having a drug or alcohol problem may hide an underlying problem with depression, or may also be causing the symptoms of depression. Substance abuse and depression often go hand in hand.
• Appetite changes. You may have no desire to eat, or you may overeat in an effort to feel better.
• Isolation. You may feel withdrawn from friends and family -- right when you need their support the most.

Depression Symptoms: Men and Women May Differ

Not everyone has the same signs and symptoms of depression. In fact, men and women may experience depression differently. Women more often describe feeling sad, guilty, or worthless when they are depressed.

Men are more likely to feel tired, angry, irritable, and frustrated, and they often have more sleep problems. A man may feel less interested in hobbies, activities, and even sex. He may focus excessively on work in order to avoid talking with friends and family about how he feels. Men also may be more likely to behave recklessly and use drugs or alcohol to deal with depression. Some men with depression can become abusive. More women attempt suicide than men do, but men are more likely to complete the act -- almost four times as many men die from suicide as do women.

Many men do not acknowledge feelings or symptoms of depression. They don't want to admit that something may be wrong or talk about their feelings. But men and women can both get better with treatment.

Depression Symptoms: When to Seek Treatment

It can be hard to admit to yourself that you may be depressed, let alone ask for help. Here are two good reasons why you should consider depression treatment:

• Treatment works. Even people with severe depression can find relief, and so can you.
• Early treatment is better. As with many other health problems, getting treatment early on can ease symptoms more quickly. If you wait to get help, your depression can become more severe and harder to treat.

Talk to someone. There are many people willing to help you overcome depression, but the first step you have to take on your own is to let someone know how you are feeling. It may help to start by talking to a close friend or family member. Ask them for support in finding depression treatment. The sooner you get treatment, the sooner you will start to feel better. Don't hesitate -- call your primary care doctor or a medical health professional if:

• You think you may be depressed.
• You notice symptoms of depression such as sadness, hopelessness, or emptiness, or if you have less obvious symptoms such as trouble sleeping or vague aches and pains.
• Depression symptoms make it hard to function.

If you have thoughts about dying or committing suicide, seek immediate medical help. You may feel hopeless now, but treatment will give you hope -- and help you see that life is worth living.

Depression Treatment: Give it Time to Work

Certain medications and medical conditions such as thyroid problems can cause symptoms of depression, so your doctor may want to rule them out. If your doctor thinks you may be depressed, he or she may treat your depression and help you manage your symptoms, or might refer you to a mental health professional.

Depression treatment involves either antidepressant medication, psychotherapy, or both. People with mild to moderate depression can benefit from therapy alone.  Aerobic exercise is also sometimes recommended as an effective treatment for mild to moderate forms of depression. People with more severe depression usually do better with medication and therapy. Note that once you start treatment, you may notice improvements in symptoms such as sleep or appetite before you begin to feel less depressed.

Antidepressants work by affecting brain chemicals called neurotransmitters and nerve cell pathways or circuits in the brain that regulate mood. Antidepressants effectively treat depression in many people who take them. However, they can take four to six weeks to notice an effect, so it's important to be patient. Antidepressants sometimes can also have side effects, including weight gain and sexual problems. It may take some time to find the right medication that works best for you with the fewest side effects. Sometimes, if a first antidepressant isn't fully successful, your doctor might add a second medicine to boost its effect, or change the medication to another that may be more effective.

Psychotherapy treats depression by helping you:

• Learn new, more positive ways of thinking
• Change habits or behaviors that may make your depression worse
• Work through relationship problems at home or work
• Help you see things in a more realistic way and face your fears
• Help you feel hopeful, positive, and more in control of your life

It can take time to break old patterns of thinking and behavior, so give therapy some time to work.

Depression Treatment: How to Help Yourself

In addition to the help and support you get from your therapist and/or doctor, there are a few things you can do on your own that will help you feel better:

• Stay physically active. Exercise helps boost your mood, and research has shown that it may also help ease depression.
• Get a good night's sleep. Sleep helps us heal from many health problems, including depression. Getting the right amount of sleep, but not too much, helps you have more energy. Try to go to sleep and get up at the same time every day. Make your bedroom a comfortable place for sleeping and sex only -- banish TV and use curtains to keep out bright outdoor light.
• Stay connected. Spending time with supportive friends or family will make you feel better -- even if you don't feel like it will. It may help to choose low-key ways to connect. Go to a light-hearted movie, meet for a coffee and some people-watching, or take a walk in a nearby park. The contact you get from others, along with depression treatment, can help bring you out of the dark and back into the light.