Symptoms of depression: these are the signals to watch out for

It is something you often see, hear, or read in a book, documentary, movie, or series. Written scenarios, sometimes partly from experience or based on what has been heard or seen. The symptoms of depression are something almost intangible. Because when you see the well-known commercial (see video at the bottom of the article), you quickly think you know what it is about. You actually assume it concerns one specific type of person, but the reality is often very different. Someone who is depressed does not always appear unkempt, neglected, and with dark circles under their eyes. To be very honest: that is how I always thought about it. But nothing could be further from the truth, and I now unfortunately know that from experience.

Disclaimer
This article is intended to raise awareness about depression and mental health issues. It does not replace professional advice or treatment. Do you have depressive feelings yourself or are you worried about someone in your environment? Always contact your general practitioner or another qualified healthcare provider.

What do researchers say about depression?

According to international guidelines, such as the DSM-5 (the official manual for mental disorders), we speak of depression when someone experiences multiple complaints for at least two weeks that make daily (simple) tasks, such as grocery shopping, difficult. How those complaints manifest varies greatly from person to person. For one, it is mainly sadness or emptiness, for another, extreme fatigue, irritability, or physical pain without a clear cause. While one can hardly get out of bed, another gets up every day, goes to work, and laughs along with everyone ‘cheerfully’. It is precisely that participation and laughter that often makes depression so hidden and unclear. Sometimes jokes are even made, while really deep conversations are avoided.

What can depression look like?

Research shows that depression has different facets. People can feel empty or hopeless, lose interest in things that previously brought joy, or get trapped in negative thoughts that keep coming back. As Fred van Leer wrote in his book ‘Nothing is as it seems‘ that a big black dog has been chasing him for years. Others mainly suffer from sleep problems, a changed appetite, or fatigue that does not go away, no matter how long they sleep (if they can sleep at all). Some people withdraw from social contacts or lose the energy to perform daily tasks. But the opposite can also happen: throwing themselves into social activities, making impulsive purchases, all to seek distraction, after which the crash at home can hit even harder. It can of course also be a combination of everything; the picture is very broad and can never be captured in one stereotype.

Why don't we recognize depression?

It is a condition that sometimes hides behind a smile, or in someone who appears healthy and successful on the outside. The Trimbos Institute emphasizes that nearly one in five adults in the Netherlands will experience depressive complaints at some point in their lives. And if parents have (had) depression, their children have about 2 to 3 times the chance of also developing depression. That is quite significant. Yet there is still a taboo on talking about mental health issues. And that is a shame. In the society we live in, it often has to look beautiful and rosy. When do we still have truly deep conversations? During a dinner at that new hotspot, it is usually not mentioned how bad someone feels. We feel we must be strong, that a dip will pass, or that someone else has it worse. Because yes, a lot is happening in the world. But depression is not an ordinary mood that you can just “ride out”. It is a serious condition in your brain that needs attention, understanding, and the right treatment.

Talking, listening, and truly hearing

We could also look at how we react to someone who feels bad. If someone indicates multiple times that things are not going well, we often have the tendency to demand immediate action: “call the general practitioner or specialist”, but that is not always wise to say. Of course, you should say that too, because it is important that someone does that, but often it helps more to offer a listening ear at such a moment, to show understanding, and to engage in conversation rather than to talk against it. Even if someone truly thinks so darkly that suicide comes into play, asking about it may be very difficult, but for that person, it can be very comforting. Then they feel heard, and that is very important. It has been proven that asking open questions about thoughts of suicide (for example, whether someone has a plan and what they envision) does not lead to suicide but can actually help to talk about it. The opposite, brushing it off or saying “look at what you do have”, can make someone feel unheard.

The risks of chatbots in depressive feelings

There are increasingly warnings about the use of AI bots like ChatGPT among people with (severe) depressive feelings. Such tools can provide information but lack real empathy and human insight, which can lead to misinterpretation of signals from someone who feels really dark. Researchers warn that AI sometimes confirms negative beliefs instead of breaking them, causing someone to sink even further. There is even more awareness of people becoming emotionally dependent on chatbots and therefore seeking less support from their environment, such as family, friends, or professional help, because everything was already expressed digitally. This makes it seem as if you have already made it discussable, while it is still very unknown to the people around you. The danger is that a bot can never replace the human connection and nuance that are so important in (severe) mental health issues. My hope is that AI will connect people faster to the right help in the future instead of just providing “nice words”, exercises, or poems. Because yes, this is really happening.

Why this article?

Because I recently experienced it very closely. My dear aunt, who struggled with severe depressive feelings, took her own life. There was laughter, jokes were made, she always looked well-groomed and neat, but behind that smile was a pain that we did not always see. And that is exactly what makes depression so treacherous: it is not always visible. That is why I hope we talk about it more often, and especially in the right way. That we learn to truly listen, without judging too quickly or imposing solutions. So that someone who is struggling feels less alone and can find the right help faster. Even though waiting times are long and the right places are often full: do not let a chatbot or negative thoughts take over during that period, but seek conversation and share your feelings.

The fact remains that the darkness inside can be stronger than the smile you see on the outside. That is what makes depression so complicated: you often do not see it.

Need help? You are not alone.
Do you feel down or think about suicide? Talk about it. Call 113 Suicide Prevention for free and anonymously at 0800-0113 or chat via 113.nl.
Are you worried about someone in your environment? You can also go there for advice and support.

Source: RIVM, GGZ Nederland / MIND Correlation, DSM-5 and Trimbos Institute.