Depression: Watch for These Warning Signs <cite>Posted Thu, Dec 04, 2008, 2:38 am PST </cite> </h1> 98% of users found this article helpful. <a href="http://null/#post" class="post">Post a Comment </a> <a href="http://null/experts/yourhealth/2995/depression-watch-for-these-warning-signs/comments/;_ylt=Ao.YbNmmoCgqJEWTPoaoqU2DnJV4" class="view">View All 37 Comments </a> The winter holiday season is upon us and, for a variety of reasons, this is one of the more common times for people to experience symptoms of depression . Even though it turns out that the suicide rate is not truly increased during this time of year, December is Seasonal Depression Awareness Month in the United States and thus a good time to review some facts about this insidious and troubling disease. Several distinct psychological diagnoses are related to depression . Most people have heard of the more serious conditions, like major depression and bipolar illness ( manic-depression ). More common, however, are a group of mood disorders that cause similar but perhaps less severe symptoms. Seasonal affective disorder , stress reactions, and low mood are some examples. Many patients are surprised to hear that anxiety and panic are closely related to depression. It turns out that the underlying biological changes and the initial treatment of most of these depression-related diagnoses are quite similar. There are multiple possible causes for depression, and also multiple ways to treat it. Like everything else in medicine, though, the first step is to recognize and diagnose the problem. What follows are some warning signs to look for in yourself and in your loved ones. Sadness. Simply feeling down, sad, or blue is a big clue. Crying frequently or easily is another symptom. I sometimes have patients who initially state that they are not sad, but what they are really saying is that they have no reason to feel sad that they are indeed feeling down but not because of any particular cause. Depressed patients typically just feel sad, without knowing why. And the other side of the coin is very important as well: You don't have to feel sad to have depression. Other mood changes . Anxiety, panic, guilt, hopelessness, and a low sense of self-worth are all common symptoms of depression. Abnormal sleep. This can be too much or too little sleep, or even a combination of the 2, with increased sleep during the day and difficulty sleeping at night. Insomnia of any kind can be a symptom of depression. In particular, waking up very early in the morning (approximately between 2 a.m. and 5 a.m.) and then finding it hard to get back to sleep is strongly associated with stress, anxiety, and depression. Fatigue or low energy . This may be closely related to sleep disturbance, but some depressed patients feel groggy or tired even after a full night's sleep and often feel the need to take one or more naps during the day. A milder version of this is simply feeling dragged out and having less energy than usual. Appetite change. People with depression may have an increased or a decreased appetite. Poor motivation. Lack of interest and/or participation in social activities is commonly seen in depressed patients. Others will have good intentions of getting things accomplished, but find it hard or impossible to get started or to complete some or all tasks. Sexual dysfunction. Closely related to poor motivation is lack of interest in sex (reduced libido). Other sexual symptoms can include erectile dysfunction (difficulty achieving or maintaining erection), difficulty reaching orgasm, and lack of enjoyment of sex. Anhedonia. This is the medical term for an inability to feel pleasure in situations that once were enjoyable. Depression tends to rob people of their enjoyment of all sorts of things that used to bring them joy. Brain fog. Depression can slow mental functioning. Common symptoms include forgetfulness, clouded thinking, poor concentration, difficulty performing simple calculations, and trouble making decisions. Psychomotor retardation (or its opposite, activation). People with depression often speak and move more slowly and are slower than usual to respond to conversation or other stimuli. They also may have a flat affect, meaning their facial and emotional expressions are markedly reduced and they speak in a monotonous voice. On the other hand, some depressed patients become agitated and have trouble sitting still or relaxing. Thoughts about death. Obviously, thinking about suicideand especially having a plan to commit suicide is a warning sign of serious depression. A less severe but more common (and still worrisome) related symptom is having a passive death wish. Patients with passive death wish have no plan or intent to harm themselves; they just feel that things would be better if they were dead or had never been born. Somatization. Depression tends to make everything worse, and can even cause physical pain, dizziness, and a variety of other abnormalities in just about any part of the body. Somatization is when a person unconsciously expresses psychologic distress in the form of real and significant physical symptoms so when a patient has symptoms that remain totally unexplained even after a thorough medical evaluation, a diagnosis of depression is worth considering. Please be aware here that if a doctor suggests to you that your physical problems may stem from your being depressed, he or she is not telling you that it's all in your head or that you're making it all up or faking your symptoms. The simple explanation of somatization is that depression involves poorly understood changes in brain chemistry, and those changes sometimes result in exaggerating the degree of pain, or even in creating a sensation of bodily dysfunction when in fact nothing is medically wrong with that body part. Of course, most of the symptoms of depression on this long list can be due to any number of medical problems. Regardless of the underlying cause, if you recognize several of these warning signs in yourself or in a loved one, it's time for a thorough medical or psychological evaluation to determine if any treatment is needed. © 2007 Johns Hopkins University . All Rights Reserved. This article from Johns Hopkins University is provided as a service by Yahoo. All materials are produced independently by Johns Hopkins University, which is solely responsible for its content.