Everyone feels down from time to time, usually as a reaction to failures or ruined expectations. Such states are generally short-lived. It is considered depression when a low mood and other symptoms last for more than two weeks. The most characteristic sign is persistent sadness, but the disorder can also manifest as disruptions in almost all body systems—from a decreased sex drive to changes in how pain is perceived.

What are the main signs of depression?

Because depression is complex and affects various body systems, it has many manifestations that vary from person to person. According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), a diagnosis is possible if at least five of the following symptoms last for more than two weeks:

• Feelings of sadness, emptiness, or hopelessness;
• Irritability and outbursts of anger;
• Loss of interest in usual activities, including sports or sex;
• Sleep disorders (insomnia or oversleeping);
• Constant fatigue and a lack of energy;
• Changes in appetite (weight loss or overeating);
• Anxiety and restlessness;
• Slowed thinking and movement;
• Feelings of guilt or worthlessness;
• Difficulty concentrating and making decisions;
• Recurring thoughts of death;
• Physical pain with no obvious cause.

I feel empty and hopeless. Is it depression?

In many cases, yes. Depression distorts thinking, making it constantly negative. The ability to feel pleasure is lost, and your own thoughts convince you of your helplessness and despair. A person begins to believe that “it will always be this way.” But remember: thoughts are not facts. Distorted thinking can be changed through psychotherapy.

Why do I have no sex drive?

A low sex drive is a common symptom of depression in both men and women. Just as interest in life or food decreases, libido is also suppressed. This is linked to general fatigue, the loss of the ability to feel pleasure, and relationship difficulties.

Can depression show up as agitation?

While depression is usually associated with indifference and slowing down, for some people, it manifests as restlessness and physical agitation. Research shows that up to one-third of patients with major depressive disorder have symptoms of agitation: from constant hand-wringing or pacing to outbursts of anger and an inability to sit still.

What does it mean to be clinically depressed?

In everyday language, people call any mood disturbance “depression”—from sadness to hopelessness. However, clinical depression (Major Depressive Disorder) is a medical diagnosis. In addition to constant sadness or loss of interest, a person experiences problems with sleep and appetite and has negative thinking that paralyzes daily functioning and makes it impossible to imagine a future.

What is the difference between depression and sadness?

Sadness is a normal reaction to loss or failure. Depression, however, does not necessarily have an obvious cause. It hangs over you like a cloud, taking away energy, motivation, and your sense of self-worth. Sadness usually passes and can even help you find new meaning. Depression lasts for weeks or months and requires treatment.

What is the difference between depression and grief?

Grief is a natural reaction to loss. It can disrupt sleep and appetite and cause guilt, but it usually comes in waves: pain is replaced by moments of fond memories or even laughter. People in grief often seek connection, while those with depression tend to isolate themselves.

How long do episodes last?

Depression is usually recurrent. A first episode lasts about four months on average if left untreated. The more severe the symptoms are at the start, the higher the likelihood of repeat episodes. At the same time, the chances of recovery are highest if treatment begins in the first few weeks of the illness.

How does depression progress?

About half of the people who have one episode will have another. Research shows that the number of stressful events in life affects the risk of relapse. The longer an episode lasts, the harder the recovery becomes. Data suggests that depression itself changes the brain, reducing the ability to form new neural connections, which makes recovery more difficult.

At what age is the risk highest?

Depression most often occurs in middle-aged people—between 45 and 65 years old. However, clinical episodes are now appearing more frequently in younger people. There is concern that Gen Z (born 1995–2015) is especially prone to depression and anxiety due to specific social pressures, the digital environment, and, in some cases, a lack of experience in overcoming life’s challenges.

Is depression common in the elderly?

Depression is not a normal part of aging. It is less common among the elderly but has more serious consequences: it is linked to an increased risk of suicide, self-isolation, and cognitive decline. In most cases, depression after age 60 is a first episode, often without a family history of the illness. A drop in daily activity can be a triggering factor.

Can children get depression?

Yes. Studies have recorded clinical depression even in children as young as 3. In childhood, it often looks different than in adults: the main sign is extreme irritability. Withdrawal, sadness, an inability to enjoy things, and feelings of guilt are also observed. Childhood depression can result from family problems, but it also worsens the family atmosphere. Some researchers link its increasing frequency to a lack of free play and excessive academic pressure.