Depression symptoms and signs

13What are the two core symptoms of depression?

Depression centers on two main symptoms, and at least one of them must be present: depressed mood (sadness, emptiness or hopelessness, which may appear as irritability in the young), and loss of pleasure and interest in things that used to make the person happy, which doctors call "anhedonia."

This symptom, one or the other, lasts most of the day, on most days, for at least two weeks, together with other symptoms that complete the picture. A day or two of distress after a hard event is not depression, but weeks of continuous loss of enthusiasm and energy deserve attention.

Importantly, loss of pleasure can be more obvious than sadness itself: the person does not necessarily cry, but stops meeting friends, neglects hobbies, is not excited by any happy news, and says "it doesn't matter to me."

14What are the psychological and cognitive symptoms of depression?

These negative thoughts are part of the illness, not a truth about the person. Depression colors memory, the present and the future in a dark shade, so the patient remembers failures, forgets successes, and believes things will never change.

15What are the physical symptoms of depression?

In Egypt and the Arab world generally, depression often reaches the doctor as a physical complaint: "my body is broken," "a headache that won't go away," "I'm tired all the time and don't know why." The patient moves between clinics and lab tests before anyone considers a psychological cause. The most common physical symptoms:

16How does behavior change with depression?

• Withdrawing from people, avoiding visits and occasions, and frequently declining invitations.
• Neglecting self-care, appearance and personal hygiene, or neglecting the home and children.
• A clear decline in performance at work or school, with frequent absences and lateness.
• Spending long hours in bed or on the phone without real enjoyment.
• Crying easily, or on the contrary, difficulty crying despite distress.
• Smoking more, or turning to alcohol, sedatives or other substances to ease feelings.
• Reckless behavior or disregard for safety, especially in young people.

17Do the signs of depression differ between men and women?

In men, sadness may hide behind anger and irritability, excessive immersion in work, sport or the phone, substance use, and complaints of fatigue or sexual performance problems. Because society expects a man to "tough it out," many are slow to seek help until the condition worsens.

In women, depression is more common, and may be linked to hormonal periods such as before menstruation, pregnancy, after childbirth and menopause. Women talk more about sadness, guilt and anxiety, and some sleep or eat more. Postpartum depression is explained in detail on the page types of depression.

18Depression across a woman's life stages in brief

The core symptoms are the same, but depression is about one and a half times more common in women according to the World Health Organization, and is linked to specific hormonal periods: before menstruation, pregnancy and after childbirth, and approaching menopause. It often shows up as anxiety, exhaustion, guilt and physical pain, and a woman may appear to be "doing her duties" in front of others while suffering in silence.

We detail the signs of each stage and the treatment options suitable during pregnancy and breastfeeding on the page Symptoms of depression in women: how they change across life stages, and you will also find postpartum depression. Residential treatment at Eradah is for men only, but the first free consultation is available to women and their families to help understand the condition and direct them to the right place.

19How does depression appear in teenagers and children?

Children and teenagers do not express depression the way adults do, so it is often misread as "bad manners," "being spoiled" or "just a phase." Signs worth noticing include:

• Irritability and repeated angry outbursts instead of obvious sadness.
• A sudden drop in grades or refusing to go to school.
• Isolating in their room and dropping friends and favorite activities.
• Repeated physical complaints such as headaches and stomachaches with no medical cause.
• Changes in sleep (staying up late and then sleeping during the day) or in eating.
• Statements like "I'm a failure" or "nobody loves me," self-harm, or talk about death.

If parents notice these signs, it is best to talk calmly and without accusation, then consult a child and adolescent psychiatrist, involving the school when needed. Early intervention at this age protects their future, both academically and psychologically.

20What are the signs of depression in older adults?

Depression in older adults is often overlooked because it is put down to "old age." But depression is not a normal part of aging. In them it may appear as many physical complaints, loss of appetite and weight loss, slowing and withdrawal, memory and concentration problems that may be mistaken for dementia, and refusing to take medication for chronic illnesses. The risk rises with loneliness, loss of a spouse and chronic illness.

21What is the difference between mild, moderate and severe depression?

Determining the degree helps the doctor choose the right plan, and is done through a clinical interview and sometimes validated scales. Even "mild" depression deserves attention because it can progress if neglected.

22How can a family notice the signs of depression?

The family is often the first to notice, even before the person. Watch for a clear change from the person's usual self: the sociable son who has become withdrawn, the energetic mother who no longer leaves her bed, or the calm father who has become quick to anger. A change that lasts for weeks matters more than any single sign.

Avoid phrases like "you have everything, why are you depressed?" or "strengthen your faith and you'll be fine." It is better to say: "I've noticed you've been struggling lately, and I'm worried about you. Would you like us to go see a doctor together?"

23Questions to help you assess yourself

• Have you felt sad, down or hopeless on most days over the past two weeks?
• Have you lost interest or pleasure in things you used to love?
• Have your sleep or appetite changed noticeably?
• Do you feel tired or low on energy even without effort?
• Has it become harder to concentrate or make decisions?
• Do you blame yourself a lot or feel worthless?
• Have you had thoughts that you would be better off not being here? If the answer is yes, talk to someone now or call 16328.

If a number of these questions apply to you for more than two weeks, or they affect your life, your next step is to see a psychiatrist. Learn about depression treatment options.

24When do depression symptoms call for seeing a doctor immediately?

• Thoughts of death or self-harm to any degree.
• Stopping eating, drinking or caring for oneself.
• Hallucinations or unrealistic ideas, such as feeling guilty about disasters one has nothing to do with.
• Depression after childbirth with thoughts of harming oneself or the baby.
• Depression alternating with periods of excessive energy, reduced sleep and impulsivity, which may point to bipolar disorder.