Some people can be depressed and not know it. Although well-known symptoms such as sadness or hopelessness can be easy to recognize, other signs of depression may be less obvious.

Although some depression symptoms are obvious, there are many hidden signs of depression. However, it is important to note that other medical issues can also cause some of the same symptoms.

This article discusses some of the less obvious symptoms of depression. It also covers common causes of depression and what a person should do if they or a loved one experiences the following symptoms.

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Eating too much or too little can indicate depression. Some people turn to food for comfort, while others lose their appetite or eat less due to low mood.

These changes in food intake can cause a person to gain or lose weight. They can also affect mood and energy levels.

There may also be physiological factors at play. For example, there is a link between excess body fat and increased inflammation in the body. This, in turn, may play a role in the development or severity of depression symptoms.

There is a strong connection between mood and sleep. A lack of sleep can contribute to depression, and depression can make it more difficult to sleep.

Research suggests that chronic sleep deprivation can contribute to depression. This may be due to neurochemical changes in the brain.

However, sleeping more than usual can also be a sign that a person may have depression.

Some people with mood disorders may use alcohol or drugs to help them cope with negative emotions, such as sadness, loneliness, or hopelessness.

The Anxiety & Depression Association of America (ADAA) reports that in the United States, about 1 in 5 people with anxiety or a mood disorder such as depression also have an alcohol or substance use disorder. Conversely, the same proportion of those with an alcohol or substance use disorder also have a mood disorder.

Negative self-talk is an inner dialogue that is damaging and self-critical. Many people with depression experience negative self-talk and default to harmful, critical thoughts toward themselves.

Although there is limited research on the long-term effects of negative self-talk, research has found that it has harmful effects on well-being and cognitive function.

Feeling excessively tired is a very common symptom of depression. Some research suggests that more than 90% of people with depression experience fatigue.

Although everyone feels tired from time to time, people who have severe or persistent tiredness — especially if it accompanies other symptoms — may have hidden depression.

Sometimes, people refer to hidden depression as “smiling depression.” The reason for this is that people who hide their symptoms may ensure that their face appears happy while in the company of others.

However, it can be difficult to keep up with this forced happiness and positivity. Over time, the mask may slip, and a person may show signs of sadness, hopelessness, or loneliness.

There is a theory that people with depression may display a trait called “depressive realism.” This means that they may be more accurate in their view of events and the control they have over those events than people without depression.

Being more realistic or pessimistic than others may be one sign of depression, especially if the person has other possible symptoms of depression.

When a person trails off during conversations or loses their train of thought, this can indicate issues with memory and concentration. Such issues are a common symptom of depression.

An older 2014 study suggests that these difficulties with concentration and focus can worsen the social impact of depression by making work life and personal relationships more challenging.

Additionally, a 2018 narrative review notes that cognitive dysfunction is a key aspect of major depressive disorder (MDD). This can significantly affect a person’s social life, returning to work, and workplace productivity.

The National Institute of Mental Health lists a “loss of interest or pleasure in hobbies and activities” as one of the telltale symptoms of depression. Disinterest in activities that a person used to enjoy can be one of the first signs that other people notice when their loved one has depression.

Depression is a mental health condition, but it can also have physical consequences. In addition to weight changes and fatigue, other physical symptoms of hidden depression to look out for include:

Some people with hidden depression experience personality changes. They may become more quiet and withdrawn, or they may be angry and irritable.

Many people do not associate anger and irritability with depression, but these mood changes are not unusual among those with the condition. Instead of appearing sad, some people with hidden depression may display irritability and overt or suppressed anger.

Some healthcare professionals consider changes in sex drive a key indicator when diagnosing episodes of depressive symptoms. In a 2018 study, more severe depression was associated with more severe sexual dysfunction. This dysfunction included trouble with sexual function, desire, and satisfaction.

There are several reasons why a person’s libido might decrease when they have depression. These include:

  • loss of interest in pleasurable activities, such as sex
  • fatigue and low energy levels
  • low self-esteem

Scientists do not yet know the exact cause of depression. However, many experts think a combination of biological and environmental factors plays a role in its onset.

Learn more about common causes of depression here.

People with symptoms of depression should consider seeking help from a healthcare professional, such as a doctor or psychotherapist. These professionals can help make a diagnosis and recommend a course of treatment.

A person with depression may also wish to get support from loved ones.

Other steps to manage depression might include:

Sources of help for people with mental health conditions and mood disorders include the ADAA’s website and Mental Health America’s list of support groups.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

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Below are some commonly asked questions about whether a person can be depressed and not know it.

Can people be unaware that they have depression?

It is possible that a person may be depressed and not know it. Less obvious symptoms of depression include:

  • weight changes
  • sleep disturbances
  • alcohol or drug use
  • negative self-talk
  • fatigue
  • loss of concentration
  • low sex drive

Is there a silent depression?

There are many types of depression, including major depression and seasonal affective disorder.

Hidden depression, or “silent depression,” is not a medical diagnosis and refers to symptoms of depression that are less recognized by others.

How often does depression go unnoticed?

According to older research, around two-thirds of all cases of depression in the United States are undiagnosed.

The reasons for this include stigma, lack of perceived need, and affordability.

Not everyone with depression will display the typical symptoms of sadness and despair. Sometimes, the only signs that a person may show are physical, such as fatigue or weight changes.

Other signs of hidden depression can include using alcohol or drugs, being irritable or angry, and losing interest in pleasurable activities such as sex and hobbies.

People concerned that a loved one has hidden depression should try talking with them about their symptoms and offering nonjudgmental support and advice. Individuals who suspect that they have depression should consider discussing it with a doctor or mental health professional.

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