Some people with depression may try to hide the signs from others, and others might not even realize that they have depression. Although well-known symptoms such as sadness or hopelessness can be easy to recognize, other symptoms 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.

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 has 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 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, return 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:

  • backache
  • chronic pain conditions
  • digestive problems
  • headache

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 that several factors play a role in its onset, including:

  • Genetics: Depression can run in families. Having a close relative with the condition can raise a person’s risk of developing it themselves.
  • Biological and chemical differences: Physical changes or chemical imbalances in the brain may contribute to the development of depression.
  • Hormones: Hormonal changes or imbalances in the body may cause or trigger depression. For example, many people experience postpartum depression after giving birth.
  • Trauma or stress: Periods of high stress, traumatic events, or major life changes can trigger an episode of depression in some people.
  • Personality traits: Having low self-esteem or being pessimistic, for example, may increase the risk of depression.
  • Other illnesses: Having another mental or physical health condition or taking certain medications can increase the risk of depression.

People who believe that they may have hidden depression should contact a doctor or mental health professional. These professionals can help make a diagnosis and recommend a course of treatment.

Other steps to manage depression might include:

  • reducing stress, such as through meditation, deep breathing exercises, or yoga
  • improving self-esteem through positive self-affirmations
  • socializing with others, although this can be challenging with depression
  • engaging in activities that the person used to enjoy
  • exercising regularly
  • eating a balanced diet
  • asking family or friends for support
  • joining a support group

If a loved one appears to have signs of hidden depression, a person can try to talk with them about their symptoms and offer nonjudgmental support and advice.

Supportive actions include:

  • encouraging the person to seek treatment
  • offering to accompany them to appointments
  • planning enjoyable activities together
  • exercising together
  • encouraging them to socialize with others

People looking after someone with depression also need to practice good self-care to preserve their own mental well-being.

People with symptoms of depression should consider seeking help from a healthcare professional, such as a doctor or psychotherapist. They may also wish to get support from loved ones.

Other 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 you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

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, insomnia, 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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