Depression Symptoms and Diagnosis: It Can Look Different in Men and Women and in Teenagers, Too

Unlike the usual feelings of sadness that pass relatively quickly, depression is a clinical illness in which negative emotions last for weeks or longer.

It’s one of the most common mental health conditions, affecting an estimated 280 million people or more worldwide, according to the World Health Organization.

Depression is treatable. It’s important to know the signs and symptoms of this mental health condition so that you can get help as soon as possible.

Depression doesn’t affect all people in exactly the same way, but the illness is associated with particular signs and symptoms.

At least five symptoms are needed for a clinical diagnosis of depression, per the American Psychiatric Associations’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5), but the combination and exact number of symptoms each person has can vary. If you have been experiencing some of the following symptoms for most of the day, almost every day, for two weeks or more, you may be struggling with depression, according to the Mayo Clinic.

• Feeling sad or having a depressed mood for most of the day (or an irritable mood in children and teens)
• Loss of interest or pleasure in once-enjoyable activities
• Unexplained weight loss or gain, or significant increase or decrease in appetite
• Insomnia or sleeping too much
• Fatigue or loss of energy
• Restlessness or slowed movements, speech, and thoughts
• Feelings of worthlessness or extreme guilt
• Difficulty thinking, concentrating, or making decisions
• Frequent thoughts of death or suicide

Additionally, you may experience physiological signs like new, frequent aches and pains, per Mayo Clinic — in some cases, people may experience mental distress physically more than psychologically. Changes in behavior or increased substance use may also be signs of attempts to self-treat underlying mental distress.

Although men and women can have the same symptoms of depression, there are important differences in how often they report specific symptoms, according to an analysis published in the journal JAMA Psychiatry.

Men with depression are more likely than women to report the following alternative symptoms of depression:

• Anger
• Aggression
• Drug and alcohol abuse
• Risk-taking behaviors

Reflecting cultural norms, men with depression may be more likely to exhibit certain unhealthy coping skills such as workaholism or gambling. Men are also less likely to be diagnosed with depression than women.

Depression is diagnosed twice as often in women than men. Women with depression are more likely to report the following symptoms, per the aforementioned JAMA Psychiatry analysis:

• Stress
• Indecisiveness
• Anxiety
• Feeling pathetic
• Sleep problems
• Depressed mood

Depression has become common in young people between ages 12 and 17, and rates of teen depression are rising fast. The number of adolescents ages 12 to 17 who’d experienced a major depressive event in the previous 12 months jumped from 8.7 percent in 2005 to 11.3 percent in 2014, according to a study in a December 2016 issue of the journal Pediatrics.

Despite the rise in depression, the researchers did not see an increase in the number of teenagers undergoing mental-health treatment, suggesting that many young people are not receiving the help they need.

Concerningly, the rates of depression and anxiety among kids and teens appear to have doubled during the first year of the COVID-19 pandemic compared with pre-pandemic rates. Recent estimates suggest that 1 in 4 youths are dealing with depression symptoms, and 1 in 5 have anxiety symptoms, according to a meta-analysis published in August 2021 in JAMA Psychiatry.

Teens have many of the same symptoms of depression as adults, but these changes in mood and behavior are sometimes mistaken as a normal part of puberty or adolescence.

Other signs of depression in teenagers, according to Mayo Clinic, can include:

• Sadness and crying spells that happen seemingly without much cause
• Anger or frustration, even over small issues
• Loss of interest in activities they once enjoyed
• Irritability
• Extreme guilt, self-blame, or self-criticism
• Sensitivity to rejection
• Social withdrawal
• Unexplained body aches and pains
• Angry outbursts or other acting-out behaviors
• Having bad grades in school or skipping school
• Conflict with friends and family
• Self-harm
• Thoughts of death or suicide

There are a number of online tools and self-tests to determine whether you may be depressed and need to seek help, but only your doctor or a mental health professional can diagnose clinical depression.

Odds are you’ll be screened for depression at your yearly checkups, too. The U.S. Preventive Services Task Force (USPSTF) now recommends that primary care providers screen all adults — including pregnant and postpartum people and older adults — for depression, according to a recommendation statement published in June 2023.

Before diagnosing major depression — the most common type of depression — your doctor will conduct exams and tests to rule out other problems that could be causing your symptoms, such as thyroid issues, medication side effects, neurological illnesses, autoimmune disease, or nutritional deficiencies.

These efforts may include a physical examination and blood tests, as well as a discussion about your medications, some of which may cause depressive symptoms, according to Mayo Clinic.

Your doctor will also ask in-depth questions about your mood and feelings, and may ask you to fill out a questionnaire, per Mayo Clinic.