How To Tell If You're Depressed: Understanding Symptoms, Severity, and When to Seek Help

Dr. Tracey Marks, a psychiatrist, outlines the clinical criteria used to diagnose depression, emphasizing that it's not guesswork but based on a specific cluster of symptoms found in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To be diagnosed, an individual must experience five out of nine specified symptoms for at least two weeks, present most of the day and almost every day. This foundational understanding helps differentiate transient sadness from a diagnosable depressive episode.

The nine core symptoms include a depressed mood (sadness, hopelessness, emptiness, or irritability in children/adolescents), anhedonia (inability to enjoy previously pleasurable activities), significant weight or appetite changes, sleep disturbances (insomnia or hypersomnia), psychomotor agitation or retardation (feeling restless or slowed down), persistent fatigue or low energy, feelings of worthlessness or excessive guilt, impaired concentration and decision-making (which can also lead to memory problems), and recurrent thoughts of death or suicide. Dr. Marks highlights how depression can profoundly distort one's perception of the future, making things appear bleak.

A critical distinction is made between passive and active suicidality. Passive suicidality involves thoughts like being okay if something accidental happened to end one's life, without a concrete plan or intention. Active suicidality, however, involves formulating a plan and is considered an emergency requiring immediate professional intervention in a hospital or crisis center to ensure safety and stability. Additionally, Dr. Marks notes common symptoms not explicitly on the DSM list, such as feeling overwhelmed, frequent crying, and increased irritability or a 'short fuse'.

The podcast stresses the importance of assessing the functional impact of these symptoms on an individual's life. It contrasts two scenarios: one person who, despite internal unhappiness, maintains daily functions like work and social activities (potentially able to 'slog through'), versus another who experiences severe impairment, such as difficulty getting out of bed, missing work, or neglecting personal hygiene. The latter scenario strongly indicates a need for professional help, which includes therapy and/or medication, underscoring that the severity of dysfunction is a key indicator for seeking treatment.

This is what clinicians use to diagnose mental disorders it's called the Diagnostic and Statistical Manual of Mental Disorders fifth edition it's our textbook.

In order to be diagnosed with depression you must have five of the following symptoms for at least two weeks.

People may say they feel sad, hopeless or even empty inside.

We call this anhedonia. So things that you used to enjoy you just don't get any pleasure out of anymore.

I've had some patients tell me they can tell when their depression is coming on because they feel their limbs getting really heavy.

Depression is a huge disrupter of your ability to concentrate and focus and if you can't focus or pay attention you will have trouble remembering things.

Suppose you were crossing the street and you thought if a car came and hit me right now I'd be fine with that. That's that's passive suicidality.

Active suicidality is an emergency and should be treated in a hospital or crisis center setting where the person can be in a safe environment until they're more stable.

Another way of putting it is how much dysfunction does this really cause?

This is the person who's probably not going to pull out of this without some sort of professional help.