You might think you know what signs to look for in yourself, or others, when wondering if you or someone you love is battling depression. But, things that might not look like depression, but actually are, often get overlooked because not all depression presents itself with the same set of symptoms. While we have made major strides in the collective mental health conversation (thank you, Carrie Fisher), we still have a lot to learn about depressive disorders, their signs and symptoms, and how to best treat them.
When most people think of depression — especially those who have never suffered from depression — they might imagine a lingering sadness. While it's true that some forms of depression can be brought on by a sad event, depression and sadness are really not the same thing at all.
"Because we associate depression with its primary symptom of pervasive sadness, many of us struggle to tell the difference between these two common psychological states," Guy Winch Ph.D. wrote on his blog The Squeaky Wheel on Psychology Today. "This is a huge problem."
Winch explained that sadness is a normal human emotion that everyone experiences. While it's often "triggered by a difficult, hurtful, challenging, or disappointing event, experience, or situation," once that event is over the sadness usually goes away. Depression is totally different.
"Depression is an abnormal emotional state, a mental illness that affects our thinking, emotions, perceptions, and behaviors in pervasive, and chronic ways. When we’re depressed we feel sad about everything," Winch explained. "Depression does not necessarily require a difficult event or situation, a loss, or a change of circumstance as a trigger. In fact, it often occurs in the absence of any such triggers. People’s lives on paper might be totally fine — they would even admit this is true — and yet they still feel horrible."
Because people most often associate depression with sadness, if it doesn't present that way, a serious problem could be missed if you don't know to look for uncommon signs of depression. Here are some things to be aware of that might not look like depression, but actually are.
1. Acting Careless, Reckless, Or Fearless
Some people who are experiencing depression engage in escapist behavior. While this is more often observed in men, plenty of women do it, too. Once, during a depressive episode, I booked a really expensive trip I couldn't afford. I told myself that it didn't matter if I had the money or not, and because all I wanted to do was feel better, it was worth it.
People engaging in escapist behavior generally aren't thinking about how it will affect their lives longterm because feeling better now is the only thing that matters. Project Helping defines escapist behavior as things like substance abuse, compulsive gambling, reckless driving, or dangerous sports.
These are generally things that put your health or wellbeing at risk, things you wouldn't normally do, and might regret later. I definitely regret spending money on a trip I never should have taken. And, aside from being expensive, it was awful because I was depressed the entire time, and I couldn't really enjoy it.
2. Inappropriate Affect
This is basically laughing or crying at inappropriate times, according to Behave.net. Inappropriate affect can manifest as behavior that "does not match the situation, or the content of talk or thought, for example laughter while describing the loss of a loved one."
This is especially important to watch out for if you, or someone you know, has a specific way of reacting to certain situations, and that changes suddenly. For instance, a friend who is always caring and compassionate begins laughing at funerals, or who seems to register no emotion upon hearing something upsetting. Your friend might might be suffering from depression instead.
3. Anger & Irritability
For some people, depression manifests as anger and irritability. It's not uncommon for people experiencing depression to feel angry or irritated about things that would not not normally bother them, even if they're not sure why. Feeling angry and irritable is often a sign that these feelings are masking a deeper emotion.
"In fact, anger almost always covers or is accompanied by hurt, sadness or fear. When anger is helpfully expressed and begins to resolve, it almost always dissolves into tears and more vulnerable feelings. Usually, as long as a person sticks with the anger, they are stuck in the depression," Cynthia W. Lubow, MS, MFT explained on Good Therapy.
"One way to look at this is that 'frozen' feelings are often at the root of depression. Someone who feels and/or expresses only anger probably has frozen hurt, fear, shame, guilt, or sadness. Someone who never feels or expresses anger probably has frozen anger. In either case, the person may be depressed and suffering and probably will continue to suffer until their frozen feelings are safely unlocked, expressed, and resolved."
I usually say that I never get bored, but technically that's not true. When I am experiencing a depressive episode I don't find anything enjoyable, and very few things can hold my attention. To the outside eye this can look a lot like boredom.
"Things stop sounding fun and seem not to be worth the effort," Melody Wilding, LMSW noted on Psych Central. "Little by little, you drop activities until only the simplest and least demanding (watching TV, surfing the Internet, napping) remain."
People not familiar with depression — who are witnessing a friend or loved one going through depression — might just think the bored person needs a new set of hobbies. But, if the person is truly depressed, nothing is going to be enjoyable. See my note about literally not being able to do anything except watch Gilmore Girls for over a month. If I ever stop wanting to watch Lauren Graham, then it's pretty much as serious as it can get.
5. Work, Work, Work
Sometimes the people struggling the most are the ones who look like they have it all together. Keeping yourself extremely busy with work and other commitments can be an attempt to avoid dealing with your feelings, especially if the behavior is out of character for you. To the outside eye, a person using work to mask depression may be seen as very high achieving, appear to have it all together, and seem like they are totally winning at life.
"Some depressives mask it by becoming workaholics," Mike Leary, a psychotherapist in private practice, said in Forbes, which reprinted the article from Quora. "They are discouraged about something they believe they cannot change about their life or in themselves so instead they immerse themselves in something they can do something about: work. It becomes a type of drug to distract oneself in the hopes that the despair will dissipate, and they’ll eventually pull out of it."
Personally, after my dad died, I enrolled in grad school, planned my out-of-state wedding, and worked a full-time job. I barely had time to breathe let alone think about all of the reasons I felt like crap. While this worked for a while, there was an inevitable crash, and all of the things I was trying to avoid were still there. And, by avoiding the original issue I inadvertently created a few new ones, too.
Being aware of symptoms of depression, other than appearing sad, is an important tool for identifying depression in yourself, or a loved one. And, recognizing the symptoms is the first step toward healing.