Symptoms of Depression: How Depression Differs from Unhappiness

What are the symptoms of depression and how do you tell it from unhappiness? Read about the signs, causes and how therapy approaches depression.

If getting out of bed in the morning is becoming harder, if things you once enjoyed no longer mean anything to you and this has been going on for weeks, you may have asked yourself, "Am I just unhappy, or am I depressed?" The symptoms of depression are sometimes plain to see, and sometimes they appear in unexpected forms such as tiredness, irritability or physical pain. Feeling sad in the face of life's difficulties is a human response; depression, on the other hand, is a condition that affects a person's thoughts, feelings, body and daily life in a deeper and longer-lasting way. In this article I will try to explain how depression is recognised, in what ways it differs from unhappiness, what may lay the ground for depression, and how it is approached in therapy.

What Is Depression?

Depression is a mood problem in which low mood and/or loss of interest and pleasure lasting nearly every day for at least two weeks is accompanied by a range of other symptoms. Although it may be played down in everyday speech with expressions such as "feeling low" or "being out of sorts", depression is not a weakness of will or a character flaw. Just like physical illnesses, it is a mental health problem that needs to be taken seriously and, when necessary, addressed with professional support.

Depression can occur at any age. In children and adolescents it shows itself more through irritability and a drop in school performance, in adults through difficulty at work and in relationships, and in older age at times through physical complaints and forgetfulness. For this reason depression has no single appearance, and the symptoms of depression can differ from person to person, and even in the same person from one period to another. Some people begin the day with intense sadness, while others describe only deep tiredness and numbness.

What Are the Symptoms of Depression?

The symptoms of depression can be grouped as emotional, mental, physical and behavioural. The signs below are among the most common:

Emotional symptoms

• A feeling of sadness, emptiness or numbness lasting for much of the day,
• Loss of interest and pleasure in activities once enjoyed,
• Irritability, intolerance and quickness to anger,
• Feelings of worthlessness or of unwarranted and excessive guilt,
• Hopelessness and pessimism about the future.

Mental symptoms

• Difficulty concentrating, making decisions and remembering,
• Negative thoughts such as "Nothing will ever get better" or "I am a burden" becoming more frequent,
• Constantly turning over past mistakes in the mind,
• In some cases, recurring thoughts about death or the meaninglessness of life.

Physical symptoms

• Insomnia or sleeping too much,
• Marked changes in appetite and weight,
• Constant tiredness and loss of energy,
• Slowing down in movement and speech, or on the contrary restlessness,
• Headaches, back pain or stomach pain with no explained cause.

Behavioural symptoms

• Withdrawing from social relationships and family gatherings,
• Finding it hard to keep up with work, school or household responsibilities,
• Neglecting personal care,
• Getting through the day retreating into the phone, the screen or the bed.

Experiencing some of these symptoms from time to time does not, on its own, mean depression. A diagnosis can only be made by a professional, who evaluates the number, severity and duration of the symptoms and their impact on life. In addition, because thyroid problems, vitamin deficiencies or the side effects of some medications can lead to similar symptoms, an assessment by a doctor is important.

What Is the Difference Between Unhappiness and Depression?

Unhappiness and sadness are a natural part of life. A break-up, losing a job, a disappointment or failing to reach an important goal makes us sad. This sadness is usually tied to a specific event, eases over time, and good moments can come in between. Chatting with someone we love, receiving good news or taking part in an activity can make us smile even in the middle of unhappiness.

In depression the picture is different:

• Duration: The depressed mood lasts for weeks or even months and spreads across most of the day.
• Pervasiveness: It seeps not into one particular subject but into almost every area of life.
• Loss of pleasure: Even things that normally feel good no longer do.
• Self-perception: In unhappiness self-worth is generally preserved, whereas in depression the person begins to feel worthless, inadequate or guilty.
• Functioning: Depression leads to a marked decline in areas such as work, school, relationships and self-care.

Unhappiness is a wave within life; depression is more like a current that makes it hard to return to shore between those waves.

Say someone is going through a difficult period at work. They feel low for a few days but relax when they meet friends at the weekend. In this case we would most likely be talking about stress and unhappiness. If, however, the same person has not wanted to see friends for weeks, cannot sleep, forces themselves to go to work and thinks "Nothing has any meaning", it is important for this picture to be assessed by a professional.

What Causes Depression?

Depression has no single cause. Biological, psychological and social factors can come together to lay the ground for it.

• Biological factors: A family history of depression, changes in brain chemistry, hormonal periods, chronic illnesses and long-term pain.
• Psychological factors: An excessively self-critical attitude, perfectionism, a tendency towards negative thinking and difficult experiences in childhood.
• Life events: The loss of someone close, divorce, losing a job, migration, a serious illness diagnosis or traumatic events.
• Social factors: Loneliness, lack of social support, economic hardship and long-term stress.

The cognitive behavioural approach treats depression as a cycle between thought, feeling and behaviour. Negative thoughts deepen low mood, low mood draws the person away from activities and people, and this withdrawal seems to confirm the negative thoughts. Noticing this cycle is an important part of change.

How does depression affect daily life?

Depression affects not only a person's inner world but also their relationship with those around them. Tension can grow within the family, and resentments such as "Why aren't you taking part in anything?" can arise between partners. Performance at work can fall, and students' academic results can decline.

In Turkey, depression can still sometimes be hidden out of fear of stigma. Well-meant but inadequate advice such as "Be grateful, there are people worse off than you" or "Get out of the house a bit, it will pass" can make a person with depression feel even lonelier and more misunderstood. The high cost of living, long working hours, the isolating effect of big-city life and collective events such as the 6 February 2023 earthquakes have also added to the emotional load of many people.

In men, depression can sometimes appear less as sadness and more as anger, irritability, overwork or turning to alcohol. In women, hormonal transitions such as the postnatal period can be an important time of risk; I have covered this in detail in my article on postnatal depression.

What Can You Do to Cope with Depression?

The suggestions below are not a substitute for professional support, but they can help if you are experiencing mild symptoms or want to support your therapy.

Take action in small steps

In depression the thought "I'll feel better first and do it afterwards" is common. Yet the opposite often works: taking one small step lays the ground for the feeling to follow. Even a ten-minute walk, a short message to a friend or half an hour of housework can be a start.

Give your day a structure

Waking at set times, eating regular meals and planning the day around a few small activities can reduce the sense of disorganisation that depression creates. Let some of the activities you plan be things that bring pleasure and some things that bring a sense of achievement.

Notice your negative thoughts

When a thought such as "I can't do anything right" comes, try noting it as a thought rather than as a fact. Then ask yourself, "What is the evidence for and against this thought?"

Stay connected

Depression pulls a person towards loneliness, yet loneliness can deepen depression. Without forcing yourself, try to keep in touch with one or two people you trust. If sharing your feelings feels hard, even a silent walk together can do you good.

Treat yourself with compassion

Depression can make your inner voice quite harsh and critical. Thoughts such as "I can't even do something this simple" or "Everyone manages, only I can't" make an already difficult process heavier. At such times, try to treat yourself the way you would treat a close friend going through a hard period. You would probably say to them, "You are very tired right now, and you are doing what you can." Showing yourself the same understanding does not mean giving up on yourself; it means opening up the space you need to recover.

Adjust your expectations temporarily

In depressive periods, trying to keep up your usual pace can increase feelings of inadequacy. Shortening your to-do list during this time, setting your priorities and temporarily sharing some responsibilities help you protect your energy. Completing a small task is also an achievement and deserves to be noticed.

Support your body

Regular sleep, getting out into daylight, light physical activity and staying away from alcohol are basic steps that support your mood. Although these steps look small, together they can make a meaningful difference.

When Should You Seek Professional Support for Symptoms of Depression?

The symptoms of depression often become clear gradually, so a person may find it hard to judge when to ask for help. It is important to speak to a mental health professional in the following situations:

• If symptoms have continued for more than two weeks,
• If your functioning at work, school, home or in your relationships has clearly declined,
• If there are serious changes in your sleep, appetite and energy level,
• If you feel worthless, hopeless or helpless,
• If nothing that used to make you feel better does so any more.

If you have thoughts of harming yourself or ending your life, please do not try to carry these thoughts alone. In an emergency, call 112 (Turkey's emergency services) or go to the nearest emergency department. Asking someone close whom you trust to be with you at that moment is also an important step.

Depending on the severity of the depression, medication may be needed in addition to therapy. This assessment should be made by a psychiatrist. Therapy and psychiatric assessment are not alternatives to each other; they are often processes that complement each other.

How Is Depression Approached in Therapy?

One of the approaches whose effectiveness in treating depression is supported by research is cognitive behavioural therapy. This approach aims to explore together, and change step by step, the patterns of thought and behaviour that keep depression going. If you would like information about the basic principles of the approach, you can read my article on cognitive behavioural therapy.

The therapy process generally works on the following areas:

• Behavioural activation: Gradually bringing back into life the meaningful and enjoyable activities that have declined with depression.
• Thought records: Noticing and examining negative automatic thoughts and developing more balanced alternatives.
• Working on core beliefs: Understanding deep-seated beliefs such as "I am inadequate" or "I am not worth loving".
• Problem-solving: Identifying workable steps for the concrete problems that contribute to depression.
• Relapse prevention: Learning to recognise early warning signs after recovery and to make a plan against them.

Therapy is a collaborative process shaped according to your pace and needs. You can find information about individual work on depression and mood problems on the depression and mood page.

Frequently Asked Questions

Do the symptoms of depression go away on their own?

Mild depressive periods can sometimes ease on their own; however, if symptoms last a long time or affect your functioning, it is important to seek support rather than wait. Recovery generally goes more easily when depression is addressed early.

How do I know if I am depressed?

Low mood and loss of interest lasting for more than two weeks, accompanied by changes in sleep, appetite, energy and concentration, are important signs. However, these symptoms on their own do not amount to a diagnosis; a definite assessment is possible through sessions with a professional.

Do you necessarily need to take medication for depression?

No, not every depression requires medication. In many mild and moderate cases, therapy alone can be effective. Whether medication support is needed in more severe pictures is decided by a psychiatrist.

If someone close to me is depressed, how can I help?

It is important to listen to them without judging, to avoid pressuring phrases such as "Pull yourself together", and to gently encourage them to seek professional support. Do not forget to look after yourself too; the person giving support may also need support. If you or your loved one are struggling in this process, it can be reassuring to know that seeking support from a professional is always possible.

• #depression
• #symptoms of depression
• #unhappiness
• #cognitive behavioural therapy

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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