How do you know if you've got depression? We sought the help of two mental health experts to find out

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Feeling down? You’re not alone. With finances, job instability and work pressures all playing on our minds at the moment, it’s no wonder many of us are finding it harder and harder to cope.

With stresses high and the nation’s mood low, are bouts of feeling down a sign of something more serious - namely, depression? Or are we too quick to assume the worst? “We often use the term depression when we’re feeling sad or miserable about life. Usually these feelings pass in due course,” explains Psychologist, Elaine Slater . “Although sometimes feeling low and sad is a common emotion, depressive illness is an ongoing condition.” How can we best spot the difference and to what extent are the two interlinked? We found out.

Are you depressed?

“Feeling down can be a symptom of being depressed, but depression  as an illness, is very different,” explains Consultant Psychiatrist Dr Paul McLaren of Priory’s Fenchurch Wellbeing Centre . “One reliable way of distinguishing ‘feeling low about difficult stuff’ from ‘depression as an illness’ is loss of enjoyment. When we are depressed, nothing excites or cheers us up, even things we usually look forward to. Depression can also feel like a physical problem, as if we are weighed down or we have to walk through wet cement.”

Why might you be depressed?

This is specific to the individual, but there are some risk factors that could make a person more susceptible to developing it. As Dr McLaren explains, there is a significant interplay between internal and external causes. “Both are important. We know that the genes we have are very important in giving us a vulnerability to depression but it is not just an inherited condition,” he says. “What we inherit is a ‘vulnerability’; and if we have that vulnerability, and the wrong sort of bad external events happen to us, then we get depressed. Different people with the vulnerability are probably vulnerable to different sorts of bad things happening. Some people may get depressed after physical stress such as a heart attack or stroke. In others, it may be triggered by a relationship or losing a job.”

if we have that vulnerability, and the wrong sort of bad external events happen to us, then we get depressed

How common is depression?

Much more common than most think and thanks to greater public awareness, more people are becoming better at talking about it. “More people are probably coming for help,” says Dr McLaren. “There is still a stigma, and people feel ashamed of how they are feeling which stops them asking for help. That is still a problem, but it is getting less. It is difficult to tell whether it is more actually more common though. It has probably always been common - we are just more aware of it.”

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What are the different types of depression?

Depression has many incarnations, ranging from the mild to the more extreme. “In its mildest form, depression can mean just being in low spirits. It doesn’t stop you leading your normal life, but makes everything harder to do and seem less worthwhile,” explains Elaine Slater. “Depression becomes a serious illness when the sufferer starts to develop more extreme symptoms. At its most severe, major depression or clinical depression can be life threatening, because it can make you feel suicidal.”

Much like with the physical, the earlier mental health problems are spotted, the easier they can be to treat and overcome. According to Elaine, the different types of depression can be separated into the following categories:

• Mild depression: has some impact on daily life

• Moderate depression: has a significant impact on daily life

• Severe depression: makes it almost impossible to get through daily life

• Postnatal depression: experienced by parents after having a baby

• Bipolar disorder: when mood swings from one extreme to another

• Seasonal affective disorder: depression caused by seasonal patterns

What are other common symptoms to look out for?

As touched on earlier, consistent loss of enjoyment can be a key marker in identifying the development of depression. The complexity of the condition is such though, that its other symptoms can vary from the emotional to the cognitive, behavioural to the physical. You needn’t need to be exhibiting the full spectrum of signs, but a useful indication may be how hard you’re finding completing everyday tasks. It is also important to note that low mood may also be as a result of physical ailments or lifestyle and so it’s definitely worth exploring these with your GP first in order to see if something else may be responsible. “Sometimes physical problems such as infections or an underactive thyroid can produce low mood,” says Dr McLaren.

If these factors have been crossed off the list, then it is worth seeing if you exhibit any of the following symptoms too. Here Elaine Slater provides a rundown of common signs to provide a helping hand:

Emotional symptoms

• Feeling sensitive and vulnerable
• Tearful and emotionally tired
• Feeling numb, empty and full of despair
• Sense of hopelessness
• Experiencing a sense of unreality
• Feelings of disassociation
• Feeling restless and agitated
• Anxiety
• Increased irritability
• Lack of energy, motivation, positivity and enthusiasm
• Lack of interest in everyday life
• Feelings of isolation and inability to relate to other people
• Feeling worse in the morning and not wanting to get out of bed
• Feelings of extreme guilt
• Confusion
• Feeling helpless
• Inability to switch off from negative thoughts

Cognitive symptoms

• Inability to concentrate or make decisions
• Difficulty remembering things
• Negative frame of mind such as; the future seems bleak or what’s the point
• Self blame
• Constant worrying
• Loss of self-confidence and self-esteem
• Suicidal ideation

Behavioural symptoms

• Avoiding social events
• Retreating from relationships
• Avoiding contact with friends
• Having difficulties in home and family life
• Not doing enjoyable activities
• Neglecting hobbies and interests
• Finding it difficult to speak
• Turning to drugs or alcohol as a way of coping

Physical symptoms

• Sleeping issues such as insomnia
• Increased or reduced appetite
• Loss of sex drive
• Self harm
• Aches and pains with no obvious physical cause
• Tiredness and no energy
• Moving very slowly

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What are the best ways to treat it?

While genetics play a pivotal part, changes in lifestyle can definitely help strengthen defences explains Dr McLaren. “If you have a vulnerability, then regular heavy alcohol consumption can increase your risk of getting depressed. Regular aerobic exercise at least twice a week and a healthy diet can reduce it as can taking a positive approach to managing stress to also reduce the chances of depression being triggered.”

Maintaining regularity in your daily routine can also help, “Including for sleep,” advises Dr McLaren. “Take simple measures to enable sleep, such as going to bed at the same time and going to bed to just sleep - not to read, text or watch videos.” Sounds simple, but in our experience a sharper, more wide awake and alert mind can help immeasurably.

Finally, seek the support of others. If the increased awareness of mental health issues has taught us anything, it’s that strength really does lie in numbers and fighting depression on your own can often end up causing more harm than good. “If you are feeling persistently down or lacking in confidence and positive emotions, it is important to seek help as symptoms can interfere with work, social and family life.” says Elaine. “Ongoing deteriorating symptoms can have a severely detrimental effect on your wellbeing and overall health.” If you feel that it is getting out of control, see your GP. Each person’s personal prescription is unique to them and could range from meditation to medication, acupuncture to CBT - there is no one-size-fits-all approach. “Share your feelings with those close to you and get their support,” advises Dr McLaren. With depression’s stigma slowly losing its sting, you might be surprised at who might be going through the same problems too.

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