What Are The Signs Of Depression?

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The signs of depression are many and varied. Depression is much more than a feeling of sadness; it is a medical condition that may cause severe, prolonged symptoms and significantly disrupt a person’s daily functioning.^[1]

Depression is thought to be the most common mental health condition in the world, with almost one in five Americans alone experiencing a depressive episode in their lifetime. Though the condition is widespread, it may be difficult to recognize. Symptoms of depression may be masked by physical complaints or substance abuse, or hidden because of one’s fear of being stigmatized.^[1]^[2]^[3] Signs of depression may go unnoticed, and the condition is thought to be underdiagnosed, particularly in primary health care settings.^[4]

General signs of depression

Symptoms of depression may vary by age and sex, but a list of some of the more common signs of a depressive episode may include:^[1]^[5]

Persistent low mood; feelings of sadness, hopelessness, emptiness or even irritability, frustration and anger
Loss of interest or pleasure in activities that used to be enjoyable; this can include sex
Excessive guilt or feelings of worthlessness
Tiredness and lack of energy
Trouble concentrating and making decisions
Memory problems
Talking or moving more slowly than usual
Restlessness or trouble sitting still
Disrupted sleep patterns, including difficulty falling asleep, not being able to sleep through the night, waking up early or sleeping too much (excessive sleeping)
Changes in appetite and/or weight, there may be an increase or loss of appetite and weight
Persistent headaches, other body pains, or digestive trouble without a clear physical trigger
Recurrent thoughts of death or suicide, or suicide attempts

Other, less obvious signs of depression may include:^[1]^[6]

Anxiety
Ruminative thinking: this refers to repetitive negative thoughts or brooding about distressing experiences or thoughts^[7]
Self-harming, e.g. cutting oneself
Substance abuse and addiction, including heavy drinking and smoking

Signs of depression are typically present for more than two weeks. If you think that you might have signs of depression.

Good to know: Depression varies in form and severity, and not everyone will experience all of the above symptoms. For example, a person may have several of the above signs of depression, but not sadness specifically.^[8]^[9]^[10]

There are many different types of depression, and the condition may occur together with a number of other health conditions – mental and otherwise. For example, depression may co-occur with an anxiety disorder, attention deficit hyperactivity disorder or a personality disorder, or diabetes, heart disease and other health conditions. The relationship between depression and other conditions is complex.^[1]

Sometimes, symptoms that appear to be related to depression may be indicators of another condition. For example, a person may develop apparent signs of depression due to a physical condition like hypothyroidism, which should get better with treatment, or another mental health condition like bipolar disorder. It is important to rule out other possible causes of the symptoms.

When to get help

It is important not to ignore signs of depression, particularly if they seem to be getting worse. Seeing a doctor as soon as possible is recommended.

Depression is considered a treatable condition. For information on depression tests, diagnosis and treatment, including psychotherapy and antidepressant medication, see the resource on depressive episodes.

If a person shows signs of crisis – obvious indicators that they are strongly affected by depression or at risk of suicide – it is important to call a doctor, emergency services provider or suicide prevention helpline without delay.

Signs of depression in women

Females seem to be more likely than males to experience depression, probably due to biological, hormonal and social factors, and some of the signs of depression may differ between the sexes.^[2] For example, women with depression may be more likely than men to experience the symptoms of excessive guilt and anxiety.^[11]

Other signs of depression that may be more likely to be present in women include:^[2]^[11]

Increased appetite
Weight gain
Sleeping too much
Lack of energy

Some types of depression are unique to women. These include depression experienced as part of premenstrual dysphoric disorder (PMDD) and perimenopausal depression. Perinatal depression, including postpartum depression, is strongly associated with women, though new parents of any gender can experience it. Women experiencing symptoms of depression are advised to consult a medical practitioner about treatment options, including psychotherapy and medication.^[12]

Signs of PMDD

It is estimated that between five and eight percent of women experience a severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD). Signs of PMDD may include symptoms of depression, such as low mood, ruminative thinking or obsessive thoughts, irritability and suicidal thoughts, sleep disturbances, changes in appetite, joint and muscle pain, as well as headaches, bloating and breast tenderness, among others.^[11]^[12]

Signs of postpartum depression

Postpartum depression is a type of perinatal depression that may occur in the year after having a baby.

Postpartum depression goes far beyond the mild “baby blues” that many new mothers experience for four to 10 days after giving birth, and can interfere with the new mother’s ability to care for herself and her baby.

Signs of perinatal depression may include anxiety, extreme worries about the well-being of the baby, severe sadness and exhaustion, among other typical symptoms of depression. These signs may begin during the third trimester. Perinatal depression is relatively common.^[11]^[12]^[13]

Signs of perimenopausal depression

During perimenopause – the transition to menopause – some women may experience depression. To an extent, mood swings, sleep difficulties and physical symptoms like hot flashes may be normal during this time, but anxiety, irritability, extreme sadness and other depressive symptoms may be signs of perimenopausal depression.^[12] If you think that you might have signs of depression, Please check with your doctor Find my Doctor to find out more about your symptoms.

Signs of depression in men

While men are less likely than women to experience depression, it is still a serious health problem that affects a large number of males. Men are statistically less likely to acknowledge their depression or seek help and treatment. Furthermore, men with depression are at a greater risk of suicide than women, which may be related to problematic societal norms and pressures.^[2]^[14]^[15]

Signs of depression in men may include:^[2]^[14]

Irritability or anger
Agitation
Behavioral changes, e.g. becoming controlling or violent
Tiredness
Loss of interest in work, family or hobbies
Difficulty sleeping
Weight loss
Physical symptoms, such as headaches, chronic pain and digestive problems
Substance abuse; including alcohol
Risk-taking, e.g. unsafe driving or unsafe sex

Despite a loss of interest in work or loss of concentration and attention, some men with depression may work longer hours than usual, possibly to avoid showing signs of the condition.

While the signs of depression may differ slightly between men and women, treatment is generally the same and typically includes talking to a mental health professional and taking antidepressant medication where recommended. Men experiencing symptoms of depression are advised to consult a medical practitioner. If you think that you might have signs of depression, Please check with your doctor Find my Doctor to find out more about your symptoms.

Signs of depression in teens and young adults

Teenagers can also experience depression, but it may be difficult for their caregivers to recognize the symptoms, and many cases go undiagnosed and untreated.^[16] Signs of depression in teens and young adults may differ somewhat to those in adults, and may include the following:^[17]

Seeming annoyed by everything and everyone
Being argumentative and picking fights
Responding to minor provocations with emotional outbursts
A much stronger than usual need for social connection and social validation
Promiscuity, substance abuse and risky behaviors
Difficulties with school work
Sleep disturbances, particularly sleeping too much^[18]

Other, more typical signs of depression, such as fatigue and loss of interest in activities that were once pleasurable, are very often present. It is important to distinguish normal teenage behaviors from teen depression. Significant changes in mood, together with changes in functioning, like serious social or school problems, indicate that a healthcare professional should be consulted.^[17]

If a teenager shows signs of suicidal thoughts or actions, it is vital to take these seriously, and it is of the utmost importance to call a healthcare professional or suicide prevention hotline without delay.

Signs of depression in children

Younger children can also experience depression. However, because their behavior may change as they go through different childhood stages, and because they may exhibit different signs of depression compared to adults, it can be difficult for caregivers to recognize that a child is depressed.^[19]

Signs of depression in children may include:^[17]^[19]^[20]

Clinging to caregivers
Pretending to be ill and refusing to go to school
Getting into trouble at school
Being irritable and negative
Being argumentative and picking fights
Responding to minor provocations with outbursts of emotions
Showing excessive anxiety about caregivers passing away
Excessive sulking
Excessive crying or tantrums
Experimenting with alcohol or drugs
Displaying a lack of care for things they used to value highly^[21]

Other more typical signs of depression in adults, such as sleep disturbances, tiredness, changes in appetite and loss of interest in activities that were once pleasurable, may be less commonly present in children with depression.

The symptoms of depression may interfere with the child’s ability to partake in social activities, complete schoolwork and enjoy family life.^[20] If a caregiver notices that their child’s behavior and day-to-day functioning has changed significantly, it is recommended that they speak to a healthcare professional.

Like people of other age groups, children can show signs of suicidal thoughts or actions. If a caregiver suspects that a child is at risk of harm, they should contact a healthcare professional or suicide prevention helpline immediately.

Signs of depression in the elderly (geriatric depression)

Despite depression being more prevalent than dementia among the elderly, it remains underdiagnosed and undertreated. Some of the signs of depression in older people may be different to those considered typical, and they may be mistaken for indications of other conditions, like Alzheimer’s disease.^[22]^[23] Depression in older adults is sometimes called geriatric depression.

In addition to manifestations like irritability, sleep disturbances and appetite changes, signs of depression in the elderly may include:^[22]^[24]

Anxiety
Aches, pains and other physical symptoms
Neglecting self-care
Confusion and agitation
Difficulty getting up in the morning
Behaving uncharacteristically
Alluding to a depressed or anxious mood with vague language (e.g. talking about their “nerves”)

A senior citizen experiencing symptoms of depression is advised to consult a medical practitioner about treatment options, including psychotherapy and medication. If you think that you might have signs of depression, Please check with your doctor Find my Doctor to find out more about your symptoms.

Types of depression

There are a number of different types of depression and conditions that cause depressive symptoms. These include:^[25]^[26]

Major depression. Also called clinical or unipolar depression, major depressive disorder or just depression, this is the most commonly diagnosed form
Dysthymia (a form of persistent depressive disorder). A milder, long-lasting form of depression^[27]
Adjustment disorder with depressed mood: Symptoms of depression that are triggered by a major life stressor, like moving house or becoming unemployed
Seasonal affective disorder (SAD). Depression that affects some people seasonally, typically in the colder, darker months
Bipolar disorder. A mental health condition characterized by periods of depression and mania

A person may experience a depressive episode as part of a chronic depressive condition, as repetitive bouts of depression, or as an isolated occurrence. For information on the causes, diagnosis and treatment of depression, see this resource on depressive episodes.

It is important to note that depressive symptoms may be a feature of other health conditions, including Parkinson’s disease and hypothyroidism, among others. Depressive symptoms may also be more likely to co-occur with certain conditions, such as diabetes, or chronic pain due to inflammatory joint conditions.^[28]

Signs of a bipolar depressive episode

Previously known as manic depression, bipolar disorder is a condition that can cause extreme shifts in mood. A person may experience periods of deep depression, where they feel very low, and periods of mania, where they feel very high. When a person with bipolar disorder is experiencing a depressive phase, they may have many of the signs of depression detailed above.^[29]

Signs of depression FAQs

u003cstrongu003eWhat are the first signs of depression?u003c/strongu003e

Any of the symptoms of depression listed above, including persistent low mood, loss of interest in activities that used to be enjoyable, and excessive guilt or feelings of being worthless, may serve as “warning signs” for a depressive episode coming on. Additionally, research suggests that a person might experience other early symptoms that indicate the onset of depression, known as a prodrome, in the days, weeks or months before becoming depressed. During the prodrome, the following symptoms may be present:u003csupu003eu003ca href=u0022#fn30u0022u003e[30]u003c/au003eu003ca href=u0022#fn31u0022u003e[31]u003c/au003eu003c/supu003eu003cbru003eu003cbru003e- A vague sense of emotional discomfort, which may be expressed as “something not being right”u003cbru003e- Anxiety, sadness or irritabilityu003cbru003e- Difficulty concentratingu003cbru003e- Loss of interest and motivationu003cbru003e- Fatigueu003cbru003e- Sleep disturbances, e.g. insomnia or sleeping a lot more than usualu003cbru003eu003cbru003eThese symptoms may be mistakenly attributed to external factors such as bad weather or stress. If a person thinks that they may be experiencing a depressive phase, it is recommended that they speak to a healthcare provider.

u003cstrongu003eIs sleeping too much a sign of depression?u003c/strongu003e

In some cases, sleeping too much can be a sign of depression. Also known as excessive sleeping or hypersomnia, a person may experience it as part of a depressive disorder. However, sleeping too much can also be caused by a number of other conditions, including hormonal conditions like u003ca href=u0022https://adoctor.org/conditions/hypothyroidism/u0022u003ehypothyroidismu003c/au003e, neurological conditions like u003ca href=u0022https://adoctor.org/conditions/parkinsons-disease/u0022u003eParkinson’s diseaseu003c/au003eu003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn32u0022u003e[32]u003c/au003eu003c/supu003e or narcolepsy, as well as certain medications. If you are concerned about sleeping too much, it is recommended that you consult a doctor.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn33u0022u003e[33]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn34u0022u003e[34]u003c/au003eu003c/supu003e

u003cstrongu003eWhat are the physical signs of depression?u003c/strongu003e

Physical symptoms of depression may include:u003cbru003eu003cbru003e- Feeling tired a lotu003cbru003e- Persistent aches, pains or ailments, such as u003ca href=u0022/conditions/headache/u0022u003eheadachesu003c/au003e or u003ca href=u0022/conditions/functional-dyspepsia/u0022u003eindigestionu003c/au003e, without a clear physical causeu003cbru003e- Slowed speech or movementu003cbru003e- Restlessness or difficulty keeping stillu003cbru003e- Unplanned weight loss or gain

u003cstrongu003eDepression and irritability: what is the connection?u003c/strongu003e

Persistent irritability can be a sign of depression in some people. A person might also be angry a lot and/or experience several of the other symptoms described above.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn6u0022u003e[6]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn35u0022u003e[35]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn36u0022u003e[36]u003c/au003eu003c/supu003e

u003cstrongu003eAreu003c/strongu003e there u003cstrongu003esigns of depression test?u003c/strongu003e

There are a number of self-assessment u003ca href=u0022https://www.uptodate.com/contents/calculator-depression-screening-by-a-nine-item-patient-health-questionnaire-phq-9-in-adults?source=see_linku0022 target=u0022_blanku0022 rel=u0022noreferrer noopeneru0022u003etestsu003c/au003e, checklists, and quizzes available on the internet, varying in length and complexity. While some of these tests may help a person to assess how they have been feeling, they u003cstrongu003ecannot replace a consultation with a GP or other healthcare professional.u003c/strongu003e If a person has any concerns or questions about signs of depression, it is important that they seek advice from a qualified medical practitioner. They can print out or take a screenshot of the quiz results and take them along to their appointment.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn37u0022u003e[37]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn38u0022u003e[38]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn39u0022u003e[39]u003c/au003eu003c/supu003e

u003cstrongu003eWhat if a partner, relative or friend has signs of depression?u003c/strongu003e

If you have recognized that your husband, wife, girlfriend, boyfriend, loved one or friend has signs of depression, you might be wondering how to help. It is important to broach the subject carefully, in a non-accusatory and tactful manner, and encourage the person to talk about how they are feeling. Listening may be helpful, and, if it seems appropriate, the person could be encouraged to speak to their GP or another medical practitioner, or join a local support group.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn40u0022u003e[40]u003c/au003eu003c/supu003e In addition, they could be encouraged to take small steps to help themselves, such as exercising, or engaging in some simple movement, like a regular walk, and eating a balanced diet. It is important to be patient when interacting with someone who is depressed.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn41u0022u003e[41]u003c/au003eu003c/supu003e u003cstrongu003eIf a person shows signs of crisis – obvious indicators that they are strongly affected by depression or at risk of suicide – it is important to call a doctor, emergency services provider or suicide prevention helpline without delay.u003c/strongu003eu003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn14u0022u003e[14]u003c/au003eu003c/supu003e

u003cstrongu003eIs it normal to develop signs of depression after the death of a loved one?u003c/strongu003e

After the loss of a partner, friend or family member, it is normal to experience intense sadness and grief. While grief and depression can seem similar, they are not the same thing. As is the case with depression, a person experiencing bereavement-related grief may have difficulty sleeping and eating, and lose interest in activities they normally enjoy.u003cbru003eu003cbru003eHowever, the symptoms of grief tend to fluctuate over the day and week and get better on their own over time, while the symptoms of depression are typically present almost constantly, i.e. almost every waking moment during an episode of depression. In some cases, grief can trigger or worsen a depressive episode, but it is important to remember that by far not everyone who is grieving will develop clinical depression. u003cstrongu003eIf a person who has lost a loved one finds that their symptoms are severe, they have difficulty functioning in daily life, or they have thoughts of suicide, it is recommended that they speak with a healthcare practitioner.u003c/strongu003eu003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn42u0022u003e[42]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn43u0022u003e[43]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn44u0022u003e[44]u003c/au003eu003c/supu003e

u003cstrongu003eCan preschoolers be depressed?u003c/strongu003e

Many psychiatrists and psychologists now believe that children as young as two or three can present with preschool depression. Parents and caregivers may notice excessive and long-lasting sadness and irritability in the child, as well as excessive guilt, a negative and pessimistic self-image, and a loss of pleasure in play and everyday activities. If these signs are evident, it is recommended that you seek the advice of a pediatrician, or a child psychologist or child psychiatrist.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn45u0022u003e[45]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn46u0022u003e[46]u003c/au003eu003c/supu003e

u003cstrongu003eWhat are the signs of high-functioning depression?u003c/strongu003e

High-functioning depression is not a recognized medical diagnosis. However, the term is sometimes used colloquially to describe people who may experience depression, but perhaps not to the extent that it significantly or noticeably disrupts their professional and/or personal life. Sometimes, signs of depression may be subtle. Furthermore, depression may vary in severity, with some people experiencing milder forms of the condition than others.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn47u0022u003e[47]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn48u0022u003e[48]u003c/au003eu003c/supu003e

u003cstrongu003eWhat are the signs of hidden depression?u003c/strongu003e

Symptoms of depression vary from person to person, and sometimes they may be quite subtle or described as “hidden”. Some of the possible signs of depression that may be less obvious to a person include:u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn6u0022u003e[6]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn35u0022u003e[35]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn49u0022u003e[49]u003c/au003eu003c/supu003eu003cbru003eu003cbru003e- Often feeling angry and/or irritableu003cbru003e- Difficulty concentrating or remembering thingsu003cbru003e- Deep feelings of guiltu003cbru003e- Persistent aches and pains

u003cstrongu003eI think I have signs of depression – what should I do?u003c/strongu003e

If you think that you have symptoms of depression, it is recommended that you see a medical doctor as soon as possible. They will be able to rule out other conditions and help you decide on a treatment plan, if necessary. contact your doctor u003ca href=u0022https://adoctor.org/u0022u003eFind My doctor locationu003c/au003e to find out more about your symptoms, and consider sharing the assessment with your doctor.

u003cstrongu003eMy signs of depression are coming back – what should I do?u003c/strongu003e

If you think that you might be experiencing a relapse of depression, it is important to see your doctor or therapist as soon as possible. They will be able to help you manage a u003ca href=u0022https://adoctor.org/conditions/depressive-episode/u0022u003edepressive episodeu003c/au003e, adjusting your treatment plan if necessary.

u003cstrongu003eSigns of anxiety disorder vs. signs of depression – what should I know?u003c/strongu003e

While there may be some overlap between signs of anxiety disorder and signs of depression, the two differ in their symptoms and are therefore diagnosed as distinct mental health conditions. Furthermore, treatment approaches may differ, depending on the diagnosis and individual presentation in a given person. Many people have both anxiety and depression. This co-occurrence is called comorbid depression and anxiety.u003csupu003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn25u0022u003e[25]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn50u0022u003e[50]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn51u0022u003e[51]u003c/au003eu003ca href=u0022https://adoctor.org/wp-admin/post.php?post=4971u0026amp;action=edit#fn52u0022u003e[52]u003c/au003eu003c/supu003e

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UpToDate. “Comorbid anxiety and depression in adults: Epidemiology, clinical manifestations, and diagnosis.” June 15, 2017. Accessed January 7, 2019. ↩

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**What are the Signs of Depression?**

Depression is a serious mental health condition that can affect people of ⁣all ages. It can cause a variety of symptoms, including sadness, loss of interest in activities, changes in appetite, and sleep problems.

**What are the symptoms of depression?**

The symptoms of depression can vary from person to person, but some common signs include:

* ⁤**Persistent feelings of sadness or ⁣emptiness**

* **Loss of interest ‍in activities that were once enjoyable**

* **Changes in appetite, weight, or sleep patterns**

* **Difficulty concentrating or⁣ making decisions**

* **Fatigue or loss⁤ of energy**

* **Feelings of ⁢worthlessness or guilt**

* **Frequent thoughts of⁤ death or suicide**

**How is depression diagnosed?**

Depression ‌is diagnosed by a mental health professional, such as a psychiatrist or psychologist. The⁣ diagnosis will be based ‍on a review of the patient’s symptoms, as well as a physical exam and a psychological evaluation.

**What are the risk factors for depression?**

There are a number of risk ⁤factors for⁢ depression, including:

* **Family history⁢ of depression**

* **Personal history of trauma or abuse**

* **Chronic⁢ illness or ⁢disability**

* **Substance abuse**

* **Stressful life events**

**What is the treatment for depression?**

Treatment for depression‌ typically involves a combination of medication and therapy. Medication can help to relieve symptoms of depression, while therapy can help individuals‍ learn how to manage their condition and improve their coping skills.

**How can I help someone who is depressed?**

If you know someone who is depressed, there are a number of things you can do to help:

* **Offer your support and understanding.** Let them know that ⁢you⁢ care about them and that you are there for⁢ them.

* **Listen to them without judgment.** Allow them to express their feelings and thoughts without interrupting ⁢them.

* **Encourage them to⁢ seek professional help.** ⁤If they are not already seeing a mental health professional, encourage‍ them to ⁣make an appointment.

* **Help them with practical tasks.** Offer to help with things like cooking, cleaning, or running errands.

* **Be⁢ patient‌ and understanding.** Depression can be a long-term condition,‌ and it is important to be patient with those who are struggling.

**Remember:** Depression is a treatable condition. With the right treatment, people with depression can recover and live happy, productive lives.

What are the Signs of Depression?