This is what I go through when I’m depressed. These aren’t exactly official symptoms, but they give a better feel of what it is like to be depressed.

You can use the information here to learn about early depression signs, so you can take action to possibly avert a depression episode, or minimise the problems it may cause.

If you are family or a friend and you notice we are showing these signs, you can warn us that we may be entering a depression episode (we don’t always see it coming), and you can help us take action to minimise the depression related problems.

Early Signs of becoming Depressed / Signs of Mild Depression

1

I START WAKING UP LATER. At first it doesn’t slip by much, just 10-15 minutes. But after a few days I may be getting up half hour to an hour later than usual. Then when I wake up, I feel slow, as if I haven’t gotten enough sleep, although I have gotten 6-8 or more hours of sleep.

It also becomes more difficult to follow my usual morning schedule of getting changed and getting out of the house. Everything takes a bit more effort and I am more forgetful. I often leave the house late, with some regular morning tasks undone, and usually in more disarray than usual.

2

IT BECOMES HARDER TO DO THINGS. I know what I have to do, but I just can’t seem to take the next step and actually do it. For example, I might know I have to put the garbage out, but I just can’t get around to actually doing it.

I would see a set of books to put away, but there would be no true connection between the mess and the need to clean it up. I might understand in an abstract distant way that the two should be linked, but I still don’t actually link them together in any concrete terms of desire or need or obligation.

It’s not laziness or forgetfulness – it’s more like the idea of taking action keeps slipping out of my mind immediately after I think of it.

Alternatively, immediately after I think about doing something, I feel an equal impulse not to do it. It’s not that I don’t think I should do the task, it just feels as my body / mind is rebelling, and often it feels as if my chest or muscles tense up in refusal.

3

IT BECOMES HARDER AND HARDER TO UNDERSTAND the task I am currently doing, and what the next step should be. My attention doesn’t wander – I just can’t figure out what is going on. It’s as if my intelligence level starts falling.

This affects even the day to day tasks that I can usually do effortlessly. They start to feel very difficult and if I can get away with it, I’ll put off whatever I’m doing until tomorrow. This inability to concentrate affects any work or studying that I am doing.

4

ANY DECISION BECOMES HARDER TO MAKE, from complex issues at work to simple things like whether to go to the supermarket this evening. Very often I waver back and forth on what to do and usually I tend to put off making any decisions at all. Or if I have to do something, I’ll take the path of least resistance.

For example, if I’m driving home, I’ll keep on changing my mind on whether to stop off at the supermarket (or the drug store, or the dry cleaners, or to visit a friend) until I pass it – and then decide I won’t go today. At office, I’ll put off decisions until the next day.

5

I FORGET THINGS. If I plan to do something, I might forget about it within minutes of making the plan. I might have something to do this evening and realise tomorrow that I forgot completely about it. I may have to meet someone tomorrow and forget about the meeting until they call to find out where I am.

There is no rhyme or reason for the forgetting. And I can’t say I’ll write it down because either I won’t (see item 2), or I’ll forget to look at my reminder list. Really. This happens.

As you can imagine, this can create havoc at work, and upsets friends whom I have stood up.

I don’t always notice the early signs of depression, but lots of things that need to be done start piling up.

Very often the five symptoms above start at a low level, so I don’t notice them. After all, any or all of the symptoms could be mistaken for tiredness or not having the time to finish things in our modern fast paced life.

So if I left stuff off for later because I felt tired, or if I don’t feel like doing anything because I had a hard enough day already, what’s wrong with that? This feeling of justifying why I'm not getting things done is particularly strong if I’ve just come off a manic high where I’ve been incredibly productive.

It’s possible to continue for quite a while (measured in days or weeks or months) in this state of low level depression. Particularly if you have activities that must happen, like going to work, or carrying children to school and taking care of them. You’ll just feel tired all the time and all the optional things you have to do or would like to do just don’t happen. Life gets dull, boring, lustreless.

No single thing is critical, but you won’t do any of them

Well, in addition to the lustreless life, you’ll start piling up lots of things, big and little, that need to get done. The groceries will sit on your countertop, your credit card bill won’t be paid, you won’t have carried the car for servicing, you won’t get around to buying the tickets for the concert you want to go to, you won’t have done laundry, you won’t have gone through the pile of papers on your work desk yet, you won’t have called your friend or your client.

The dogs need to get bathed, the house needs to be swept, the DVDs need to be returned to the rental shop. You’ve been missing classes. You won’t have picked up a present for the birthday party. You won’t have watered the plants or collected your clothes from the dry cleaners.

You get the idea. No single thing is a critical problem, but you won’t fix any, and you’ll find your life starting to crumble around you because of all the things you are failing to do. You’ll be aware of all the things that need to get done, but you just can’t get around to, well, doing them. And this is going to really really stress you out.

Depression CAUSES stress

It is usually said that stress causes depression. I think this is flat out wrong. My experience is that depression causes stress, because low level depression creates all of the little problems that add up over the course of a week or two or more to create one big heaping pile.

Then you’ll really be stressed.

And the stress then makes the depression worse. For me, it takes only about one week of deepening depression and skipping out on the little things to create a huge enough backlog to drown me. If you have a hectic lifestyle, it can take even less time to derail you.

To make matters worse, you will also have annoyed your family, friends and co-workers by not doing what you are supposed to do. So in addition to knowing that you are failing on your responsibilities and your competence, you have to deal with annoyed people.

Depression is very much a downward spiral. The worse things are, the worse they get.

Incredibly, so far the things I’ve been describing, I classify as mild depression. The following are additional symptoms that I also get. I tend to think that they appear later in the depression episode. But it’s not so clear cut.

I suspect that all the symptoms all appear at the same time, but when the symptoms are mild, the symptoms described below are either easier to miss or easier to overcome / work around. Then as the depression worsens, these start becoming more apparent because I can’t work around them any more.

Signs when you're definitely Depressed (but not the worst symptoms)

So as depression episode deepens, what happens next?

1-5

MORE OF THE SAME. The 5 signs / symptoms mentioned above continue to happen. Of course by now, my life is starting to derail in a big way and I am now clearly recognising that I cannot fix what is happening because of these depression symptoms.

6

MY SELF CONFIDENCE FALLS DRASTICALLY. I don’t feel as if I will ever succeed in anything. Which of course is made worse by the fact that I’m currently not succeeding in anything.

The loss of self confidence is not just because things are going wrong – it seems to be an intrinsic part of the depression itself. But like all parts of depression, the two pieces feed upon each other. You won’t do something because you don’t feel confident to do it, and then not doing it lowers your self confidence even more.

My self confidence usually fails to the point that I don’t like seeing myself a mirror. I try not to look in one, and when I do look, I do not see myself in the mirror, just a face that had no particular meaning to me.

7

I START LOSING A CLEAR SENSE OF IDENTITY. I FEEL AS IF I AM ACTING IN PUBLIC ALL THE TIME, or putting on “a public face,” or wearing a shell which does all the chatting and smiling, when all I feel like doing is staying at home and not talking to people.

It’s quite an effort to pretend to act like normal in public, but nobody seems to notice how fake my actions are. Which somehow makes me feel worse.

8

I BEGIN TO FEEL SLIGHTLY LIGHTHEADED ALL THE TIME. Everything feels as if it were a bit distant or dreamlike. I see and understand everything that is going on around me and will have a coherent discussion if someone asks me anything, but I don’t feel completely connected – as if everything around me isn’t quite happening to me.

Other people can notice this sense of disconnection – someone who talks to me will feel as if I am not paying attention or as if they are talking to someone who is not completely there. Or as if they are talking to a blank wall or a black hole. I’ve been told that this can be extremely disconcerting or very annoying.

9

I GET ANXIOUS AND NERVOUS DEALING WITH PEOPLE. I feel as if everybody is going to accuse me of some little thing I did wrong, or shout at me. I feel as every little thing I do is being judged and that I am going to be criticised for doing it stupidly. I feel as if I ask for help or a favour I will be turned down or laughed at.

It doesn’t matter whether I’m at work requesting information from someone else, or if I am asking a friend if they want to go to the movies this afternoon. It doesn’t matter if I actually did something wrong or if I am doing a favour for someone, and it doesn’t matter if what is being discussed is important or trivial or silly. I always feel as if I am going to be yelled at.

There is no logic or sense to these feelings – the sensation comes from inside me, not from what is actually happening. As a result I tend to avoid calling people or answering my phone, or even opening letters.

10

I STOP TALKING MUCH WITH MY FRIENDS AND FAMILY or I don’t attend any social functions, even if I have told people I would go. I beg off at the last minute or I simply don’t show up.

This is a combination of three things – nervousness in dealing with people (item 9), the inability to think make decisions (item 4) and the sheer inability to get things done (item 2). It doesn’t manifest as the separate symptoms – I just think “I don’t want to go out – it’s too much effort to get organised,” to “There will be so many people there and I don’t want to deal with them,” to simply not being able to decide what to do, so I eventually end up with the default and stay home.

I can understand that attending the function is important – like a sixtieth birthday for an uncle – but I just won’t be able to get my my act together to go.

11

I tend to want to break off relationships. I feel that the relationships are too much work, or that I am not good enough to be in one, or that I don’t have the energy to spare to cope with a relationship while the rest of my life is failing.

Usually, up to this point I am still able to act and move around in public. I’ll be slower starting off and not getting all that much done as I should and not dealing with people well, but I’m still functioning of sorts. By this point, however, it is taking huge amounts of my energy and willpower to maintain a semblance of normal life, as much as 70-80% of all my energy. But at some point I fall into what I would call serious depression.

The "I’m Seriously Depressed" Symptoms

The onset period of serious depression for me is very sharp. It usually starts on an afternoon when I return from work into the safety of my house. I would have been fighting the depression symptoms for a few days, but when everything becomes a burden to do, I can fight for only so long. Once home, I stop fighting, because I can’t keep it up any longer, and I let the depression take over. It’s a battle lost. It’s a battle I always lose.

What happens next is

12

COMMUNICATIONS FAIL COMPLETELY. I don’t call my family or friends, and I don’t return phone calls.

I don’t answer my cell phone – if it is ringing I will ignore it or hide the phone under cushions so I can’t hear it. I’ll turn it off or put it in silent mode or not bother to recharge it when it discharges. I’ll unplug my land line from the outlet so I don’t have to hear the telephone ringing.

I don’t listen to my answering machine. Heck, I’ve asked the telephone company to deactivate my voice mail because I’ve realised it is pointless – I never listen to the messages.

I don’t read text messages or my e-mail and I don’t reply to them. I may lurk on social networks but I will not actively respond to any requests to contact me.

I may or may not answer my door bell.

I don’t want anyone to get in touch with me and I don’t want to get in touch with anyone. This includes my parents, my brother, my partners, my closest friends. Nobody.

I can’t call for help because by the time I realise that I won’t be able to fight the depression anymore, my ability to communicate or reach out to others has already failed.

13

I BECOME TERRIFIED TO TALK TO PEOPLE or hear from people. When I say terrified, I mean terrified – the fear factor is huge. I cringe at the thought that someone might talk to me. This is item 9, but magnified one hundredfold.

14

I HIDE IN MY HOUSE. I don’t go to work and I don’t go visiting people. I don’t want to go outside for any reason.

Any activity that requires me to leave the house stops happening. I stop going to the gym, I stop meeting with friends, I stop talking walks.

Well, I go out when I need food. But that’s I usually after I have rummaged through the entire house and eaten everything that is in a box or bag that needs only microwaving.

But

When the fear becomes high enough or when I have not left my house in a few days, I become scared that my family or friends might come looking for me. I no longer feel that my house is a safe haven. So I disappear.

I get in my car and go driving. I can drive for hours. Or go to the beach, or anywhere the people don’t know me and won’t talk with me. Or I might hang out in a KFC or a restaurant where they won’t throw me out and read for an hour or two.

I’ll stay out until very late, often going to a late movie so I have somewhere to be. I’ll return at midnight or later so I won’t have to see anyone. I sneak up to my apartment to see if anyone is there. If anyone is there, I don’t go inside. I get back in my car and go driving.

If there is no one there, I gratefully get into bed, but the next day I’ll wake up and leave the house early so no one can see me. And so the days go. From my family’s point of view, I disappear completely.

When I disappear, I don’t relax. The purpose is escape and all I want to do is to put my body somewhere reasonably safe and comfortable so I can shut my mind down to escape the terror I feel.

I spend days like this with an almost completely blank mind. Just enough of me is alive to make sure I eat and sleep and to be cunning enough so that the average person doesn’t suspect what is going on.

Because my mind is so blank, I usually have a hard time remembering what went on. I can only remember if I put a bit of effort into it.

On some occasions the terror factor was so high that even though I am home alone, I have hidden under my bed and read and slept just so that in case someone comes visiting, they won’t find me. This was when I was 35 years old.

15

I SPEND A LOT OF TIME TRYING NOT TO THINK. I read the same magazines over and over again, and I read a lot of trashy sci-fi novels. Good science fiction, good literature and text books are usually beyond my ability to understand properly.

I watch television six to ten hours a day if I get the chance. Or more. I can easily watch television from 5 pm to 4 am without even getting up for dinner.

I can’t study or do anything productive that requires concentrated thought.

I don’t have the desire to do anything. Everything piles up to do. Clothes to be cleaned, dishes unwashed, garbage to be taken out, books strewn everywhere, bed unmade, clothes in the living room. You name it, it’s not done.

The inability to do things is not just for housework. It includes studying, work, social activities, brushing my teeth, bathing. I may abstractly think they might be important, but really, I am not thinking enough to care.

16

My sleep patterns become odd. I stay up until two or three in the morning, reading. I like being up after midnight because no one will bother me and so I feel “safe.” I dread that in the next few hours another day will start and people might want to talk with me.

I can spend sixteen or more hours a day sleeping. I would often sleep hoping I would not wake up, or that the world would disappear before I woke up.

17

I tend to crave food, particularly sugar. I can eat an entire box of chocolate cookies in half-hour. And then be disgusted with myself. And nauseated because I don’t particularly like sugar.

I tend to eat a lot. I can put of 2-6 pounds over the course of a three week depression. Which really doesn’t help my self confidence.

18

I become self destructive because I stop caring enough about anything. It’s not important to me if my relationship fails, or if I don’t go to work.

I tend to end up in a loop of destructive thinking – “Nothing matters anymore,” or “I don’t care” or “So what, I’m failing anyhow.” Or if the idea is sufficiently painful or requires thinking, I let it slip from my mind and I don’t think about it – because if I don’t think about the problem I don’t have to deal with it.

I become suicidal because of a combination of not caring and because it feels too difficult to continue living. And yes this happens in every depression. Most times I don’t do anything about it, but sometimes I try.

When the Depression Episode Passes

Eventually, the Depression episode passes and I come out of the Depression episode. The episode usually passes on its own after one to three weeks, though I have had longer depression episodes.

My experience has also been that if I am depressed, the regular antidepressant (and other) drugs don't make any difference in getting me out of the depression.

Except. A combination that gets me out of depression at the moment, though I don't understand why, is carbamazepine (200 mg each morning and afternoon) plus clonazepam (0.5 mg each morning and afternoon), and 2-4 double espresso cappuccinos, spread through the day. Because the cappuccinos can trigger hypomania and lots of irritability, I don't really recommend this unless you have an effective antimanic that works rapidly. And that you're desperate to get out of the depression. Remember to talk with your psych before trying this.

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