Depression causes over half of all suicides worldwide, and the rate of treatment for those suffering from depression is poor. In the U.S., 64% of those with major depressive disorder are seriously impaired in their inability to function. Yet only 65% of everyone experiencing clinical depression gets treatment. These numbers are far worse in poorer countries. Yet most people respond well to treatment when obtained.


  • Major or clinical depression is a mood disorder and very different from the passing feeling of being “depressed” that many people experience, which is often a passing feeling related to particular circumstances or an event. Major depressive disorder or clinical depression is persistent – it lasts at least two weeks – and greatly impacts daily functioning.
  • The average age for the first episode of depression is 32.5. However, depression is most prevalent in adolescence and young adults.
  • About 15% of adolescents and young adults will experience depression.
  • The earliest age children experience depression is dropping. In fact, studies show that children as young as three can be diagnosed with clinical depression and their signs of depression are the same as those among adolescents and adults.
  • Depression can also occur following the birth of a child. This is called postpartum depression.
  • Mental Health First Responders need to know that clinical depression manifests in a wide variety of ways – some of them surprising and counter intuitive. Depression is not always the person who can’t get out of bed. It is sometimes the person who is angry and irritable much of the time. It can often look like laziness, meanness, rudeness, or just being a “bad” friend, partner, roommate, coworker, etc.

Depression is very often mistaken for poor character and the person suffering from it is blamed, shamed, and/or judged for his/her lack of interest, responsibility, participation, and ability to “just get over it.”

These judgments are, of course, devastating and completely contrary to what a person experiencing depression needs to get well. All of us should be aware of the following signs of major depressive disorder and be ready to HELP.

Adapted from Depression at


Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day nearly every day. You can recognize signs of depression from the following thoughts, feelings, and behavior:

  • Feelings of sadness, tearfulness, emptiness, or hopelessness
  • Anxiety, agitation, or restlessness
  • Behavior that looks like extreme laziness, rudeness, or disregard for others
  • Angry outbursts, irritability or frustration, even over small matters
  • Feeling misunderstood and extremely sensitive
  • Loss of interest or pleasure in most or all normal activities
  • Social withdrawal
  • Inability to return calls, texts, emails
  • Agreeing to go out then cancelling plans
  • Staying in bedroom/isolating
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort or become impossible
  • Poor self-care
  • Failure to do chores/participate in housekeeping tasks
  • Inability to bond with or care for a newborn.
  • Not doing homework
  • Missing class or work
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Unexplained physical problems, such as back pain or headaches
  • Slowed thinking, speaking, or body movements
  • Feelings of worthlessness or guilt
  • Fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Talking about feeling trapped or in unbearable pain
  • Chronic hopelessness about the future
  • Repeatedly talking about it being better to be dead, that others would be better off if they were dead
  • Feeling like a burden to others
  • Giving possessions away, talking as though they may not see you again
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts
  • Searching for or obtaining the means to die by suicide

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities, or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.


Common signs and symptoms of depression in children and teenagers can include those of adults, but there can be some differences.

In Children, Additional Signs of Depression May Include:

  • Clinginess
  • Refusing to go to school

In Adolescents, Additional Signs May Include:

  • Poor performance or poor attendance at school
  • Using recreational drugs or alcohol
  • Self-harm


Depression is not a normal part of growing older, and it should never be dismissed. Unfortunately, depression often goes undiagnosed and untreated in older adults, which can be deadly. Older adults make up almost ⅕ of all suicides, and elder suicide may be under-reported by 40% or more. Not counted are “silent suicides,” like deaths from overdoses, self-starvation or dehydration, and “accidents.” The elderly have a high rate of completing suicide.

In Seniors, Additional Signs of Depression May Include:

  • Abuse of prescription medications
  • Poor diet, malnutrition, dehydration
  • Breaking medical regimens (going off prescribed diets and/or medications)
  • Putting affairs in order, giving things away, or making changes in wills
  • Stock-piling medication or obtaining other lethal means
  • Preoccupation with death or a lack of concern about personal safety. Remarks such as “This is the last time that you’ll see me” or “I won’t be needing anymore appointments” should raise concern.
  • Stating the wish to die.


This sign can be very difficult to identify but is critical to take into account when considering someone who has struggled chronically or repeatedly over a long period. This may mean that a person has created a plan to die by suicide and has acquired the means to die. At these times, a person may suddenly re-enter life, start or complete projects, be more social, become employed, and re-engage in hobbies. BUT THIS CAN MEAN THEY FEEL RELIEF BECAUSE THERE IS AN EXIT PLAN THAT CAN BE IMPLEMENTED AT ANY TIME, AND THE DECISION TO DIE CAN BE IMPULSIVE AND QUICK.

  • When you know someone like this, it is imperative to keep checking in and asking how things are going. Ask things like “It seems like you’re doing better. Are you feeling better?”
  • “Do you have a plan to hurt yourself if you feel bad again?”
  • If this person says yes, they have a plan, this is an emergency

IF YOU OR SOMEONE YOU KNOW FEEL(S) SUICIDAL, go to the emergency room, call a mental health professional who can talk to you NOW, or call the police and say you have a mental health crisis, not a criminal situation!

In the US, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)


Text HOME to The Crisis Textline at 741741. They are available 24/7 in the U.S., Canada, United Kingdom, and Ireland.