Depression Symptoms

Everyone feels sad or discouraged at times. Depression is different: it is a medical illness that changes how you sleep, eat, think and feel, and it can last for months if it isn't treated. The good news is that depression is one of the most treatable conditions in psychiatry.

Symptoms of major depression

Major depression may be unipolar (only a depressed mood, as opposed to bipolar disorder, which involves both depressed and manic moods). It may occur as a single episode or become chronic, lasting more than six months. It involves an imbalance of chemical messengers in the brain called neurotransmitters, such as serotonin, norepinephrine and dopamine. Symptoms may include:

• Depressed mood that is not simply the result of an environmental event such as divorce, job loss or the death of a loved one
• Difficulty falling or staying asleep
• Decreased appetite
• Decreased energy
• Decreased motivation
• Decreased social interaction
• Decreased sex drive
• Decreased pleasure
• Difficulty concentrating, resulting in memory problems
• Irritability
• Suicidal thoughts, plans, attempts or intent

Depression does not look the same in everyone. Some people sleep and eat more, not less. Some feel mostly irritable or numb rather than sad. Many first notice physical complaints such as fatigue, aches or poor concentration at work.

Depression or normal sadness?

Grief after a loss, or discouragement after a setback, is a normal human reaction and usually eases with time and support. Depression tends to persist, affects nearly every part of life and often arrives without a clear reason, or stays long after the stressful event has passed. If your symptoms last most of the day, nearly every day, for two weeks or more, or they are making it hard to work, study or care for yourself and your family, it is time for an evaluation.

Different forms of depression

• Major depression: one or more episodes of the symptoms above lasting at least two weeks.
• Chronic (persistent) depression: a lower-grade depressed mood that lasts for years, often mistaken for "just my personality."
• Depression during or after pregnancy: mood symptoms that begin during pregnancy or in the months after delivery.
• Seasonal depression: episodes that return at the same time of year, most often in the fall and winter.
• Premenstrual mood symptoms: depression, irritability and tension tied to the menstrual cycle. Dr. Granoff also treats PMS.

Depression and bipolar disorder

Bipolar disorder includes periods of depression and periods of abnormally elevated or irritable mood, with high energy, little need for sleep, racing thoughts or risky behavior. Getting this distinction right matters, because treatment for bipolar depression differs from treatment for unipolar depression. This is one reason a careful history taken by a psychiatrist is so important.

Depression and anxiety often occur together

Many people with depression also have anxiety, panic attacks or phobias, and long-standing anxiety can itself lead to depression. Treating both conditions together gives the best chance of full recovery.

Medical causes to rule out

Thyroid problems, other medical illnesses, some medications, and alcohol or drug use can cause or worsen depressive symptoms. As a medical doctor, a psychiatrist considers these possibilities as part of the evaluation.

How depression is treated

Treatment starts with an accurate diagnosis. At your first visit, Dr. Granoff takes a complete history of your symptoms, past episodes and treatment, medical problems and family history, and does a mental status examination. Treatment may include antidepressant or other medication, psychotherapy, or a combination of both, all provided by the same physician so your care stays coordinated. Follow-up visits check your progress and adjust treatment as needed. See the services provided or read common questions about starting treatment.

Helping someone you love

People with depression often don't recognize it in themselves, or they feel too tired or ashamed to ask for help. If you are worried about a family member or friend, tell them what you have noticed, listen without judging, and offer to help them make an appointment. Take any talk of suicide seriously, and don't hesitate to call 988 or 911 if you think they are in danger.

If you are thinking about suicide

Suicidal thoughts are a symptom of depression, not a personal failing, and they deserve immediate attention. If you are thinking about harming yourself, call or text 988 to reach the 988 Suicide & Crisis Lifeline, call 911, or go to the nearest emergency room now. You don't have to wait for an appointment.

Common Questions

How long do depression symptoms have to last before I should get help?

If symptoms are present most of the day, nearly every day, for two weeks or more, or if they are interfering with work, school or relationships, it is time for an evaluation. Seek help immediately if you have thoughts of suicide.

Can a psychiatrist treat depression with both medication and therapy?

Yes. A psychiatrist can prescribe and manage medication and also provide psychotherapy. Dr. Granoff provides both himself, so your treatment stays coordinated.

Is depression caused by a chemical imbalance?

Depression involves changes in brain chemical messengers such as serotonin, norepinephrine and dopamine, and it often runs in families. Stress, medical illness and other factors can also play a role, which is why a thorough evaluation matters.

Ready to take the next step? Call 757-461-7571 to schedule a consultation with Dr. Granoff. The office is at 1604 Hilltop West Executive Center, Suite 309, Virginia Beach, VA 23451.

If you are in crisis: call or text 988 to reach the 988 Suicide & Crisis Lifeline (available 24/7), call 911, or go to the nearest hospital emergency room.