What ’10 Signs of Depression in Men’ Won’t Tell You

In this video, I discuss the most common signs and symptoms of depression, offering advice for how to make sense of all the information available online, with suggestions about the different treatment options.


If you’ve been searching the Internet for information about how to recognize depression, either in yourself or in someone close to you, this post will introduce you to the 10 most common signs of depression that appear on many mental health websites, with little variation; I’ll also discuss how to understand and make use of them.  These signs of depression derive from the Diagnostic and Statistical Manual IV issued by the American Psychological Association; the DSM-IV is the official manual of the mental health profession and is used by psychiatrists, psychologists, social workers, etc. who must provide a diagnosis to insurance companies before the insurer will  issue reimbursement.  Here are the 10 most commonly recognized signs of depression:

1.    Depressed mood indicated by persistent sad, anxious, or “empty” mood
2.    Feelings of hopelessness or pessimism
3.    Feelings of guilt, worthlessness, or helplessness
4.    Loss of interest or pleasure in hobbies and activities once enjoyed, including sex
5.    Decreased energy, fatigue, or feeling “slowed down”
6.    Difficulty concentrating, remembering, or making decisions
7.    Insomnia, early-morning awakening, or oversleeping
8.    Appetite and/or weight loss or overeating and weight gain
9.    Thoughts of death or suicide or actual suicide attempts
10.  Restlessness or irritability

This kind of symptom list is very common in the DSM-IV for a broad range of diagnoses; in order to earn the label, you have to meet X number of the “diagnostic criteria,” as they’re called.  To receive a diagnosis of a Major Depressive Episode, for example, you have to exhibit at least five of those 10 signs of depression during a two-week period, and those five have to include either (1) or (4).  If you exhibit only four symptoms, or if you have six symptoms for less than two weeks, then you don’t qualify.

Just about every mental professional who must chart and deal with insurance companies owns a copy of the DSM-IV.  So why are there websites disseminating this information?  Since it’s not for the psychotherapist who already knows the details or has them close at hand on the bookshelf, who is it for?  Clearly, it’s for depressed people searching for help, or parents worried that their teenager is depressed, or possibly someone concerned that a
husband or father may be depressed.  Believe it or not, “signs of depression in men” is a commonly searched term on Google.

All right, so you search for “signs of depression” and you hit upon one of these sites with its 10-point list. What have you learned?  I guess there are people who aren’t sure if they truly are depressed, or if a loved one actually is depressed; this list may confirm a suspicion.  Then what?  Many of these sites recycle the familiar information about negative self-statements, affirmations and biochemical imbalances; a few might tell you something of value, but the vast majority are commercial sites designed to sell you something — online therapy, for example — or to get you to click on banner advertising so the website owner can earn revenue.  The goal of so many of these sites isn’t to provide anything of actual value, but to lure troubled people in order to make money from their distress.  A look at the advertising on these sites shows how Big Pharma uses them to shill for their worse-than-ineffective drugs, hyped with the baseless claim that depression results from an imbalance in brain chemistry.

Excuse me if I sound cynical.  In all fairness, therapists have to earn a living just like any other professional; the only way you can do so is if you have clients, and advertising is an accepted method for drawing people into your practice. I don’t have a problem with the advertising; what I find troubling is that these sites offer so little of value. Their primary purpose is to show up on search engines when suffering individuals plug certain phrases related to their pain into a search box.  If you suspect that a loved one is in trouble, or if you yourself are struggling, you may search for “10 signs of depression”, “signs of depression in men” or simply “signs of depression” to learn more.  Something like 6,000 people a day search those three terms alone.

If you’re lucky, you may find a website that tries to help you understand what depression means, the “why” of depression, but to find a resource that goes beyond negative self-statements and low serotonin is rare.  The search for “meaning” isn’t strong in my profession these days, in large part because long-term psychoanalytic treatment (the “talking cure”) is expensive and out of favor.  We live in a society that expects quick and easy answers.  Short-term treatments based on cognitive behavioral theories, along with psychotropic medication, are preferred by the public as well as the insurance companies.  Those insurers want the mental health professional to have a clear-cut diagnosis for the insured, with five of those 10 signs of depression; they want a set of goals and an expeditious plan for how to achieve those goals, with documented progress along the way.

A lengthy, meandering and difficult journey of self-discovery, without a well-defined route, doesn’t fit this model.  In my experience, it’s the only way to learn anything of real and lasting value about those signs of depression and how you came to exhibit them. You won’t discover your unique and personal reasons for being depressed by searching for ’10 signs of depression in men’, or on any of the sites you’ll discover in your search results.

Finding Your Own Way:

I appreciate that many of you who have found this site are suffering intensely.  I know you’re looking for answers and for relief from your pain.  I wish I could offer you those answers; I wish I had a pill that would do the trick.  I’ve been in the profession long enough now to have been through several cycles of new and miraculous anti-depressants.  When I was in my 20s, Deseryl was all the rage.  Then came  “Listening to Prozac” and the other SSRIs.  As I’ve pointed out before, recent studies have shown these drugs to be no more effective than a placebo.  You can’t solve depression with a pill.  There are no easy answers.

Depression has a meaning and a psychological genesis.  Yes, one can inherit genetic tendencies; no doubt brain chemistry plays a role (though it’s an unresolved chicken-egg problem:  does your brain chemistry cause your depression, or does your depression alter your brain chemistry?).  Some of the posts on this site should get you started on your journey, particularly the posts that have to do with feelings of shame and problems of hatred.  Another post discusses the meaning of different varieties of depression and the psychological issues behind them:  rage, a fragmented sense of self or toxic levels of shame.

[NOTE: Depression and Bipolar Disorder are a central focus of this website; all related articles can be found under that subject heading in the category menu to the right. This post provides information about common symptoms of depression you may already have found on other sites; if you’d prefer to learn more about some of the emotional factors behind depression, you might want to read my post on hopelessness or another on psychotherapy issues involved in bipolar disorder, which discusses intolerable feelings of shame and psychological damage. I’ve also written about the different types of depression. If you’re considering the use of medications to treat your depression, I strongly advise you to read my later three posts that analyze the dubious benefits and serious proven side-effects of these drugs. The first post deals with the completely unfounded theory that psychological illness is the result of a chemical imbalance in your brain; the second shows how, contrary to common perceptions, psychiatric medications have led to worse rather than improved outcomes for people taking those drugs; and the third discusses the false notion that anti-depressants are “like insulin for diabetes” and shows that SSRIs actually introduce a new imbalance into your brain chemistry where one did not before exist. To read about the role of SSRIs in the explosive rise in bipolar disorder as a diagnosis, click here.]


By Joseph Burgo

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.


  1. Thanks for your honesty. I was diagnosed about 4 years ago with a Major Depressive disorder. Started treatment with a civilian psychotherapist. 6 months in I got charged with a DWI. I lost the best job and one that I had been on the longest,( 3 and a half years) I fought it and won. I was unable to continue treatment because of the job loss. The depression then became incapacitating. I was hospitalized at the VA. I did psychotherapy and Zoloft. I had a positive experience. Within a year and a half I started college and working in the MH field. Did that for two and a half years. Then I sabotaged it and got terminated. I’m trying to find out why I can’t stay anywhere more than two or three years. I’m 52, I’ve moved over 60 times and had over 70 jobs and careers. I suspect that losing my mother at 16, a brother in law, an uncle, and my best friend to suicide are the culprits. Any suggestions are welcome. Oh, and by the way, I’m homeless gain.

    1. What about a low-fee counseling center where the interns work on a sliding scale? It’s where most of us start out. They’ll set your fee at whatever you can afford. While these are usually graduate students accumulating enough hours to sit for the licensing exam, they’re under supervision. You definitely need to be seeing someone. Call the VA or your doctor and ask for a referral to a clinic where they’ll charge on a sliding scale.

  2. I appreciate you honest explanation regarding the limited role medical professionals play in an individual’s treatment and recovery from depression. However I cannot agree with your statement on most medication being no more effective than placebo. As someone who has suffered from depression for many years and although I may not class myself as suffering at present – I am aware of the necessity of regular amounts of (however small) of SSRI medication to maintain my chemical balance. Its as though my body has lost its ability to produce sufficient serotonin itself and I am grateful for an alternative if synthetic substitute to maintain my health..
    Regarding your comments’ society trends’ influencing treatment options.
    I feel it ironic that western society today with all its pressures, fast paced living and materialistic aspirations should require a quick-fix solutions to a serious side-effect (namely depression) of it’s limited values. Of course treating the symptoms however helpful ( mentioned earlier) is ineffectual to a successful and sustained outcome unless the root cause is identified and sufficiently resolved. It brings to mind an early posting dealing with REALITY , I feel we as a society need to be realistic about damage resulting from aspirations but treatment regimes to true recovery.

    1. My own immediate experience with SSRIs is not vast so I can’t make a general statement with any authority. I was referring to last year’s Newsweek article. Newsweek

      As for the irony of Western society demanding a quick fix for problems created by its own misguided values, I think you make a very good point.

  3. By the way, I just realized that the list presented here at the beginning of the article should be printed on a booklet “Parental instructions for dummies” under “Commonly recognized signs in parents dealing with teenagers” 😉

  4. Thanks for a very honest write up about depression, its ‘treatments’ and the interrelated ‘hype’ on the web. I’ve been on pills for just over a year now, with now noticeable effect whatsoever on the long run. There are still bad days, and good weeks. Yet, some voice in me tells me to keep taking them, because “what if…”? What if they actually do work, and without them I am bound to fall deeper?

    I’ve just finished reading Wiliam Styron’s amazing booklet “Darkness Visible”. Which gives some hope, that it won’t be for the rest of my life. Another great read has been “Manufacturing Depression” by Gary Greenberg.

    At the end of the day though, it is just me and my depression, my depression and me. If only we could make this relationship be joyful, all would be swell and well. 🙂

  5. Wow, what a candid article! I’m curious as to whether most psychiatrists would agree or be so honest with their patients.

  6. Great post. It is really hard to diagnose depression. I have been seeing a psychiatrist for two years and I still don’t know if I have clinical depression or bi-polar depressive disorder. Maybe they/we will figure it out one of these days. Then, maybe they’ll be able to figure out a way to treat it. Until then, I’ll just keep on being miserable I guess.

  7. I can’t tell you how many sites I have been too late at night trying to find some answers. My boyfriend, whom I live with, has shown signs of depression continually for two years. He has been prescribed antidepressants and anti-anxiety pills by his doctor who will willingly prescribe any pill. He doesn’t talk much, he abuses drugs whenever he thinks he can secretly get away with it, and I just don’t think I can take this anymore. I don’t want to give up on him, but I’m pulling my hair out. I just want to shake him and say “Just be happy. Life is good!” I at least know now he cannot see it that way and it’s not me. What can I do? How do I get him to see a therapist?

    1. Melinda, if you could get him to a therapist, that would be a good thing, but truthfully, the motivation has to come from within him. You can’t force him to get the help he needs, and your primary responsibility needs to be to take care of your own self. If you do that — which might mean deciding you deserve a better partner — then he might wake up. As for the antidepressants, buy him a copy of Whitaker’s book and ask him to read it. That should at least open his eyes to what he’s really doing to his mind and body by taking those drugs.

  8. I think part of the problem with the illegal drug use may be that he is no longer taking the Alprazolam for anxiety. He took it for approximately five years. He stopped abruptly around six months ago. He was up to 3-4 pills per day. Maybe I should also read Whitaker’s book.

  9. I am one of those who has often googled on depression, wondering if I am depressed or not. In a way that is downright ridiculous, I am a lot nearer to answer that than physician who at best observes me for a few minutes. I have concluded that I am depressed, and I am also inclined to think that man should accept lows in himself as well as lows in topography, economy , meteorology and other areas. However, when the mental depression continues for months and years, the urge for for help may grow strong…but unable to decide and act, nothing is done. Well, I do “google”, not much of an act, but still an act, and recently I stumbled upon “livereal.com” which I suspect may be of some interest to other depressed persons. I`ve not detected any helpful remedy at “livereal”, however to read that others struggle with thougths similar to mine is a joy , a kind of ligth in the darkness.

  10. I love it when I see your twitters; followed one here. I’m not convinced that you are more well intentioned than a host of others who do have advertisements on their sites, but point well taken. From a psychiatric point of view, what more can you say about depression than to list the symptoms and medical treatments? That’s why I like your posts; they go beyond that and dig a little deeper. Thanks.

  11. I think my husband has been depressed for about 2 years, but there are reasons for it. He was laid off from a job he was really good at, when other less-skilled were kept on. Nearly a year later, he did find a job he likes. But then about 6 months ago, he was charged with molesting his grand daughter, which supposedly happened while he was laid off. He is still fighting the charges, but it is his word against hers. Now he still goes to work, but has no interest in doing anything except listening to music after work, or watching TV. So there are reasons for a depression, probably not because of a chemical imbalance. His lawyer suggested he attend group counseling for sex offenders, and all that does is make him worse because he feels those people are sick, and that he’s not like them. Any suggestions?

    1. It sounds as if your husband is in some kind of denial, splitting off guilt, responsibility and a sense of his own illness: those *other* people in the support group, they’re the sick ones, not me. It sounds to me as if he needs to keep going to that group and he needs to feel depressed. At some point, he has to face the truth about himself.

  12. It’s 4AM and I have been wondering if I have ‘clinical depression’ and stumbled across this website. Finally, someone in ‘the business’ who isn’t a pill pusher.

    I think I know the answer to why I feel as I do; my ex wife is bipolar (we were married for 15 years and have been divorced for about 6 months now) and with the divorce she just dumped all of her pressures and problems on me. I have all the bills, full custody of our daughter, etc etc etc and I feel just plain overwhelmed.

    On top of that, my father died suddenly of lung cancer and the estate is a mess. So I’m dealing with that as well (co executor ofthe estate).

    I have hit about 8 of the 10 signs of depression, and on a regular basis too. I need to do something about this but I don’t know what.

    The ‘easy answer’ everyone gives is just pop a pill. I really dislike that whole thing, I saw what it did to my ex, no thank you. I think instead I need to learn new habits of thought. Do you have any suggestions on how to do that?

    1. I know that when I take on too much, feel overwhelmed and don’t get enough rest, I start to feel mildly depressed; you’ve got an awful lot on your plate and my advice to you would be to ask for help (if it’s available) in dealing with your father’s estate; to put your health and well-being ahead of everything else so that you will be able to deal with the other things, and to recognize that you have some legitimate reasons to feel angry. It would probably help to have someone to talk to — I mean short-term, supportive psychotherapy or a group. You don’t need to go through this entirely alone. Feel free to write to me at: AfterPsy@gmail.com. I don’t do Internet or phone therapy but I can “listen”.

  13. Refreshing for sure. I have been on and off of 3 or 4 different types of anti-depressants at different concentrations for the past 7-8 years. I never really did notice a big defference while on them. The last one was Zoloft and while on a trip I ran out and just decided to stop taking them. I’ve read a stack of books on the topic and I have been in therapy for about 5 years as well and that too seems to have varied results. All in all I can’t seem to shake the overall feelings of depression and often wonder if there is truly a ‘cure’ or at least a way to reduce the feelings of it. I am presently doing a lot of inner child work and it has really brought on depression bigtime. It’s pretty hard to find effective ways to help.

    1. Hang in there, Mike. It just takes a long time. I don’t believe in a “cure” but I do believe that knowing yourself better and finding out the meeting of your depression is worth the effort.

  14. Thanks for the forum. I think I’ve been dealing with depression for several years. It forced me to retire from a good job several years ago. Alot has happened since then, moving to another state, dealing with the ex wife taking 30% of my retirement and my best friend (Boston Terrier) leaving while I was out of town for 8 days in training. That put me over the edge. I just cry when I think of him, all the time and can’t get a handle on it. I know time will heal the wound but this one was a very deep one. I’m thinking of adopting another dog, but I still have hope my “Tiny” will return. I need a good kick in the butt I guess. I have so much to be thankful for but can’t seem to appreciate what I have. I want to get help but I’m embarrassed to admit I have a problem. Men aren’t supposed to have these feelings………..:)

    1. I know what you mean about men, but there’s nothing shameful about needing help. I bet you’ll feel relieved once you do.

  15. My son seems to have recurring patterns of self destructive behavior, generally related to school. He began in 11th grade not completing assignments, seemingly unable to focus and stick with ‘the grind’. He graduated and started community college, registered for classes and then withdrew, not finishing. This went on for 2 yrs. Then suddenly he seemed to wake up and started achieving, doing well, completed 2 yrs at community college and started at a university, did the first semester on the Dean’s List. Then this last semester he again bombed out, said he’s quitting college, just doesn’t want to do this anymore. I’m concerned we are seeing more than just a young man who is not “into” school. He has everything going for him, but just seems to be floundering. It hurts to see this happening and we don’t know what to do. He knows he should finish but just doesn’t seem to be able to make himself do it.

    1. Given your chronology, he must at least 23 — it’s up to him now. The most you can do is to be supportive of his constructive efforts, don’t collude with or enable his self-destructive patterns and just keep letting him know you’re there.

  16. I’m truly worried about my husband (Paul), and our marriage of 30 years is in serious trouble. He fell at work (General Motors) back in 2002 which caused a disk to rupture in his back and it took 3 hospitals and nearly 2 weeks before a doctor figured out what was causing his pain and paralysis. After the doctor operated he spent 2 weeks in a rehabilitation Hospital learning how to walk again, but his doctor told him that the nerve damage was permanent and that he could never work again. And would be on pain medication the rest of his life. With 3 kids at home we struggled to make it from month to month and had a lot of hard times. but we always got through them. However without going into to much detail about the past, over the last 2 years he out look on things have gotten worse and worse, and lately he is nearly impossible to be around. He literally complains and gripes constantly about everything me and the kids do. which they are of age now. Nothing anyone does is right, or done done fast enough, he doesn’t like any of our friends and will say mean things to them so they will leave. Every day is a constant battle whether it is with me or one of the kids. And when we do everything we can to try to avoid a confrontation he will start looking for something, and when he can’t find anything else he will cuss at the T.V. about how stupid everything and everybody is. When anyone visits all he does is gripe about anything he can think of, and no one stays for very long because he never has anything good to say about anyone or anything. He finds something to hate about everyone. He cusses at me and the kids when we don’t do what he wants when he wants it. which is always right now. And he just keeps getting worse and worse, now he has started wishing people would just die , and telling me how he doesn’t care any more. He never used to be this way. He will even cuss and kick at our dogs. So much that i have considered giving them away because they are good dogs and don’t deserve to be treated that way. He even cusses at little kids and doesn’t care what he says to them. I have tried over the years to talk to his doctor about depression, but he says how do i know if I’m depressed, he said his doctor has ask him if he was depressed and he tells him he don’t know. The doctor tried to get him to talk to a psychiatrist but he want. And when i ask him tonight why he don’t try to get help for depression or what ever it is that is causing him to be so mean and hateful all the time. He said well if the doctor doesn’t know if I’m depressed how should I know, I’m no doctor I can’t diagnose myself. Everyone ask me how I stay with him an put up with it. But if something doesn’t change I won’t be able to take much more, I already feel like I’m, about to have a nervous break down. I never used to keep anything from him, I never lied to him before, But now I find myself doing it all the time just because I can not take the verbal abuse I know I will hear. I love him but I can’t continue living with him if something doesn’t help to change him back to the way he was before. I don’t know if he is depressed or bi-polar or really has just turned into a mean nasty person. All he does is sit in his chair and watch t.v. day in and day out. he will play games on the t.v. an hour or so a day, always the same games. But he never goes any where except to his Dr. appts. and sometimes to the grocery store. He always says he doesn’t have the money to do anything or go any where. And money is tight but he could visit family or anything just to get out for awhile but he says he can’t afford the gas. Myself I think he is just making excuses. He can walk, if he has to walk a long distance he may need to use his cane. and he won’t take his pain medicine unless he absolutely has to because it makes him feel bad and he stays in bed most of the day. He has trouble sleeping. And he is putting on weight because he doesn’t do anything. I used to have him unload the dish washer and get the clothes out of the dryer, and fold towels. He would occasionally run the vacuum in at least one room. Just so he was getting some exercise. But he rarely does any of that any more. I was hoping you could tell me if he is depressed, bi-polar maybe, or if I just need to cut my losses and move out because he is just a mean person now. If you think it is depression can you tell me what I can tell him that would convince him he needs to get help. I don’t want my marriage to end over an illness that could have been treated. Thank you for your time.
    Sincerely desperate,

    1. Dear Ginger, my heart goes out to you. He certainly sounds depressed … and with some good reasons, too. Chronic pain can also make you depressed and turn you men, in just the way you’re describing. It sounds to me as if your husband is “mad at the world” and feeling sorry for himself (understandably) that a physical injury has taken away so much.

      But whatever the diagnosis (and I’m not big on labeling things), the current situation has become intolerable for you. You can’t going on absorbing all his rage the way you’ve been doing. You may need to tell him so in a “tough love” sort of way: either he gets the psychological help he needs or you will have to move on. I think it might be helpful for you if you could go talk to a psychotherapist to get some support during this process. It’s going to be tough.

  17. Hi I could really do with some advice right now about my husband. He left 7 weeks ago and looking back in time til now i believe his is very depressed looking at your list. Iam very concerned is there other things we can try rather then medicaton? He is seeing a councillor and trying to find himself again but worried he is never going to be the same again. He is completle different to the man he once was. Please help

    1. I think the person who can most help is the counselor your husband is seeing. Given that this emotionay transition is something that *he* is going through, I honestly don’t think I can be of much help. I’m sorry.

  18. Dr Burgo – I fully appreciate your experience and knowledge in this field, but more so, your integrity and honesty for sharing this information with such consideration. Although I was diagnosed at age 40 with Bipolar/ADD and have tried several medications (Adderal, Lithium) with some counseling, I did find myself leaving the daily medication belief system behind me and focused on living a life in harmony with who I naturally am as a human being. It has been a struggle, but I left the high dollar, high stress corporate life style to live a more bohemian entreprenual life style. My wife, kids and me are far happier today. I feel the need for meds only a fraction of the time and I seem to have found a zen like balance between the two (natural versus synthetic solutions). What has helped me is using structure, planning, reasoning and self reflection to encircle the creativity, boundless energy and fractal thinking I experience so I don’t stray too far outside of the lines (where it causes problems). My oldest daughter has Bipolar (diagnosed at 13 years) son has Aspergers (diagnosed at 4 years) and youngest daughter has bipolar (diagnosed be fore me at age 11) but we have trained ourselves with what works and know its possible to be self reliant with lots and lots of faith in the process (I emphatically believe in a high power). My wife has been the ultimate saint and I know family life would be impossible without the essential factors she brings to our home. Hope there’s something here in this message for someone journeying here for answers in their own life.

    1. Your account of how you and your family are coping with minimal use of meds is inspirational. The difference is that you have recognized that no drug will do it for you, and that the alternative is to face the challenge and hard work of learning how to manage yourself. “Structure, planning, reasoning and self-reflection” — excellent! Thanks for contributing to this conversation.

  19. Thanks for the information. I looked at this site to get the 10 signs of depression and I guess I’d have to say I meet many of them. The biggest problem I have is that I don’t feel like I have ever fit in anywhere. People have said I’m very intelligent but “different”. At this point I’m feeling extremely tired all the time and useless.

    Frankly, I have been thinking about throwing caution to the wind and heading out into the woods to see if I can survive out there as Dick Bernaky did. Probably spelled his name wrong but he’s the guy that got tired of living in society and made his way in the Alaskan bush country. PBS did a show on him if anyone is interested.

    1. I think you mean Dick Proenneke. There was also a film called “Into the Wild,” about a young man named Chris McCandless who went to live in the Alaskan wilderness and died. It might be safer to consult a psychotherapist before you take off for the woods.

      1. The only problem was McCandless had some mental issues. He also went into the wild without food or supplies, he just figured one day he would hitch to Alaska and live off the land totally unprepared. His only reference for navigation was a road map given to him by someone who picked him up.

    1. You probably don’t need me to tell you that it means you’re deeply depressed — you must feel that. Have you talked to a professional about it yet?

      1. No, and I don’t believe in them anyway, just like I don’t believe in God, or little green men visiting earth, or magic.

  20. I don’t expect a reply. I just want to vent. I’m 17 and I think I can relate with pretty much all of the list. I’ve always done well in school (in my second year of college) and worked pretty hard in my sports (coach’s award 3 years in a row with 3 coaches). But now, I just don’t care about anything. I go complete days and sometimes more without eatings (almost passed out at practice). I failed my english class with an F, due to effort, and can’t play baseball which is my favorite thing in the world. What bothers me the most is that I just don’t care. Things like skiing and even my favorite sports teams which I use to have a strong passion for, I don’t care much about. I’ve always had the lonely and empty feelings since I can remember, but these last couple months, it has been much worse. I’ve always been a little wierd and standoffish. I remember keeping myself awake for hours thinking about why I can’t ever remember the moment I fall asleep. I’ve contemplated suicide a few times throughout my life, but figured I didn’t want to hurt my mom and siblings. Last year was the first year I was put into public school, so I never really had any friends other than through my brother. This year was the first year, I actually met some people on my own. I try to completely fill my days because when I’m home doing nothing, I always feel like I have something I need to do, but I don’t. I think that going to college has really helped because the people there are smarter than me and I don’t feel dumbed down. When I’m out trying having fun, I always feel like it is an act. Everything is so artificial and we keep doing the same stupid things everyday. Another thing about myself that anoys me is that I want to talk about with my mom, but for some reason, I never feel like I can trust her. She is kind of a blabber mouth, but loves me and wouldn’t do anything to hurt me, but I can’t trust her and don’t know why. I’ve never told anyone this because it is embaressing, but sometimes I cry for anywhere from 30 min. to an hour or two for what seems like no reason. I always try to think of why, but I can’t think of anything that would make sense or make me that sad. I know that it is no one else’s fault and everything should be great. Nothing is really wrong with me and everything should be going great. I always feel like I’m just complaining and being a whiner and everything I do or don’t do just seems to bug me. As I said, I’m just venting and feel at least a little relief in my chest. This is the most I’ve ever opened up in my life by far. Thank you for listening.

    1. Many many apologies for not getting back to you sooner. Your complex description of these personal feelings just goes to show that “depression” is not some identifiable medical syndrome, but a complex of emotions and thoughts with an origin and a meaning. I hope you can continue opening up — I think it will help you feel a little less alone with your experience.

  21. Let’s see…. symptoms 1-5, 7, 9-10 check. Now what to do about it. I have a wonderful wife at home, and for some reason I’m hell bent on destroying my marriage for over 23 years by trying to fill a void. Not in the physical sense, but emotionally; so not sure if this is onset by depression or just plain stupidity. I read the article above about the GM worker who has suffered so long from injuries that I did not know that chronic pain can sometimes lead to depression. I suffered a 22′ fall from a ladder over 10 years ago causing multiple injuries to my body (right foot fractured, left ankle completely shattered, right knee issues, and let’s not forget my compressed spine, ruptured discs which led to degenerative disc disease). So after 8 surgeries in the past 10 years, screws, bolts, plates and wires, pain is all I know. But I don’t like taking pain pills daily so I’m not sure what’s worse: being in a zombie state from pain pills or living a life as if I can get nothing accomplished physically or emotionally. I want to do things, but I can’t and I feel like I fail my family down because of it. I literally have no drive to do anything, including sexual activity, and at times just feel like I want to explode from the stress and anxiety at work. I travel quite a bit for work and every time I do I wonder if my family would be better off if I just died in a plane crash. No energy, no drive, no self worth…. why am I here again?

    1. Jay, I apologize for not responding to this sooner. Given your physical injuries and disability, you have some pretty good reasons to be depressed, although as with most forms of depression, it sounds as if there’s a healthy dose of rage in there. I’d find it totally understandable if you were “mad at the word” and internally raging, maybe without quite realizing it. You might want to look at a recent post I wrote about depression symptoms and the role of rage. Also, another much earlier one about different types of depression.

  22. Hi. I feel like I’ve done the hard yards – 7 years of therapy for major depression and anxiety (now recognised as complex ptsd) , a lightbulb moment in terms of confronting my mother’s narcissistic personality disorder and processing years of abuse and ceasing contact with her, trial and error with medication, hospitalisations after the birth of 2 babies, a husband with depression etc etc However, notwithstanding that I seem to have come to the core of my emotional health issues, I still find value in the prudent use of medication (lexapro 20 mg daily and, when sleep starts to evade me and irritability sets in the addition of zyprexa 2.5 mg) The medication truly makes a difference and the need to be functioning for my family is an important consideration in deciding whether to take it. But I’d be lying if I didn’t acknowledge that I would like to be medication free! Do you see many patients who come to the core of their depression and then eventually move forward in their lives without medication?

    1. Yes, I’ve worked long-term with many people who came in for severe depression and eventually felt much better and were no longer depressed. I’m also one of those people. I started therapy when I was in my late teens because of severe depression and no longer struggle with it. But it takes years and many people aren’t willing to wait that long, or they can’t afford the cost of therapy.

  23. i think i suffer from depression. The main problem is i guess i have been rejected twice in last 2.5 years and the last rejection was very embarrassing. Its not that i am good looking but girls dont seem to be interested, many friends think that i must be having a lot of girlfriends, must be enjoying life to its fullest and wish to live my life. Its not that i just sit at home, i have tried to make public appearances where i can find someone special even after that embarrassing rejection but still i dont know what’s wrong in me. I have had 2 girlfriends in past. But since last 2.5 years i have not been lucky, sometimes i feel its because of my college, because my college is full of boys (top engineering college), so there r very few girls, girls who r nt that much pretty looking and also i am not interested in them. I am sayin handsome to myself because my frnds tell me, i never try to b oversmart or pretend to be a prince in front of girls, i just try to talk to them politely but still, i feel if i will go to a psychiatrist, they will tell me to make appearance in public, but now i guess i am tired of tryin, and feel i am never gonna be lucky again. Feel so lonely this valentines day. Sometimes feel this city is not good for me, but no there are friends who r enjoying. Its all because of my college, i still have 1.5 years left in college. Sometimes i feel looking myself, i can have a much better life, but not having, god has given me evrything but i dont know why things are not working out. i am saying all this problems jus to make myself a bit better, jus wish someone could hold my hand and show me that this is the way, you hav to go this way and you will be successful. Just waiting for good days.

    1. I think you need to speak to someone about this. It’s hard for me to get a clear sense of what the trouble may be, but finding a therapist to talk to might make you feel less alone with your experience, and could shed some light on why you have such a hard time developing an intimate relationship. I’m not sure that “depression” per se is your issue.

    1. Yes, but it takes time and a lot of hard work in therapy. I’ve work with many depressed people who have come through on the other side and no longer feel that way. But when offered the illusory promise of a pill that will quickly rectify their supposed chemical imbalance, most people have a hard time taking that route. Not to mention that there’s so much bad therapy out there, as well.

  24. Dr Burgo,

    I like your forum very much, recently my BF(45 years old) just broke up me by email due to his depression,he could not face me, because he felt guilty that not able to be a loving caring person in the relationship… at that point, I realized that only way to make things easy for him is accepting the break up, and be friend with him… he had tough life last few years, he is cancer survivor, lost business and struggle with his career choice … he have all the signs as depression, as I was not really understand depression at that time, so I thought it just like everyone have experienced in life up and down, after broke up, I have searched online and realized that he have more than just depressed, he have clinical depression! he is proud man, I want to point out to him that he need take care this very seriously, as I do not know his friends and family that well, and I have not speak with him for 2-3 weeks, do you think I should talk with him on the subject, I know he have start see a therapist on and off last 3 months, recording to him, he see her, because he needs figure out few things;mainly his life direction, do you thinking his therapist will know he has serious depression? how I can pouch him on his illness and not make him mad ….

    Thanks for your advices!!

    1. If he has already started with a therapist, I think it’s probably best to live it to the professional to figure it out. If he or she is any good, it probably won’t be hard to identify the major depression in your former bf. Good luck!

      1. Thanks for your suggestion, also for your professional experience, as I am very much hope to get back with him in the future, but I am not sure should I contact and support him as friend now, or I should leave him for now and let him to solve depression issues alone, we have not contact each other for 2 weeks now, we left in a good term as want respect each other, any suggestions how I should handle from my end….
        Thanks again!!!

  25. I was diagnosed with depression about 3 years ago and been on anti depression meds most of that time. It would appear now from my own research that i have developed the co-morbid condition of CFS. While i havent been to my doctor yet to talk about it, i have researched a number of websites and they all basically agree on a core set of symptoms and signs. I am a 51 year old male and have been caring for my 8 children aged currently 6 to 17 full time for the last 3 years. 2 have adhd and one has aspergers, so no need to describe the challange. Is going to the doctor my next step. What options am I seriously able to explore to get some relief from all this.

    Thank you

    1. You may have heard that Asperger’s will be eliminated from the next edition of the DSM, but in any event, don’t focus too much on the labels. You have a lot on your plate, but I doubt that the meds are actually helping you. The more I read, and the more experience I have with people who have been on these drugs long term, the more it seems that they do more damage than good. I’ve written quite a lot about the subject of psychiatric medications and the chemical imbalance theory of depression, and there are many books you can read on the subject that challenge the whole theory of chemical imbalances. What you might find more helpful is some kind of support group made up of parents who are faced with similarly challenging kids.

  26. I really think my boyfriend is depressed, but he doesn’t seem to want to do anything about it. We’re in college and he’s planning on dropping out after this semester and consequently can’t live in student housing anymore. He hasn’t told his parents about his plans, even though they still think they’re paying for school. He won’t even talk to me about where he wants to go or if he wants to move in with me. He never wants to do anything but sit around and he hardly even looks at me anymore, much less anything else. I tried to get him to talk to someone or at least consider seeing a psychiatrist, but he says it’s “not an option.” I asked him what he wanted to do to fix how he’s feeling and he says there’s no way to fix it or make him feel better. I’ve just been watching him get worse and worse over the past year and he rarely even talks to me about what’s going on, much less lets me try to help.

    I’ve got my own things going on–about a year free of cutting (after 8 years), trying to stay healthy and not go back to my old eating disorder, a recent chronic GI condition that has kept me in bed on and off for the past year, and possible Chronic Fatigue Syndrome (I need 11-16 hours of sleep a night and nap regularly, but after blood tests my doctors have said it’s “all in my head.”) An old psychiatrist thought I had an anxiety disorder, but one I saw recently says I might have rapid cycling bipolar, but because of my GI condition, I can’t take any of the medications. I’m trying so hard to keep my grades up and stay on the Dean’s list so I don’t lose my scholarships, but I’m still getting into so much debt because I can’t work. I’ve tried going to a therapist here, but you can only go 3 times on campus for free, and the cheapest one around was $30 a session. It was more stressful knowing I was spending $30 on it than just NOT going. I’ve been relying so much on my boyfriend over the past few years because he wasn’t having the problems he is now. Now he’s too worried about stressing me out to tell me how he feels, and I want to help, but it really IS stressful not being able to help him! I feel like I can’t tell him about when I’m upset now either because I don’t want to stress him out, so we’re both stuck not being able to talk to the one person we could rely on and trust. It sounds so selfish, but he was the one really happy and good thing in my life that kept me from stressing and helped me get up every day, but now the stress of keeping everything in and at the same time watching him be sad all the time is even worse than it was initially. If he’d let me help, at least I’d feel like we were making progress and he might start feeling better, but knowing he’s not doing anything and things will stay the same is just awful. Where do we go from here?

    1. I wish I knew what to tell you. There’s no easy answer to such a complex situation. Your boyfriend needs help, and you sounds like you very much want to continue in therapy. Is there a low-fee counseling center nearby (not affiliated with your school)?

      1. They referred me to the $30 a session person, which was about the cheapest that I found. I’ve always had trouble staying with one person though. I haven’t been 100% honest with any one of the counselors that I’ve had because when they don’t directly ask a question, I’m too embarrassed to bring it up. I’ve tried really hard and have promised myself a number of times that I’ll say everything with the next person, but I can never get it out. Because of that, I never end up working through everything. They always say that I sound like everything is going fine and that I have a good head on my shoulders, and I’m almost always super cheery in every session. The moment anything happens or I cry in a session or have a hard week, I stop going. It feels weird and awkward and like I can’t hold things together like I should be able to. I’ll work things out and be pretty okay for a few months and then I’ll have some sort of breakdown (panic attack?) and try to find someone new. Sometimes I just get so stressed out that I don’t know what to do! It’s like there are no words to explain what I’m thinking or feeling, so I can’t let them even know! Also, I mostly feel fine in the afternoon when my appointments are–it’s at night when I’m thinking that I really would want to talk to someone. I just need to get everything out and I don’t know how.

        1. I think you know, as well as I do, that what you need is to stick with one person long enough and to be brave in your self-disclosure. No therapist can help you — no matter how good he or she may be — if you’re not honest and truthful.

  27. Of these 10 I have 9 of them. I have never seriously contemplated suicide. My wife abandoned me on Feb 25th and I am a wreck. It was a total surprise. I have asked her to come back but I am more depressed every day as she says NO. I have NEVER felt like this before. I cry twice a day in my lonely apartment. I have been having “revenge” sex with prostitutes which is making me feel worse. We were together 5 wonderful years then the last 6 months she turned COLD. I am a wreck – any advice? I need to feel differently. Due to my job, I cannot go on an anti-depressant unless I find a doctor on the side and not report it to my employer.
    1. Depressed mood indicated by persistent sad, anxious, or “empty” mood
    2. Feelings of hopelessness or pessimism
    3. Feelings of guilt, worthlessness, or helplessness
    4. Loss of interest or pleasure in hobbies and activities once enjoyed, including sex
    5. Decreased energy, fatigue, or feeling “slowed down”
    6. Difficulty concentrating, remembering, or making decisions
    7. Insomnia, early-morning awakening, or oversleeping
    8. Appetite and/or weight loss or overeating and weight gain
    9. Thoughts of death or suicide or actual suicide attempts
    10. Restlessness or irritability

    1. I wouldn’t recommend anti-depressants in any event. Find yourself a good therapist. If nothing else, you won’t feel so alone with this experience.

  28. I think my partner suffers depression. We have been together for just under two years.
    About four months ago i moved out of our house becuase i just couldnt take it anymore.
    He admitted that it was the depression he was suffering and just need to be alone. I moved back into our place and things were good for another 4 months but ive just started to see the signs again. I just dont know if i can go through it all again esp when he refuses to talk about it.

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  30. My 41 year old boyfriend has been struggling since his divorce to keep a job. Part of the problem is his spotty employment history. He’s also trying to finish college, which is part of the reason for not having a great job history. He went through horrific abuse as a child, which scarred him terribly, followed by the death of his infant son several years ago, which nearly destroyed him. He goes through bad dark periods, threatens suicide, then rallies and tries again. After this last job loss, he took a bunch of pills, which scared me to death. I want to help him, and I’m really trying. But financially, I’m barely making it myself. He is still very down, and is upset by the fact that he has one last class to finish so that he can get his BA, but now won’t be able to pay for it. I offered to help him pay for it, but honestly, I am not sure that I can (or want) to do it. I want to support him, but not financially. He lives part of the time with a roommate, and part of the time with me. My friends and family all think he is just a liar and a manipulator, but I know he did lose his child–I’ve seen the pictures of him, and I’ve heard his ex-wife talk about him.
    He did go to see his therapist, but he says he won’t be able to afford to continue because of the job loss. He is on anti-depressants, although he stopped taking them for a few days when he really went downhill. Can you offer any suggestions or advice? I have a 16 year old son who lives with me part time (when boyfriend isn’t here), and I don’t want all of this to affect him. I know I can’t “save” him on my own, though I want to, and have tried. I just don’t know how far my support for him should extend. One person told me that she didn’t know if our relationship should continue, because he is too “broken.” Any thoughts?

    1. Your 41 year old boyfriend does sound awfully broken, and you have to take care of yourself first. It’s not your responsibility to save him, and you might want to examine your own reasons for staying in a relationship that seems awfully one-sided. What’s in it for you? I don’t mean that to sound cold but relationships should be mutual.

  31. I am actually the one going through severe depression. I have been for over a year. It all kind of started when my youngest sister died of an overdose. We had a lot of other stressors. I could feel extra anxiety in my body at times. I also felt hypervigilant. My nerves were frayed. While sitting in the ER with my mother, I felt something in my body just “go.” I was in a constant state of fight or flight for months. No drugs would relieve it. Then came the depression.

    Claire Weekes’ book seemed to help me get a grip on anxiety but by the time I discovered it, the depression had taken hold.

    I am also going through “the change” and have been told that could be a factor. Be that as it may, I’m at a loss as to what to do. I want to live. I have a wonderful husband, a son, and a blessed life. There is just a dark cloud hanging over me that I cannot seem to get out from under. My faith in God keeps me hanging on.

    I “thought” that the average depressive episode lasted 9 months. So, I held on to that. Now I’m being told that this could be “treatment resistant” and never end. I just don’t get how that happens to someone in their early 50’s out of the blue.

    I do have a history of post partum depression. I soldiered through that many years ago. I also had a depressive episode a couple of years later for which I did take medication. I’ve been off meds for a very long time. And I don’t honestly know if the meds helped with that episode or it resolved with time. I did see a psychiatrist regularly. Back then they talked and didn’t just hand out meds.

    I really did not see this coming. We’ve had many stressors in life over the years, including sudden deaths, and I’ve never broken down like this. It’s maddening.

    I feel that a psychotherapist will immediately send me back to a psychiatrist for medication. I haven’t been able to get on a therapeutic dose of anything but do wish I had someone to talk to. I don’t feel like anything in particular is driving this depression except the fact that I am depressed and fear I’ll be stuck this way for life.

    I am a Christian counselor and at the moment can’t seem to help myself. If medication isn’t the answer, and right now it doesn’t seem to be for me, what is? I was meditating, exercising, eating healthy, engaging with friends and still this came upon me.

    I feel really bad for my husband. He’s a wonderful man. So patient and supportive. He is hurting even though I try hard every day to function and stay as upbeat as possible. It is heartbreaking for both of us.

    I believe there has to be a way out of this episode. I just haven’t found it.

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