As with anything that has a stigma attached to it, there is a preconceived idea of what depression looks like. It is a complicated illness with many symptoms. Everyone experiences the symptoms in their own way. As someone who has lived with depression for almost 40 years, I can share my picture of what depression is and the signs the I recognize as part of my mental illness. The picture someone else provides might differ. Of course, there are a lot of commonalities. Many of us experience symptoms that others would recognize as depression, but what are the signs that go unnoticed? There are quiet signs of depression that can persist in our lives.
In this post I would like to share some of the quiet signs of depression that often go unnoticed. These quiet signs can be broken down into five categories: 1) Emotional and Mental Signs, 2) Physical and Energy Changes, 3) Behavioral and Social Signs, 4) The “Looks Fine” Signs, and 5) Thought Patterns People Miss. As we look at these signs, remember not everyone will experience all these signs. Even experiencing one or two can make life difficult. These symptoms should be taken seriously.
Emotional and Mental Signs
A person with depression might feel flat, empty, or disconnected. This might appear as feeling numb or not experiencing emotions. The world around you feels gray. There is a feeling of detachment. You might feel a heavy stillness. There can be a sense of hopelessness. These are indications that you are experiencing depression.
Another emotional and mental sign is constant self-criticism. It can be frequent hard on yourself thoughts. You might lose interest in things you previously enjoyed. While indecisiveness can be normal, when it starts occurring more frequently, it can be a quiet sign of depression.
Physical and Energy Changes
People who do not live with depression often think it is just in a person’s head, but depression can affect us physically. Persistent fatigue is a physical symptom. This is a fatigue that does not improve with rest. Youi just feel constantly fatigued. Related to this is sleeping too much or too little. It may seem odd to include these opposites, but how sleep affects a person is different for everyone. Low motivation is another physical sign. It is that feeling that you just cannot do something. You do not have the physical or emotional energy to engage in an activity. Other quiet signs include aces, headaches, and digestive issues without a clear medical cause. Depression can hurt. While depression is a mental illness, many of us experience physical pain.
Behavioral and Social Signs
Another quiet sign of depression is withdrawing socially. A person might show up for required things like work but turn down social situations. Excuses are made to avoid going out with friends or attending family events. Canceling plans without connecting with others or explaining the reason for the cancelation can be a quiet sign of depression. Depression can result in a person just going through the motions at work or school. There can be a decrease in productivity. There might be a struggle to start tasks even when the person wants to get the task completed. They might take too long to complete simple tasks. The person might hide behind perfectionism or find themselves overcompensating. This can appear with a person working long hours to make up for a lack of focus. The person might push themselves harder than they are able to in order to keep up with at work or school.
The ”Looks Fine” Signs
The “Looks Fine” signs occur when a person presents a façade. The person may smile, joke, or appear functional when inside they are struggling. When I think of this I am reminded of the actor/comedian Robin Williams. He spent his life making others happy and making them laugh, when inside he was struggling. A person who looks fine might be downplaying distress. They might say, “I am just tired.” They may try to tell themselves “It’s not that bad.” Another looks fine sign is comparing yourself to others. It is that “others have it worse” thought. This invalidates the pain the person is going through and masks their depression. Often, this prevents a person from getting help. The “looks fine” signs are often seen in high-functioning depression. The person can meet responsibilities while inside they feel awful.
Thought Patterns People Miss
Our thoughts are not seen by others. So, it is easy for many of us to put on a mask and hide our thoughts. That leads some people to miss the quiet signs that they are struggling with depression. Some of these thoughts might be “I should be able to handle this,” “Other people have it worse,” “I’m just lazy,” “I’m just weak,” or “This is just how I am.” These thoughts are quiet signs and easy to ignore or normalize. When we are frequently having thoughts like these, we need to reach out for help.
Quiet signs of depression are often missed. A person can deny them in their own mind. Others are not aware that the person is struggling. As a result, the depression worsens. This is why we need to normalize talking about mental health. If we talk openly about these and other signs of depression, we can make it easier to recognize and accept that we are experiencing depression. This will lead to more people receiving help for depression.
Many primary care providers give their patients a depression screening when they go in for a physical. This is an important step. I think there is room for improvement here, though. I have taken this screening many times. I know how to answer to hide my depression if I do not want a provider to know I am struggling. Because the depression screening that is commonly used is just simple scale, it is easy to miss the presence of depression. It does not catch the quiet signs. For this reason, I think primary care providers should ask questions about a person’s mental health. I realize that in today’s healthcare system there is little time for this. Providers are expected to push patients through. Sadly, healthcare is now ruled by corporate policies. Healthcare has gone from being about patient care to being about making money. Providers are not able to spend as much time with patients as they want to. This leads to the quiet signs of depression being missed. In reality, even the obvious signs of depression are often missed.
It is important that we understand and recognize all the signs of depression, even the quiet signs. If you recognize any of the signs present in this post in yourself, I urge you to reach out for help. You can talk to your primary care provider, reach out to a mental health professional, or join a support group through NAMI. Of course, the presence of some of these signs does not mean you have a depression disorder, but it can be an indicator. Take the signs seriously. You do not need to wait for the signs to get worse to seek help.
It can be helpful to name what you are experiencing. You might try journaling or keeping notes about what you are feeling. This allows you to monitor what you are experiencing. It is helpful to use neutral words to describe what you are feeling. The purpose of journaling or taking notes is to collect information that can be useful if you reach a point where you need to seek help or support.
When you recognize the quiet signs of depression try to adjust your expectations of yourself. It is okay to do just enough. Try not to place unrealistic expectations on yourself. Just do what you can and let that be enough.
If you are not at a point where you need support from a mental healthcare professional, you might share what you are experiencing with one safe person. You do not need to tell them everything. You might say something like, “I’m not okay, but I don’t know how explain it yet.”
It is important to watch for escalation. Quiet depression can worsen. If you experience a worsening of the quiet signs, you start feeling hopeless or trapped, or you start having thoughts of self-harm, you need to reach out for help right away.
Depression looks differently in everyone. Sometimes our experience varies at different times. This is why we need to talk about depression. We need to normalize having discussions about depression and other mental illnesses. This will help make it normal to seek support. If you are experiencing any of the quiet signs of depression, please do not ignore them. Monitor them and reach out for support.
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