How to know someone is going through depression

Author : Dr.Tulika | 27 Dec 2023

Depression is an affective disorder that results in episodes of feeling miserable, despondent, and blank. It is a well-known word these days and is also termed as “Major Depressive Disorder” or “Clinical Depression”. It influences the way you act, anticipate, and feel and can eventually lead to various physical problems. Depression can be so intense that many times the person may feel suicidal. 

It's like a trap where its victims get trapped and fail to find a solution. Sylvia Plath, the renowned English poet and novelist and spoken of her experience with depression in her book titled “The Bell Jar”. Here in this novel, she has narrated her depression in terms of a bell jar, a glass dome placed over fragile items to protect them. Her metaphor catches the terrifying sense of feeling both disconnected and suffocated; she cannot join with others, and others can’t reach her. You might have heard that Sylvia Plath was suffering from severe depression and tragically died by suicide.

Around 264 million people suffer from depression worldwide. Depression can be precipitated by stressful life events like divorce, separation, death of a loved one, financial loss, exam stress and career stress. According to a report, 76-85% of people experience stress and depression. Chronic stress contributes to the development of mental health problems. Sometimes it becomes very difficult to draw a conclusion if a person is depressed or not. This is known as masked depression. They seem normal to you but many times they are struggling to figure out what’s wrong with them. Depression can be caused by various factors and many of them fuel in its severity. Some of them can be excessive stress, divorce, breakup, body shaming, peer pressure, substance use, bad childhood experiences, traumatic experiences etc. People with neurodevelopmental disorders like Autism, ADHD are more vulnerable to depression. Depression can cause to suicidal tendencies. Therefore, it is very crucial to detect depression in people around you as many times they can't seek help and continue to remain in the situation they are in. 

Depression can be detected using the following ways: 

1. Through analyzing symptoms 

2. Through Certain Psychological Tests 

3. Through Medical Tests 

Now, let’s discuss each way one by one.

Detecting Depression Symptoms  

The best way to detect depression is to keep an eye over the person and keep a record of their behavior, habits, etc. In case you find one or more than one of the following symptoms in the person then first try to talk to him/her and then take him/her to a Psychiatrist. 

Here are some of the symptoms of depression:

• Feeling hopeless, guilty, worthless, and helpless 

• Continuously feeling sad, empty or numb 

• Low energy and getting tired easily 

• Feeling cynical and despondent 

• Insomnia, or oversleeping 

• Feeling unease or restlessness 

• Irritable behavior 

• Lost interest in activities one enjoyed before 

• Eating too much or loss of appetite all of a sudden 

• Pain or cramps that won’t go away 

• Problems in digestion even after treatment 

• Feeling anxious persistently 

• Continuous suicidal thoughts or suicidal attempts. 

Detecting Depression Through Psychological Tests

Many Psychological tests can detect if a person is going through depression or not. However, they can be reliable to some extent but not 100% accurate. So, if you feel like you or someone is going through depression or feeling low then you can consult a Psychologist and go through various Psychological tests to confirm if it's really depression or you just need a break from your regular hectic schedule. Many of these tests are in the form of a questionnaire, you just have to think about exactly how you are feeling and mark them down. The basic idea behind these tests is to have a track of the symptoms only but it's always better to go through these tests rather than just watching the symptoms and concluding that you have depression. Some psychological tests for depression as per the American Psychological Association (APA) are:

 1. BECK DEPRESSION INVENTORY (BDI): This test is commonly used to screen depression and its severity. It is also used for the measurement of Behavioral Manifestations. It is designed for people between the age group of 13 yrs - 80 yrs. It contains 21 self-report items which one has to complete using the Multiple Choice Response format. It takes roughly around 10 minutes to complete. 

 2. CENTER FOR EPIDEMIOLOGIC STUDIES DEPRESSION SCALE (CES - D): It is first designed for use in General Public but currently used in primary settings as a depression Screener. This test includes 20 self-reports items and it is scored on a 4 - point scale and this test approximately takes up to 20 minutes including scoring.  

 3. HAMILTON DEPRESSION RATING SCALE (HAM - D / HDRS or HRSD): This test is used to measure depression at each stage of treatment (before, during, and after). The HAM - D test is conducted by Health care professionals. It includes 21 items and is measured either on 5 - point or 3 - point scales which takes 15 - 20 minutes including completion and scoring (based on the first 17 items). 

 4. MONTGOMERY - ÅSBERG DEPRESSION RATING SCALE (MADRS): It is a 10-item based test that is used to measure the severity of depression among 18 years or above that. It takes 20 - 30 minutes and is rated on a 7 - point scale. This scale has more sensitivity to change with time and is adapted from the Hamilton Depression Rating Scale.  

 5. CHILDREN’S DEPRESSION INVENTORY (CDI): CDI is a modified form of the Beck Depression Inventory and is used for children. It is used to evaluate the severity of depression among people of age group between 7 - 17 years. This test takes time between 5 - 15 minutes and has three different rating forms for parents (17 items), teachers (12 items), and Administration reports (28 items). 

You can also take a few self-assessments online. You just have to follow the instructions and answer the questions honestly without any second thought. 

Here are some of the assessments:

1. DEPRESSION SCREENING TEST BY MED INDIA 

2. DEPRESSION AND ANXIETY SELF ASSESSMENT TEST BY NHS 

3. 3 MINUTE DEPRESSION TEST BY PSYCOM 

 These were only a few tests out of a large number. You can search for more tests like these on Google and screen for depression if you think you are having these symptoms.  

Detecting Depression Using Medical Tests 

The diagnosis in psychiatry in clinical based on presence of clearly defined cluster of psychological symptoms and signs. Research has shown that there are significant differences in brain activity in specific areas of the brain between depressed and non-depressed individuals. FMRI, SPECT, NIRS are some of the modalities in which such differences have been observed. Similarly genetic makeup of a person and individual variations in genes related to neurochemicals and brain functioning have been associated with higher risk for depression.

Research has also shown how chronic stress and trauma impacts brain functioning and gene expression. 

We have developed a good understanding of involvement of neurochemicals in behavioral disorders like depression but much more research is needed to utilize these insights for diagnosis in an individual patient. 

Conclusion  

Depression is a serious problem as it affects a large number of people. Depression can lead to loss of functioning, increases vulnerability to other medical disorders and also increased risk of suicide.

Fast paced lifestyle where we neglect our emotional health and the impact that stress is having on us till we reach a breaking point has contributed to people becoming more depressed. It is very crucial to know if you or somebody around you is going through depression, so that they can get proper treatment on time. Try to talk to people around you, know what they have been through or how they are feeling right now. If you feel like they are not well or they need help then either you can talk to them, take them out or try to make them happy and if nothing works then please consult a psychologist or a psychiatrist. Only a psychologist or psychiatrist can detect the severity of depression one is going through. It is very crucial to see a psychologist or psychiatrist and to take proper medication and to go for therapy and follow all the advice given by your doctor strictly.  

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