Dr. Henry Paul, MD

Psychiatrist, Author and Educator


November 18th, 2014

Depression is a scary word to hear, especially from a doctor who is diagnosing you! It is important to remember, when you are diagnosed with depression that you are not alone. Depression affects about 25 million Americans each year. That is about 5-8 percent of adults in the United States. What is startling is that only a fraction of these people receive any treatment.

Depression is a mental disorder. But depressive symptoms present themselves within other mental disorders such as: bipolar disorder, posttraumatic stress disorder PTSD, panic/anxiety disorder, obsessive compulsive disorder (OCD), schizophrenia and borderline personality disorder.

Depression can happen a few times in a lifetime, present with several episodes over a year or have ongoing symptoms that get better and worse. When someone comes in and receives a diagnosis of major depression, it is unknown whether this depression (not associated with mania or hypomania) is a plain unipolar depression or one that is part of bipolar disorder. Bipolar disorder is characterized by episodes of depression and mania/hypomania (like mania but less severe). This is very important because the depression that is part of bipolar disorder, called bipolar depression, is treated differently than simple unipolar depression.

When you first visit your psychiatrist make sure that you can provide a complete history of your mental health. This includes the drugs and treatments you have had over the years, as well as all your symptoms.

Depression symptoms, as listed by the National Alliance on Mental Illness NAMI, include:

  • Changes in sleep. Some people experience difficulty in falling asleep, waking up during the night or awakening earlier than desired. Other people sleep excessively or much longer than they used to.
  • Changes in appetite. Weight gain or weight loss demonstrates changes in eating habits and appetite during episodes of depression.
  • Poor concentration. The inability to concentrate and/or make decisions is a serious aspect of depression. During severe depression, some people find following the thread of a simple newspaper article to be extremely difficult, or making major decisions often impossible.
  • Loss of energy. The loss of energy and fatigue often affects people living with depression. Mental speed and activity are usually reduced, as is the ability to perform normal daily routines.
  • Lack of interest. During depression, people feel sad and lose interest in usual activities.
  • Low self-esteem. During periods of depression, people dwell on memories of losses or failures and feel excessive guilt and helplessness.
  • Hopelessness or guilt. The symptoms of depression often produce a strong feeling of hopelessness, or a belief that nothing will ever improve. These feelings can lead to thoughts of suicide.
  • Movement changes. People may literally look “slowed down” or overly activated and agitated.

Your doctor will ask you if you have mania/hypomania to determine if your depression is only depression or if it is bipolar disorder. NAMI also has a good fact sheet with the symptoms of mania. Symptoms of mania/hypomania can include:

  • Feeling overly happy for an extended period of time.
  • An abnormally increased level of irritability.
  • Overconfidence or an extremely inflated self-esteem.
  • Increased talkativeness.
  • Decreased amount of sleep.
  • Engaging in risky behavior, such as spending sprees and impulsive sex.
  • Racing thoughts, jumping quickly from one idea to another.
  • Easily distracted.
  • Feeling agitated or “jumpy.”


Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

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