Diagnosing The Symptoms Of Depression

by Marcelle Pick, OB/GYN NP

What Is depression?

As humans, too often we seem to be struggling to maintain our balance. While modern medicine has vanquished most of the acute infectious diseases that were once our greatest threat, depression is still prevalent. I know that many of you may have had bouts of depression in your life. It’s overwhelming, but there is hope!

For example, let me tell you about Sarah. She’s a busy physician and a 46-year-old mother of two small children. When she first came to me, she was complaining of anxiety, fuzzy thinking, premenstrual syndrome (PMS) symptoms, and significant depression. She was also struggling unsuccessfully to lose about 15 pounds that she gained with her pregnancies. Sarah had a very demanding job and admitted to me that her life “was not going well.” This sounds like so many women today, as we attempt to juggle our relationships with our family, our friends, our work, and make time to take care of ourselves! That, unfortunately, comes last.

Let’s review what I told Sarah about her symptoms of depression. One of the primary things to assist you with your symptoms is for you to understand the symptoms and treatment options and see if they apply to you.

Understanding the symptoms of depression

The symptoms of depression can include a variety of normal negative emotions, and most women will experience symptoms of depression at some time in their lives. However, clinical depression is drastically different from situational or mild depression, even though some of the symptoms can be the same. There are a numerous of types of depression. But it is important to understand where and if your symptoms fit in so that you can find the best help for depression. So lets look at some of the symptoms of depression.

Symptoms of depression some may experience

  •  Overwhelming, persistent feelings of grief, anxiety, guilt or despair
  •  Feelings of worthlessness, feelings of never being enough
  •  A sense of numbness or hollowness, nothing makes you happy
  •  A loss of interest or pleasure in activities that were once enjoyed
  •  Decreased energy, dullness
  •  Difficulty concentrating or making decisions
  •  Irritability, small things make for huge reactions
  •  Disrupted sleep patterns, including insomnia or not being able to get out of bed
  •  Overeating and weight gain
  •  Reduced appetite and weight loss
  •  Lack of interest in sex, complete and utter loss of desire
  •  Sense of not wanting to get up to do your day

Mild or situational depression

In mild or situational depression these symptoms usually go back and forth and eventually they are gone. For example, this is an appropriate reaction to something that happened, such as going through a major life transition; experiencing a crisis, loss, such as a death of a loved one or trauma; or placing too much physical stress on the body. Working 15 hour days without a break. Women may experience postpartum depression or depression as one of the symptoms of premenstrual syndrome (PMS). Many women, especially in the north are affected by seasonal affective disorder (SAD), in which their symptoms of depression consistently follow a seasonal pattern.

Mood disorders

The difference between mild depression and clinical depression is that the mood symptoms are more severe and perhaps extreme, and there isn’t a clear cause of the severity of the depression. For people with clinical depression (called major depressive disorder or MDD), the symptoms are incapacitating and often occur spontaneously. Mood disorder symptoms do not go away, in spite of many changes and they often spiral into a mental health crisis.

Major depression can be accompanied by suicidal thoughts, obsession with death, or suicide attempts. If you have a general feeling of hopelessness, or if you or someone you know seems to have these symptoms or thoughts, especially if they have attempted suicide or considered it have even considered suicide you should find help immediately! Don’t wait to see if the symptoms improve. Seek the advice of your doctor or a psychiatrist, psychologist, or social worker. People with severe MDD can experience psychotic symptoms. In this case, medical treatment is absolutely necessary.

A variant form of clinical depression is dysthymia, also known as double depression. Dysthymia is recognized as chronic depression that lasts for more than two years. The symptoms are not as severe as those of MDD, but are more definitely more persistent.

Some people experience bouts of depression, but they may be mild or severe, interspersed with periods of intense energy or impulsivity. This is a sign of a more complicated disorder known as manic depression or bipolar disorder. Bipolar disorder is rare, but, we are seeing this disorder more often. You certainly hear about it more often in the media. It can become debilitating without treatment. If you are having or have had symptoms that make you question that perhaps this may be true for you, you should seek help from a mental health expert. These symptoms may include feelings of mania, excitement, excess energy, need for little sleep, and feelings of being invincible or better than others and then followed by periods of extreme depression.

Treatments for depression

For people with major depressive disorder, dysthymia, or bipolar disorder, antidepressants or mood stabilizing drugs are a very important part of their treatment. However, patients with these diagnoses will benefit greatly from additional, more integrative approaches that must include lifestyle and dietary interventions. Be sure to discuss your symptoms of depression with your practitioner or mental health provider.

Women who experience common types of mild depression can often find significant relief through alternative treatments. For more information on depression relief using a more natural approach without medications, and why this may be the best choice for you, read our full article on antidepressants.

Finally, chronic unrelenting physical symptoms that don’t seem to respond to treatment, such as headaches, overall body aches, sleep disturbances, digestive disorders, and pain can be an indication of depression, but these symptoms might be caused by an underlying physical condition that needs to be tested. Before taking antidepressants for these symptoms, you may want to get get a second opinion. Functional medical practices (those that combine alternative and conventional medicine) are extremely successful at finding the true source of these seemingly disconnected ailments. For more information, see our article on how to make alternative/functional medicine work for you.


Let’s see what happened in Sarah’s case. All of her conventional tests were normal, so we had Sarah take a neurotransmitter test and found that her serotonin was severely depleted and her dopamine was elevated. We also discovered that her adrenals were suffering and needed support. Our first step was to start Sarah to begin to heal by removing caffeine, sugar, gluten, and wheat from her diet; and we added a few targeted nutrients to support her body’s ability to replenish her neurotransmitters and hormones naturally.

On the lifestyle front, Sarah vowed to start putting more limits on her practice and to take more time for herself. I also recommended more exercise, at least three times per week, intense enough to break a sweat and get her endorphins going. Sarah entered psychotherapy and carved out time to exercise regularly. She was strict with herself about meals and sleep, and she reduced some of her work demands. Within a month, Sarah reported a huge shift in her mood and energy levels and began losing weight. She felt inspired to stay with her clean diet and lifestyle changes and continued on neurotransmitter supplemental support. Now, six months later, she feels that her life is back on track. She’s lost all the weight, her mood is great, and she has all the resilience and energy she needs to take care of her kids and her medical practice. But best of all, Sarah is back in control and happy with her life. Now she can be more present for herself, her patients, and her family.

Sarah’s depression and neurotransmitter imbalance was on the low end of the scale. If you have a diagnosed clinical biochemical imbalance – such as clinical depression or post-traumatic stress disorder – it may take more work – and with the help from a team of trusted health-care practitioners and therapists, I hope.