Depression is a complex medical condition. It can affect every aspect of a person’s life, from their personal relationships to their physical health. And of course, it impacts mental wellbeing.

But being unhappy isn’t the same as being depressed. Depression is a term often used loosely to describe how people feel after a bad week at work or when they’re going through a breakup. Clinical depression, also known as major depressive disorder, is more than feeling blue. Specific symptoms differentiate depression from the type of generalized sadness all people sometimes experience.

In 2021, at least 8.3% of U.S. adults experienced a major depressive episode. Depression has become one of the most common mental health disorders in the country.

In this article we cover eight signs of depression.

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The symptoms of depression tend to be more pervasive, severe, and debilitating for non-white individuals, who are more likely to be under-diagnosed or misdiagnosed when they have depression. Many do not get treated for the condition, and their symptoms grow even more intense as they get older.

Research suggests that American Indians, Native Americans and Alaska Natives are the most likely to develop psychiatric disorders, including depression. This group lives with an enormous amount of post-traumatic stress, and members are more likely to engage in substance use disorders than people in other communities. Suicide is the second leading cause of death for young people (ages 8 to 24) in this demographic.

Additional research suggests that white people are more likely to experience depression during their lifetimes (17.9% prevalence) than African-American individuals (10.4%). (Other data counters this, and finds that the latter group is more likely to experience depression, especially as its members age.) Socioeconomic factors, interpersonal issues, and concerns about racism tend to be major drivers of mental health for Black individuals.

Depression is found to be less common among Asians, and more common among Hispanics and Latinx people.

The signs of depression may differ between racial and ethnic groups. Understanding these differences can help people and their healthcare professionals better identify and treat the condition.

Determining whether persistent dark feelings are the result of depression can be the first step toward healing and recovery. The following signs indicate that it’s time to see a mental health professional.

People who are depressed often experience feelings of hopelessness, though this is not the same across all races and ethnicities.

Hispanic and Latino individuals are the most likely to report feeling hopeless “all or most of the time,” followed by people of two or more races, according to a recent National Health Interview Survey.

Sometimes people who are depressed feel like they are worthless, a sentiment that the survey found most common among people of two or more races, as well as American Indians and Alaska Natives.

Native Hawaiians and Pacific Islanders are most likely to feel like “everything is an effort, all the time,” followed by Black or African-American individuals.

Some people who live with depression also experience inappropriate guilt. They may often think, “It’s all my fault,” or “What’s the point?”

Loneliness and isolation are among the top three reasons people describe themselves as having poor mental health, as reported by more than 1 million people who screened themselves for depression and anxiety on Mental Health America’s website in 2020. For Hispanic/Latinx people, it was cited as the biggest cause of mental health issues.

Depression can take the pleasure or enjoyment out of the things people love. A loss of interest in or withdrawal from activities that were previously looked forward to — sports, hobbies, going out with friends — is frequently a sign of major depression. In 2020, a whopping 90% of people who identified with more than one race reported symptoms of depression to Mental Health America.

Another study of 25,503 older Americans found that Black and Hispanic individuals were 1.5 to 2 times more likely than white people to experience sadness and a loss of interest in everyday life.

Losing interest in sex is common. Symptoms of major depression include a decreased sex drive and even impotence.

Learn more about types of depression, symptoms, and causes.

Part of the reason that people living with depression might stop doing things they enjoy is because they feel very tired. Depression often comes with a lack of energy and an overwhelming feeling of fatigue, which can be among its most debilitating symptoms. This can lead to excessive sleeping.

Asian and Pacific Islander people (particularly those from older age groups) may report feeling tired or sleepy rather than depressed, as the latter can be seen as less culturally acceptable. Because these symptoms can be attributed to other conditions, including chronic fatigue syndrome, healthcare professionals may miss the true cause.

Depression is also linked to insomnia, and they can feed off each other. A lack of restful sleep may lead to anxiety.

Depression and anxiety often occur together. Symptoms of anxiety can include:

  • nervousness, restlessness, or a sense of tension
  • feelings of danger, panic, or dread
  • rapid heart rate
  • rapid breathing
  • increased or heavy sweating
  • trembling or muscle twitching
  • trouble focusing or thinking clearly about anything other than one central preoccupation

Native Americans and American Indians were most likely to report high levels of anxiety in Mental Health America’s 2020 screenings. Their rate of moderate to severe depression also increased sharply after 2019.

Depression can affect the sexes differently. Research shows that men with depression may also experience irritability, escapist or risky behavior, substance abuse, or misplaced anger.

Overall, men are less likely than women to recognize depression or seek treatment for that condition. They are more likely to get help when their symptoms resemble traditional” depression but may not identify their irritability or other strong feelings as something requiring treatment, according to a 2018 study.

Women are about twice as likely to take antidepressant medication as men, with the most frequent users being those over 60, according to the most recent National Health and Nutrition Examination Survey. White people are also far more likely to take antidepressants than Black, Hispanic, or Asian individuals.

Men, for their part, prefer medicine to talk therapy when they get treatment, a 2020 studyfound.

Weight and appetite can fluctuate for people with depression. This experience may be different for each person. Some people will have an increased appetite and gain weight, while others won’t be hungry and will lose weight.

One indication of whether dietary changes are related to depression is if they’re intentional or not. If they’re not, it may mean that they’re caused by depression.

One moment it’s an outburst of anger. The next, tears are flowing uncontrollably. Depression can cause mood swings that fluctuate wildly, and it has nothing to do with anything outside of the person experiencing them.

Depression is sometimes connected to suicide. In 2020, nearly 46,000 people died from suicide in the United States, according to the Centers for Disease Control and Prevention (CDC). Black people are less likely to die by suicide than white people, but Black teenagers are more likely to attempt suicide than white teenagers.

Statisticians were surprised to note a significant decrease in the number of people who died by suicide in 2019 and 2020, after years of increases. In 2020 alone, the number of white females who died by suicide dropped 10%, while the number of white males doing so decreased 3%. The number of Asian men dying by suicide also dropped in 2020.

At the same time, some groups saw increases. In 2020, the number of Hispanic men dying by suicide rose 5%, while the number of Black and American Indian men dying this way also rose.

According to the CDC, American Indian and Native American people are far more likely to die by suicide than any other group, followed by white people.

In Mental Health America’s online screenings, 46% of American Indians and Native Americans reported thinking about suicide or self-harm in 2020, and the number of those having such thoughts increased 7.5% over 2019. This reflected the largest jump in suicidal ideation from any racial or ethnic group surveyed.

Those who die by suicide usually show symptoms of depression or mental health issues first. Often people will talk about it or make a first attempt before succeeding in ending their lives. When people are at immediate risk of self-harm or hurting others, those around them should:

  • Call 911 or a local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other potentially dangerous items.
  • Listen, but don’t judge, argue, threaten, or yell

Depression affects millions of people, but there are myriad options available for treatment, from lifestyle changes to medications. No matter what path one follows, asking for professional help is a critical first step toward starting to feel better.

What that help looks like may differ across communities of color and other marginalized groups. Because “traditional” depression symptoms can vary by race and ethnicity — and some people are reluctant to report their symptoms — often, individuals in these communities go undiagnosed.

The reasons for anxiety and depression in each community also differ, and they are not static. In Mental Health America’s 2020 screenings, white people said coronavirus played the biggest role in negatively affecting their mental health. But Black people cited financial matters as a primary concern, while Hispanic/Latinx people were deeply affected by loneliness/isolation, and Native Americans impacted by trauma, loss, and relationship issues (also a major concern for Asian or Pacific Islanders).

People in these racial and ethnic groups are typically less likely to be screened for depression and don’t receive mental healthcare treatment as often as those who are white.

Healthcare professionals who work with people experiencing depression must tailor their approach to address differences among those of varying ethnicities and races. Using a cultural accommodation model(CAM) may help bridge the gap. CAM helps these professionals adjust their viewfinder when diagnosing and treating conditions, urging them to be more culturally appropriate and sensitive to the unique characteristics of these populations.