The head of the Mental Health service at the Blua Sanitas Valdebebas Hospital, Carlos Atef Harkous, has pointed out that recognizing depression can be especially complicated when the discomfort is not shown with evident sadness, but is camouflaged behind symptoms that are often attributed to stress, fatigue, or physical ailments.
"Depression can manifest through a low mood, but also through the loss of interest or ability to enjoy usual activities, lack of energy, sleep disturbances, changes in appetite, concentration problems, or various physical discomforts for which a medical explanation is not always found," the expert has indicated.
Coinciding with World Mental Health Day, Harkous has emphasized the importance of paying attention to the duration of these changes, especially if they last two weeks or more and clearly impact personal, family, social life, or work performance, as in that context it may be a depressive episode.
The specialist suggests evaluating the changes regarding the person's previous functioning rather than as an isolated signal. "Stopping proposing plans, responding less and less to messages, abandoning hobbies, or feeling indifferent to events that previously generated excitement are details to consider if they appear consistently," adds Harkous.
How to identify the signals
In this same line, the psychologist from Blua de Sanitas, Virginia del Palacio, has prepared a list of signs that may suggest the advisability of a professional consultation. Among them, she highlights the increasing difficulty in making seemingly simple everyday decisions, such as choosing the day's food or responding to an email.
Other alerts she mentions are variations in the way of judging one's own mistakes and the tendency to gradually reduce personal goals and projects. She also insists on monitoring the emergence of an increasingly pessimistic outlook on the future. "More than sadness, some people start to speak as if things were going to go wrong from the outset or as if any effort had little usefulness," she has detailed.
In older people, specialists point out that detection can be more difficult, as depression tends to express itself through apathy, loss of initiative, somatic complaints, anxiety, sleep disturbances, or cognitive problems, without necessarily highlighting a clear sadness.
"These changes should not be automatically attributed to aging. It is important to assess their onset and evolution, functional impact, concomitant diseases, pain, grief, alcohol consumption, and medications, and to carry out a differential diagnosis with delirium and neurocognitive disorders. The risk of suicide, which may go unnoticed, should also be explored directly," expressed Miriam Piqueras, medical director of Sanitas Mayores.
When to seek professional help
Specialists insist that the isolated presence of any of these manifestations does not in itself imply a diagnosis of depression, as stress, certain organic diseases, grief processes, or other life circumstances can generate similar signs. However, if these changes persist over time or begin to hinder daily life, they recommend seeking a health assessment.
"Detecting these changes allows for studying their origin and offering an individualized approach. If symptoms persist, cause suffering, or interfere with daily life, it is advisable to consult a healthcare professional. In the face of thoughts of death or suicide, self-harming planning, a marked inability to care for oneself, or a sudden worsening, urgent attention should be sought," conclude from Sanitas.