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Some people relate that their depression feels like a cloud of despair coming down over their lives. Many people feel like they have little energy or poor concentration. Others feel irritable for no apparent reason. The symptoms vary from person to person, but if you feel "down" for more than two weeks, and these feelings are interfering with your daily life, you may be clinically depressed. Most people who have gone through one episode of depression will eventually have another one. You may begin to feel some of the symptoms of depression several weeks before you develop what can be a partially debilitating to overwhelming depressive episode. Depressive symptoms also comprise a needed component in the diagnosis of a bipolar disorder. Depression and bipolar disorder are treatable.


Major depressive disorder (MDD), commonly referred to as "depression," can severely disrupt your life, affecting your appetite, sleep, work, and relationships.

The symptoms that help identify depression include:

  • Feelings of sadness, irritability, or tension
  • Decreased interest or pleasure activities or hobbies
  • Loss of energy, feeling more tired, burnt out, empty
  • Change in appetite, with weight loss or weight gain
  • Change in sleeping patterns and fatigue
  • Decreased libido
  • Early morning awakening
  • Excessive amount of sleep
  • Poor sleep quality or lack of sleep
  • Nightmares
  • Feeling tired upon awakening
  • Restlessness or feeling slowed down
  • Decreased ability to make decisions or concentrate
  • Feelings of worthlessness, hopelessness, or guilt
  • Thoughts of suicide or death and disturbing thought patterns

Male pattern depression can include signs seen infrequently in women:

  • Lower stress threshold
  • Aggressive behavior or difficulty controlling impulses
  • Irritability, restlessness, dissatisfaction
  • Anxiety, especially in the morning
  • Alcohol abuse or illegal drug use
  • Excessive exercise or work
  • Hyperactive behavior
  • Eating too little or too much
  • Antisocial behavior and/or pushing or testing social norms

If experiencing symptoms, see your Psychiatric ARNP.


Dysthymia, another mood disorder, involves feeling mildly depressed on most days over a period of at least two years with symptoms resembling major depression, but less severe.

Symptoms of depression may surface with other mood disorders. They include seasonal major depression (also known as seasonal affective disorder), postpartum depression, and bipolar disorder.

Seasonal Affective Disorder has symptoms seen with any major depressive episode. The recurrence of the symptoms during certain seasons is the hallmark of this type of depression.

Postpartum Depression can occur in women who have recently given birth. It typically occurs in the first few months after delivery, but can happen within the first year after giving birth. The symptoms are those seen with a depressive episode. Often, postpartum depression interferes with the mother's ability to bond with her newborn. It is very important to seek help if you are experiencing postpartum depression. Postpartum depression is different from the "Baby Blues", which tend to occur the first few days after delivery and resolve spontaneously.

Bipolar Disorder, another mood disorder, is different but similar to depression, and has different treatment approaches that at times may at times be similar to that of treating other forms of depressive symptoms.

Most people with depression never seek help, even though the majority will respond to treatment. Treating depression is especially important because it affects you, your family, and your work. Some people with depression try to harm themselves mistakenly believing that how they are feeling will never change.


Depression is a treatable illness. Through working with a Psychiatric ARNP one learns to manage depression. Various medications/therapies may be tried to find what is best for you.

By learning more about depression, and bipolar disorder, you and your family will be able to manage your illness more successfully. If you know how to identify the early warning signs, such as unusually high energy levels, sleeplessness or recurring depression, you can get help faster. You can also help to keep yourself well by understanding how aspects of daily life such as sleep patterns and stressful situations can affect your mood.


Keeping a mood diary/chart is a useful tool to help you and your psychiatric ARNP monitor your illness. It allows you to bring together information about your daily mood, events happening in your life, sleep patterns and medications you are taking. You may notice emerging patterns that would otherwise be difficult to detect. When you visit your provider, it may be helpful for him or her to see how you have been progressing by reviewing your mood diary.

Contact Rainier Professional Psychiatry