Psychiatrist lists nine depression symptoms she would watch for

A New York City psychiatrist has outlined nine changes she would watch for in herself as possible depression symptoms. Dr. Samantha Boardman told Today.com that pulling away from friends and family or repeatedly canceling plans would be a “huge” warning sign, especially when it marks a clear change from usual behavior.

Boardman’s list is not a diagnostic checklist. She said people should look for a cluster of changes over time rather than attach a diagnosis to one difficult day, and noted that relatives and friends may notice a shift before the person experiencing it does.

What depression symptoms would a psychiatrist watch for?

Boardman’s nine observations fall across daily routine, behavior and thinking:

• Eating more or less than usual.
• Sleeping substantially more or less than usual.
• Losing interest in activities that once felt enjoyable.
• Withdrawing socially or backing out of plans.
• Feeling more irritable, agitated or easily frustrated.
• Finding it harder to concentrate on familiar tasks.
• Letting personal care or grooming slip in an uncharacteristic way.
• Changes in posture, movement or speech, such as slumping, moving more slowly or speaking more quietly.
• Rumination, or repeatedly replaying negative thoughts and feelings.

Loss of pleasure in formerly enjoyable activities is often called anhedonia. Boardman described rumination as becoming stuck in a loop of negative thoughts.

Several items on the list overlap with common signs identified by the National Institute of Mental Health, including changes in sleep or appetite, loss of interest, irritability, difficulty concentrating, feeling slowed down and isolation from others. The agency also lists persistent low or empty mood, hopelessness, fatigue, feelings of guilt or worthlessness, and thoughts of death or suicide among possible symptoms.

When do possible symptoms need professional help?

Major depression involves depressed mood or a loss of interest most of the time for at least two weeks, with interference in daily activities, according to NIMH. A clinician assesses symptoms, their duration and their effect on work, relationships and other responsibilities; a person does not need to have every listed symptom to need support.

The American Psychiatric Association similarly says one or two changes alone cannot predict a mental illness. But several changes occurring together, particularly when they disrupt school, work, relationships or self-care, may warrant an evaluation by a health or mental-health professional.

NIMH and the Centers for Disease Control and Prevention advise speaking with a health care or mental-health professional when symptoms persist, worsen or affect everyday life. For thoughts of suicide or self-harm in the United States, call or text 988. In an immediately life-threatening situation, call 911.

This story draws on original reporting from TODAY.com.