Surprising Symptoms of Depression and When to Talk with Your Provider

Chandni “Chunnu” Bhatia, MS, LPC, NCC, CMHIMP, is a licensed clinical professional counselor, she serves as an Integrated Behavioral Health Therapist with Inova Behavioral Health Services.

When we think of the word “depression,” often times many of us get a certain picture in our minds of an individual closed off from the world in a dark room, unkempt and unable to stop crying. While depression may occasionally look like this for some people, the reality is much more complex and nuanced. In honor of National Depression and Mental Health Screening Month in October, we’re shining a light on some common, yet surprising, signs and symptoms of depression and how to know when it’s time to talk to your primary care provider or mental health professional.

Challenging stereotypes about depression

The stereotype outlined above does not reflect the way many people experience depression. On the contrary, a person can be experiencing immense inner turmoil and still be taking care of hygiene, going to work, and managing responsibilities to family and others.

While depression may include feelings of deepening sadness, it is different than feeling sad or down. Depression can ebb and flow. For most people, it can also be a longer-term and persistent experience. Sadness, on the other hand, is transient. Depression is also not laziness or weakness. Many people struggling with depression have the will to take action, but changes in the body’s chemistry, experience of trauma and loss, or even excess stress can leave an individual physically incapable of functioning.

Depression is often experienced as a sense of “emotional collapse” – a void or even a heaviness that can be difficult to shake. Individuals struggling with depression may be going through the motions of their daily lives while feeling flat inside.

Common signs and symptoms of depression

  • A feeling of physical and emotional heaviness – like a weight is pulling you down
  • Apathy – feeling like you just don’t care
  • Thoughts of “I don’t want to be here” (note: this is different from suicidal thoughts)
  • Loss of interest in things that once brought you pleasure
  • Loss of motivation
  • Social withdrawal – feeling of being disconnected from others
  • Hopelessness
  • Low self-esteem
  • Disassociation – “spacing out” or checking out
  • Difficulty seeing the future

Some surprising signs and symptoms of depression

  • Loss of appetite
  • Excess eating
  • Agitation or irritability
  • Sleep problems – not sleeping enough or sleeping too much
  • Excess guilt – feeling more guilty than usual
  • Difficulty making decisions, concentration problems, procrastination
  • Digestive problems
  • Increase in reckless or risky behaviors – gambling, risky driving, drug and alcohol use

How to talk to a provider about mental health

If you recognize some of these signs or symptoms are negatively impacting your daily life, relationships or sense of wellbeing, there are several resources available to help support you to get relief. Your primary care provider, a psychiatrist and a mental health therapist are all great places to start getting the support you need to feel well. Here are some tips to guide the conversation:

  1. Focus on how you feel. There are no good or bad feelings, and you are not wrong for feeling how you do. Part of the human experience is experiencing our emotions and our connections with others. When we start owning our emotions, it becomes a catalyst to set ourselves free. When we share those feelings with a trusted doctor, therapist or other healthcare provider, we are building a connection both within ourselves and with another human being who cares about us. That’s a great first step.
  2. Be as specific as you can.Try to put words to how you’re feeling – “stuck” or “shut down,” for example – and include any physical symptoms as well. Our mental and emotional health has a real impact on our physical health. Explain how your symptoms are affecting your daily functioning.
  3. Share stressors that are going on in your life. Be open and honest about what’s going on in your life, as persistent stress can exacerbate depression symptoms. Many people tend to minimize what they’re going through, saying it’s “not that bad.” Instead, take ownership of how you’re struggling and acknowledge it, so your provider can help you work through it and begin to move forward.

It takes time, but it’s worth it. Working with a doctor or mental health provider can support you into living a more fulfilling and engaging life.

Resource: Mental Health National Depression Screening Day


If you or someone you know is experiencing a mental health crisis, please call 911 or go to the nearest emergency room. Learn more about Inova Behavioral Health Services or about our Inova adult mental health inpatient services specifically.

If you do not have a primary care provider, we welcome you to make an appointment with a provider at any of our Inova Primary Care locations.

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