How to know if I have depression

HICOA · Mental Health Clinic — Online sessions and in Matosinhos

Short answer: depression is considered when, on most days for at least two weeks, there is depressed mood or loss of interest and pleasure in things — known as anhedonia — together with other changes: disturbed sleep (too much or too little), lack of energy, difficulty concentrating, altered appetite, and a diminished view of oneself.

Of all of these, the sign that best separates depression from a period of sadness is anhedonia: the things that used to give pleasure simply stop giving it. It is not being sad while doing what you enjoyed — it is what you enjoyed no longer producing anything at all.

No article makes a diagnosis, and this one does not either. But it helps you work out whether what you are feeling deserves an assessment — which is the question most people are actually asking.

Sadness or depression: what is the difference?

Sadness is a normal and necessary emotion. It has an identifiable cause, fluctuates through the day, coexists with good moments, and eases with time, conversation and support.

Depression is something else. It settles in, occupies most days, and does not respond to positive events as expected — good news or a restful weekend do not lift it. Above all, it strips the pleasure from things that used to provide it. Many people describe it less as sadness and more as emptiness, apathy or numbness. Some do not feel sad at all: they feel irritable, flattened, or simply nothing.

What are the symptoms of depression?

Clinical criteria require several of these to be present on most days, for two weeks or more:

• Low mood — persistent sadness, emptiness or flatness; in many cases, mainly irritability.
• Loss of interest or pleasure (anhedonia) — the activities, people and plans that used to give pleasure stop doing so. It is the most characteristic symptom of depression, and what most distinguishes it from passing sadness.
• Changes in sleep — sleeping too little, or sleeping a great deal and still waking exhausted.
• Lack of energy — tiredness that rest does not fix; simple tasks feel heavy.
• Changes in appetite — eating much less or much more, with weight change.
• Difficulty concentrating — reading the same line three times, forgetting things, being unable to decide.
• Guilt or worthlessness — feeling like a burden, a failure, or of no value.
• Slowing or agitation — moving and speaking more slowly, or the opposite: constant restlessness.

A detail many people do not know: depression frequently shows up in the body — headaches, muscle pain, digestive problems, tightness in the chest. It is not unusual for someone to spend months investigating physical symptoms before the possibility is considered.

When it is urgent to seek help

If thoughts arise that life is not worth living, of disappearing, or of harming yourself, this is not weakness and not something to be ashamed of — it is a sign that you need support now. If you are at immediate risk, emergency services are always the right route: in Portugal, 112 or the SNS 24 line (808 24 24 24); elsewhere, the services of the country where you live. Talk to someone you trust as well.

If you are not in immediate danger but this has been weighing on you, the next step is an assessment. You can talk to us — HICOA brings together psychology, hypnotherapy and psychiatry, and the first conversation is precisely to work out what makes sense in your case.

Does depression go away on its own?

Some mild episodes do remit with time and a change of circumstances. But waiting has costs: the longer it lasts, the more entrenched the patterns that maintain it become — isolation, inactivity, self-criticism. And each untreated episode raises the likelihood of another.

The practical rule is simple: if it has lasted weeks and is affecting your sleep, work or relationships, it is time to seek assessment. The sooner you do, the faster recovery tends to be.

How depression is treated

It is among the mental health conditions that respond best to treatment. Most people improve significantly with the right support.

• Psychotherapy — approaches with strong evidence, such as Cognitive Behavioural Therapy, help break the downward cycle, rebuild activity, and work on the thought patterns that sustain it.
• Antidepressant medication — indicated in moderate to severe presentations, assessed and monitored by a psychiatrist. The decision is individual and is not required in every case.
• A combination of both — in more severe presentations, this is often the most effective approach.
• Clinical hypnotherapy — as a complement to psychological care, it helps work on sleep, arousal and the patterns that sustain the condition, and strengthens inner resources. It does not replace psychotherapy or medical assessment.
• Exercise and sleep rhythm — with demonstrated effect, particularly as a complement to treatment.

What helps while you decide

Depression pushes towards isolation and inactivity, and both make it worse — that is the central cycle of the problem. Countering it on a small scale helps: keeping regular sleep hours, getting outside into daylight every day, moving your body even minimally, and keeping some human contact, even just a phone call.

None of this replaces treatment. It is there to stop the cycle deepening while you deal with the rest.

Seeking help does not require certainty

Many people delay because they are not sure it is "serious enough". A first appointment exists precisely to answer that question — and if it is not depression, knowing that has value too.