How do I know if I’m depressed? I honestly can’t tell if I have symptoms of depression or if I am just lazy. Sometimes interacting with my kids, cleaning the house, making dinner, etc. all just feels like too much. How do I know if this is my fault? I don’t know if it’s just who I am or if I’m actually depressed.

—Tired

Dear Tired,

I’m so sorry you’re struggling, and I don’t think you’re “just lazy.” But because everyone’s health and individual circumstances are unique, I don’t know enough to answer the question of whether or not you’re depressed. I do want to respond to your question in general terms, though, because so many people struggle with issues like the ones you’re describing.

There are two components of depression:

1. 1. How you feel
   2. What you think

The physical symptoms of depression, or how you feel, can include persistent sadness, irritability, lethargy, loss of interest in enjoyable activities, trouble concentrating, and significant changes in sexual desire and ability to sleep and eat. When you are depressed, you may feel like you are in quicksand or you just want to crawl into bed and never get out. The world is tiring, overwhelming, and grey. Even when you are able to rest or you receive positive news, you feel little sense of recovery.

The mental symptoms of depression, or what you think, include excessive guilt, hopelessness, low self-esteem, negative thoughts that just won’t go away, and the thought that life is not worth living or has no point. It may seem as if there is no way out of your situation, that things can’t possibly get better, and that you are a failure and a burden to others.

Some people experience depression with mainly physical symptoms. Others have mainly mental symptoms. Many experience some of both. Some symptoms of depression last for days at a time, others for weeks at a time, and some people spend months or years of living in the grip of their symptoms. Bipolar disorder is a mood disorder that involves experiencing depressive periods that alternate with intense and lasting periods of elevated thoughts and feelings, or mania.

Having multiple symptoms that last for an extended period of time is a hallmark of depression. Depressive disorders can be mild, moderate, or severe, and the length, severity, and the pattern of symptoms determines the type of disorder and the best treatment options. If you have more than one or two of these physical or mental symptoms, and if your symptoms persist over weeks or months, it is time to talk to someone to be evaluated for a depressive disorder.

People can develop depression in response to life stressors, and depression can also be result of poor health, biology or brain function. So begin your road to recovery by going to your doctor for blood work to rule out a physical cause for your symptoms. Then, if blood work does not uncover a physical reason for your symptoms and you are still hurting or not feeling like your usual self, you owe it to yourself and your loved ones to go and talk to someone about what you are experiencing. You’ll be looking for someone who is qualified to recognize clinical depression and who can help you identify the life variables that may be contributing to your depressive symptoms and get you access treatment.

To find a qualified therapist in your area, I recommend starting here: https://www.psychologytoday.com/us/therapists. If you belong to a faith community, you can also inquire about pastoral counseling through your place of worship.

Your treatment and path to recovery will be greatly influenced by who you reach out to for help. Your primary care physician or a psychiatrist is likely to emphasize medical solutions. A psychologist or therapist will likely focus on mental, behavioral, and interpersonal solutions. A spiritual guide or clergy person will emphasize spiritual solutions. All of these options can be instrumental for healing, so my recommendation is to take a holistic approach. And as you integrate professional recommendations, know that science suggests that a bedrock for wellness is proper sleep, diet, exercise, meaningful activity, and social connection. So please also reach out to people who know and love you to ask for their support and presence through this process.

Whether or not you are clinically depressed and in need of treatment, please banish the thought that your actions are “your fault.” See your struggle to get things done as a divine indicator light that something is amiss. It could be something medical, or psychological, or spiritual. It could just be a phase of life that you are going through that will pass with time. Be curious to understand what is going on within yourself and patient to know what to do with it. Search for answers in trustworthy places. Usually in time, people gain a sense of what their symptoms are telling them and how to respond. I trust this will be true for you and that the way you’re feeling today will not be the way you feel forever.