Is COVID-19 Making You Clinically Depressed? The Warning Signs Might Be Different Than You Think!

If you haven't battled depression before, you might imagine it as a constant state of active sadness — complete with signs like crying and despair. Depression isn't always like that. For some people, depression looks more like being bored out of your mind all the time, unable to get excited or motivated to do much of anything, and experiencing a chronic sense of low-level doom. 

We're living in weird times right now. Most of us will never have lived through something even remotely similar to COVID-19. The coronavirus isn't a personal tragedy, or even a nation-wide disaster. It affects the entire world, and nearly everyone's life has been at least slightly disrupted. You're no exception, whether you are sheltering in place with all the surreality that surrounds that, or you're an essential worker on the now infamous front lines, risking your health and life whenever you go to work. 

So, here's a checklist of warning signs. Is COVID-19 making you depressed, and what do you need to know about the different kinds of depression that may strike during times of extreme stress? 

Major depressive disorder: The warning signs in the context of the COVID-19 pandemic

Major depressive disorder — one of the most common mental health conditions out there — is more often simply called "depression". It can strike anyone, anywhere, of any age, without any apparent trigger in their environment.

That doesn't mean there aren't risk factors for depression, though. Some of them include, as you may have guessed, serious stress, major life changes, and trauma. You'll be dealing with at least one of these right now, and quite possibly all of them.

Being freaked out about the pandemic and everything that surrounds it is normal — and not necessarily a sign that you need mental health help from a professional (though most of us could benefit from therapy right now, frankly).

Might you actually be dealing with major depression? You may not reliably be able to diagnose yourself, but you can certainly take a long and honest look at the diagnostic criteria, without exaggerating or brushing symptoms you do have off as "nothing".

• A "depressed mood" on most days and for most of the day. This is indicated by feelings of sadness (which may or may not involve crying), emptiness, or hopelessness. If you're not sure, which can happen, also ask people you talk to often how they perceive your mood.
• Losing interest in most activities, on most days and for most of the day. That can mean not feeling like doing things you used to get excited about or find meaningful, or things you need to do but just can't bring yourself to actually carry out — like perhaps work or chores. If you still manage to do all the things, it's on autopilot rather than with any real engagement. 
• Weight and appetite changes. Some depressed people lose their appetites and forget to eat. They then lose weight. Others mindlessly eat a lot more, out of boredom or in a bid to find comfort. They gain weight. 
• Insomnia (not being able to go to sleep or stay asleep) or hypersomnia (sleeping too much) on most days.
• The hardest symptoms to understand would be "psychomotor agitation and retardation". This means a physical speeding up or slowing down. You may be fidgety and restless, or barely drag your body around when you need to. It's not just a feeling — for these symptoms to be counted toward a diagnosis of depression, they must be observable.
• Fatigue or loss of energy on most days. You might wake up feeling exhausted and spend your whole day that way.
• You feel worthless, guilty, or both, for no apparent reason.
• You have trouble concentrating and making decisions. Everything might feel like a fog. 
• You think about dying, or even suicide. If you feel suicidal, the thoughts may but may not evolve to specific plans. 

Because a lot of these symptoms are considered context-appropriate in cases of bereavement, extreme stress, serious illness, or natural disaster (and I think we can consider the COVID-19 pandemic to fall into that category), not everyone who has these feelings right now would be diagnosed with major depression.

What about situational depression?

Situational depression isn't a clinical term — but most of us would understand it to mean mild depression triggered by something objectively bad in your life, that then goes away when the bad thing does. A lot of us will certainly be going through exactly that at the moment!

There is a diagnosis that closely matches the colloquial "situational depression", and that is adjustment disorder with depressed mood. Here's what that's all about:

• People with adjustment disorder with depressed mood will have symptoms of depression, but not enough to meet the diagnostic criteria for major depressive disorder. 
• The symptoms will be triggered by a known stressor — in this case the pandemic itself, the fact that you or someone you care about was infected, losing someone to COVID-19, the stress of working on the front lines, job loss or fear of it, or even being in COVID-19 quarantine and unable to go out.
• The symptoms you're having should also be considered excessive in relation to the stressor — which is subjective — and appear within three months of the source of stress. They should have a clear negative impact on your functioning, but disappear without treatment within six months of the end of the stressor (let's hope we'll find out about that part very soon!).
• Your symptoms can't be better explained by another condition. 

Situational depression is often alleviated by doing some of the things that are hard to do right now — relying on a solid social support network, getting outside to exercise regularly, eating well, and going out to do things you enjoy.

"Hard" doesn't necessarily mean impossible. My friend convinced me to go out and enjoy the sunshine and a brisk walk today, alongside social distancing measures, and that time really did do me some good, for instance. Connecting with the many others who are feeling the same way can also be of tremendous help in these times.