Four signs depression is sneaking up on someone you know
While some people may appear happy and content on the outside, they could be battling an internal demon they are trying to mask.
At times it can be obvious to identify whether or not somebody is struggling with depression and anxiety, but if the signs go unnoticed it can fester into a struggle much harder to battle.
Head of Crisis Support at Lifeline, Rachel Bowes, told Yahoo News Australia as part of its What's Up? mental health series how people could be hiding behind a smile and the signs that they may need somebody to talk to.
Ms Bowes said people don't often realise they are depressed so they don't know to seek support or tell somebody about how they're feeling.
"It creeps up quite gradually," she said.
"They dismiss it as being trivial and often people don't deliberately try to hide it, they downplay it."
Ms Bowes said people might start to recognise they have a mental health issue if they are gradually withdrawing and spending a bit more time in their own head.
People turning down invitations
A red flag somebody may be struggling is if their usual social activities diminish.
Ms Bowes said people with depression and anxiety may start turning down invitations or other opportunities to get out of the house.
"One of the things that we notice is people start to withdraw," she said.
"If they live in a communal or family situation, they may start to spend all their time in their bedroom or are a bit less present, and not as engaged in the conversation as they normally would be."
Feeling down in the dumps
While we all have bad days, Ms Bowes said if somebody had a low mood consistently for a couple of weeks, it could mean something more serious is going on.
"To get an actual diagnosis of depression you need a set of symptoms for at least a couple of weeks," Ms Bowes said.
"Everyone can have a day or two where they just feel really down in the dumps and can't be bothered to talk to anyone or they're feeling a bit emotional, it happens to all of us.
"But when somebody has depression that happens every day – so people are regularly, most days, feeling like their mood is low.
"They might be a bit tearful or emotional when they wouldn't have usually felt that way."
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Ms Bowes said people may also become more irritable and any shift in mood could be an indicator of a bigger problem.
"Someone's responses or reactions usually shift towards the negative," she said.
"They're feeling irritable, tearful, sad and don't know why that is. It's a feeling of hopelessness and you can't imagine you're ever going to feel better."
Losing interest in self-care
Simple acts like not showering can be a major sign somebody is struggling with their mental health, according to Ms Bowes.
If somebody is depressed they tend to lose interest in their self-care and you may notice for the first time in years somebody is not showering every day or washing their hair.
"Somebody who would wear make-up is starting to not do that, or they aren't getting dressed until lunch time," she said.
"Those signs showing a bit less interest in yourself – you don't care how you look or can't be bothered to have a bath – that's a very common sign."
Changes in routine
Ms Bowes said a change in people's daily routine is also a common symptom in somebody struggling with depression.
People may start skipping meal time as their appetite decreases and they become less interested in food, or they may start comfort eating when they want to feel a little bit better.
There are also often changes in sleep patterns, where people may sleep in late after an erratic night sleep or just barely sleep at all.
"People sleep less if they are depressed or have something particular on their mind," Ms Bowes said.
"Changes in your sleep pattern – too much sleep or not enough sleep – is a sign of depression."
How can I help?
"The most common things people notice is eating and sleeping, people not looking after themselves, motivation levels dropping, withdrawing socially and changes in mood," Ms Bowes said.
"Some symptoms might be present a lot but some may hardly be present as well. Some people's depression is very much in their head as their inner voice switches to the negative.
"If they get an invitation to go somewhere they might think, 'I was only asked because they felt like they should', 'why would I inflict my terrible company', 'there's no point getting dressed, nobody will notice me'.
"It's those negative thought patterns people don't realise they're doing. On the more extreme end of it people might ask whether life is worth living."
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Ms Bowes urged people whatever stage of depression they were at, to keep a log about how they felt when they woke up in the morning.
"How do you feel, how well have you kept your routine, and rate your mood on a scale of 1 to 10," she said.
"After a couple of weeks go and see your GP so you can say this is what has been happening.
"It can really help if you take a list of symptoms to your doctor."
The importance of routine
Ms Bowes said while routines may sound boring, it's also critical to try and stick to them.
"People tend to lose their motivation quite quickly and before they know it they are staying up late and sleeping until noon, skipping meals and not getting out of their PJs," she said.
"They might start to drink alcohol a little earlier and it's really hard to shift from that once those changes become really engrained.
"Try hard to stick to a routine – go to bed the same time each night, wake up to an alarm, have regular meals and put a bit of effort into making something nice for yourself.
"Be mindful of alcohol and other drug intake – that can creep up when people are depressed, and they can use it to self-medicate or when they care less about consequences."
If you are however thinking of taking your own life, Ms Bowes said it was critical to seek help right away.
Ms Bowes said those who notice the signs in loved ones should start a non-judgemental conversation letting them know something is wrong.
Readers seeking support and information about depression and suicide prevention can contact Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, Sane Australia on 1800 187263 or Suicide Call Back Service on 1300 659 467.
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