If the following aspects are present, it is likely that a person may be suffering from depression:
- Sadness and/or anxiety most of the time, disclosed by the person or observable in their looks and demeanour;
- Loss of interest and pleasure in previous engaging and preferred activities like going out with friends, seeing a football match or spending time with family;
- Complaining of chronically being fatigued or without vitality;
- Expressing ideas of excessive or inadequate guilt (in some religions, requesting God's forgiveness);
- Expression of hopelessness, helplessness and global pessimism;
- Loss of appetite, loss of weight, insomnia or sleeping too much, and problems with physical intimacy;
- Ideas and fantasies about death and sometimes of self-harming.
These symptoms usually affect several areas. The number of symptoms as well as their severity can vary, from person to person and from period to period.
If you want to check whether a person you know may be suffering from depression, you may screen for possible depression through completing a self-test for the person you have been listening to.
A clergy member could explore the present situation of a person seeking help through a screening question, for example by asking if the person feels sad, how intensively and for how long.
Listening attentively – something clergy members routinely do – is a key feature.
An interested person who listens carefully to a depressed person and is attentive to verbal and non-verbal cues will notice three different areas of problems and changes (see box):
- Psychological symptoms – thinking, feeling and motivation are affected
- Physical symptoms – such as headache, stomach ache, back pain. Sometimes depression is expressed only through somatic symptoms
- Behavioural symptoms – these result frequently from the interaction between psychological and physical symptoms
Sometimes it is possible to be more effective in detecting these changes as an observer: if you feel that someone might be depressed, try to remember how this person usually behaved half a year ago. How were they acting towards you and others? This might help to get a better idea. However, some people also try hard to hide their symptoms because they feel ashamed or guilty.
The next section contains information on symptoms of depression.