Warning Signs of Severe Depression: How to Help a Loved One Recognize Symptoms and Get Help

A diagnosis of major depression indicates that someone is struggling with a more severe form of a normal depressed or sad mood. When depression persists and prevents someone from functioning normally in their lives, they need professional treatment. Knowing the signs of this severe and difficult mental illness can lead to your loved one getting the care they need. It may even save their life.

Depression is a perfectly normal mood and response to difficult situations. But when depression becomes severe and persistent, and interferes with the ability to function, it may require a diagnosis and treatment. Understand the signs of depression and severe symptoms so that you can reach out to help a loved one get much needed treatment.

Depression is a mood and a feeling that everyone experiences. If your loved one shows signs of depression once in a while, there may be nothing to worry about. We all go through low moods, especially when triggered by an external event like a breakup or after losing a job.

Major depression, or major depressive disorder, is a clinical diagnosis for a mental illness that is a more severe form of ordinary depression. For most people, a depressed mood is temporary, mild or moderate, and triggered by some event.

Someone with major depression has more severe, persistent symptoms. The symptoms may or may not be triggered by something upsetting or distressing. The clinical criteria for being diagnosed include:

  • A depressed, sad mood
  • Loss of interest in normal activities, or an inability to feel pleasure
  • Changes in appetite with weight loss or gain
  • Difficulty sleeping or sleeping more than normal
  • Fatigue
  • Agitation and aimless physical movements, or the opposite, lack of movement
  • Feelings of being worthless, ashamed, or guilty
  • Trouble thinking, concentrating, and focusing on tasks
  • Thinking about death or suicide

A diagnosis of depression requires that your loved one experience some of these symptoms, and at least number one or two, for two weeks or longer.

Additional Warning Signs of Severe Depression


Any diagnosis of major depression can be considered severe. The criteria indicate someone who is experiencing more than the normal, occasional sadness or depression. Their symptoms persist. No matter what they try, they can’t shake the low mood.

For someone who is not a clinician, seeing the signs of this mental illness is not necessarily easy. You may see some signs your loved one is depressed or sad, but it may be difficult to recognize if it is a normal mood or a severe case of depression.

In addition to the official criteria for diagnosing depression, there are some important signs you can look for in a loved one. If you see these clues or warning signs, it may indicate their feelings of sadness and depression are becoming overwhelming and that they may qualify for a diagnosis:

  • Your loved one is having problems in close relationships because of persistent depression and related symptoms.
  • The symptoms are causing them to have difficulties at work or school, such as missed time or diminished performance.
  • Recent passions, like a hobby, exercise, or even work, are now diminished. They show no interest in these things anymore.
  • They may have physical symptoms that can’t be explained by an illness or injury: aches and pains, indigestion, headaches, and back pain.
  • Most people don’t associate anger with depression, but men in particular with depression may have angry outbursts and be extremely irritable.
  • Your loved one may have more severe mental illness with co-occurring disorders. Watch for signs of anxiety, compulsive behaviors, substance use, and any other troubling symptoms or behaviors.

Warning Signs of Severe Depression Also Include Suicide


Depression also predisposes your loved one to think about suicide and self-harm. This doesn’t mean they will act on those thoughts, but this severe outcome is more common in people with depression. Signs someone may be at risk for suicide include:

  • Talking about killing or harming themselves
  • Getting their affairs in order
  • Behaving in dangerous, reckless ways
  • Talking about being desperate for relief or people being better off without them
  • Having a preoccupation with death
  • Suddenly changing from severe depression to a sense of calm and peace

Types of Depression That May Be Severe


Major depression is just one diagnosis in the family of depressive disorders. Your loved one may have specific circumstances, such as just having a baby, or particular symptoms that indicate a different diagnosis. Many of these types can also be severe and dangerous if untreated:

Perinatal and postpartum depression

One in seven women who are pregnant or recently gave birth develops this type of depression. Hormones may play a role in the onset, but new mothers also face anxiety, stress, and worry associated with such a big change.

These can lead to severe depression in some cases that may cause anger, extreme worry, difficulty caring for or bonding with the baby, and even self-harm or thoughts of harming the baby. If you see a new mom struggling to cope or showing worrying signs like these, getting help is essential.

Depressive psychosis

If someone you care about with depression begins to show signs of psychosis, they may be going through a severe type of this mental illness. Psychosis is losing touch with reality and causes symptoms like hallucinations and delusions.

Bipolar depression

Bipolar disorder causes changes in mood between periods of depression, which have the same symptoms as major depression, and mania. People with bipolar disorder can exhibit severe symptoms that make normal functioning impossible.

Look for signs of mania, which are often the opposite of depression: high energy, decreased need for sleep, racing thoughts, high self-esteem, frenzied activity and attempts to get a lot done, and impulsive, dangerous behaviors.

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How to Help Your Loved One Get Treatment


For the person experiencing depression, it can be difficult to ask for help. There is shame and guilt involved, but also the sense of being so overwhelmed that it feels as if there is no way out. Severe depression can feel like being in a hole that you can never climb out of, no matter who tries to help.

When dealing with someone you care about, it’s important to push for help in a calm, supportive, and non-judgmental way. Don’t be afraid to talk to your friend or family member about your concerns. It may be just what they were waiting for: someone to show they care and offer some solutions or advice.

If your loved one doesn’t listen or denies they need help, enlist other people who care about them. With enough caring family and friends pushing for treatment, they will be more likely to recognize that their symptoms have become severe and they can’t go it alone.

Residential Treatment for Severe Depression


Treatment for depression includes therapy and medication, but there is no quick fix or cure. Your loved one will need ongoing care that treats depression as a chronic illness. Like chronic physical illnesses, depression will simply come back if it is not managed regularly.

This is a good reason to push your loved one to consider residential treatment. It will provide them with a strong foundation for a lifetime of good management of symptoms. Another reason is that severe depression can be truly dangerous.

Your loved one is at risk of self-harm and suicide. They may be struggling to work and earn a living or maintain a healthy lifestyle. Getting into residential treatment now will reverse these trends and keep them safe while they learn how to heal and manage depression.

Confronting someone you care about is not easy. Mental illness still carries an unfortunate stigma. But to remove that stigma and make sure your loved one gets needed professional help, it’s essential that you speak up and lend support.

If you’re concerned about a loved one and believe they may need residential care, we can help. BrightQuest offers long-term treatment for people struggling with complex mental illnesses. Contact us to learn more about our renowned program and how we can help you or your loved one start the journey toward recovery.