Physical Signs
- Aches, pains, or other physical complaints that seem to have no physical basis
- Marked change in appetite (or weight loss or gain)
- Change in sleep patterns (insomnia, early morning waking, sleeping more than usual)
- Fatigue, lack of energy, being "slowed down"
Emotional Signs
- Pervasive sadness, anxiety, or "empty" mood
- Apathy (lack of feeling anything at all)
- Decreased pleasure or enjoyment
- Crying for no apparent reason, with no relief
- Indifference to others
Changes in Thoughts
- Feelings of hopelessness, pessimism
- Feelings of worthlessness, self- reproach, inadequacy, helplessness
- Inappropriate or excessive guilt
- Impaired concentration, slowed or disorganized thinking
- Forgetfulness, problems with memory
- Indecision: unable to make decisions or take action
- Recurrent thoughts of death or suicide
Changes in Behavior
- Loss of interest or pleasure in previously enjoyed activities, including sex
- Neglect of personal appearance, hygiene, home, and responsibilities
- Difficulty performing daily tasks - ordinary tasks are overwhelming
- Withdrawal from people and usual activities; wanting to be alone
- Increased use of alcohol and drugs
- Increased irritability, arguing, or hostility
- Greater agitation, pacing, restlessness, hand wringing
- Suicide attempts or talking about suicide
Reprinted with permission from , by Vicki L. Schmall, LaJean Lawson, and Ruth Stiehl.