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Depressed or Anxious? When to Seek Counseling

Depression and anxiety affect many Americans. Numbers from the Centers for Disease Control show millions of visits to hospitals for depression each year, and estimate that over 7% of Americans suffer from depression over any given two-week period from 2009 to 2012. It's really a kind of silent healthcare epidemic that we have to deal with. So how can you tell when someone is clinically depressed, as opposed to just unhappy?

It can be hard to really identify depression in yourself and others. When you're trying to figure out whether you or someone else needs help with depression, it’s important to look at the ways that this mental illness affects lifestyle. This can help you figure out when you need help, as opposed to times when you may be able to jog yourself out of a mental rut.

Knowing the Signs and Symptoms of Depression

Understanding depression starts with knowing the most fundamental signs and symptoms of this disease.

Many of these symptoms are interrelated, but they're not all the things you would think of as being linked to depression. Some basic symptoms include:

● loss of appetite

● loss of interest in previously enjoyed activities

● fatigue

● difficulty concentrating

In addition to these symptoms, which seem largely psychological, there can be other warning signs of depression that are more physical. Someone might feel a lot of fatigue throughout the day, or even experience physical pain in the form of migraine for headaches, or some other form. Insomnia can also be a symptom of anxiety and depression.

While some of these symptoms seem to make a lot of sense (people who are depressed often just won’t take the same joy from eating food, and resulting emotions, feelings and body chemistry tend to shut down the appetite), others seem more abstract and hard to link to feelings of depression, so it becomes more important to really consider the person’s whole context and figure out where the symptoms are coming from.

In addition, people talk about the other symptoms of depression that involve having dark thoughts or unhappy thoughts and feelings on a regular basis. A lot of this has to do with a person's basic personality and how that may have changed over time. For example, if someone who was largely positive becomes fundamentally gloomy, that can be a sign of depression. Again, this can be hard to really pinpoint – sometimes, talking about depression can help – but too often, those who are suffering just clam up and go about their business in silence, partly because of the stigma surrounding mental illness, or for other personal reasons. Sometimes it takes encouragement from someone else to help someone to come forward and start to get the treatment that will change their lives –so if you see someone struggling, take time to talk to them and discuss a course of action.

Life Changes

In so many cases, depression, or something that looks like depression, is related to life changes. It's important to understand what's going on in someone's life when diagnosing depression -- what have they been going through? Was there a death in the family? Was there a change in employment or some other big transition?

All of these things have to be taken into account when trying to figure out a level of clinical depression and how to treat it. This resource from Everyday Health explores the idea of situational depression and gives some advice to people who may have been through hard times.

Alternative Treatments

Another helpful idea here is that there are alternatives to clinically treating depression. If it's difficult for you or someone else to get to a psychiatrist and get medications because of a lack of health insurance for some other reason, or you want to rule out a lesser form of chronic anxiety or sadness, you can try these lifestyle changes to see if depression and anxiety respond. In many cases, you will actually feel better, regardless of everything else that is going on around you.

Experts recommend changing your diet and eating better, combined with a regular regimen of physical activity. Lots of us might wonder why exercise would have positive effect on depression, but doctors, nutritionists and other professionals understand the various ways that this works.

Exercise increases blood circulation and the body's metabolism, which can have a profound effect on someone's mental outlook. Exercise actually releases endorphins, which can work on the body's hormonal balance and really make someone feel happier in the aftermath of a workout.

The American Psychological Association has come out with resources showing the positive effects of exercise, and suggested it’s something that should be more closely integrated into treatment plans.

In addition, others suggest adding meditation or some other kind of practice to try to work through minor depression and anxiety with lifestyle changes.

Making the Choice to see a Medical Professional

In the end, there's only so much that someone can do before agreeing to see a psychologist or therapist to figure out how deep their depression and anxiety go. It's important to consider how these treatments will be paid for, so that a patient can go ahead with some confidence and peace of mind in the course of treatment. To put it another way, having the structure for payment in place is a vital part of experiencing the treatment and making sure that it will last going forward.

One of the basic guidelines for clinical treatment of depression and anxiety is that when these things start to affect your daily life, they're probably more than just what you can handle on your own. However, a mental health professional can really do the diagnosis and ascertain what's going on and tell you more about your particular personal situation. The hard truth is that there are many real barriers for patients who want to get help. Some of them are mental; some, as mentioned, are psychological. But when patients do seek help from qualified professionals, they can start to climb out of the hole that depression and anxiety have put them in.


About Sam Nabil

Sam Nabil is the founder of Naya Clinics and is a Boston therapist and a Boston Marriage Counselor.

Sam offers therapy in Boston and Boston Marriage Counseling for adults suffering from relationship challenges, life transitions and anxiety.


Naya Clinics is a top-rated Marriage Counseling, therapy and Life coaching practice.

Naya Clinics offers Marriage Counselors near me, individual therapy near me, and life coaching near me in various locations across the USA and the world.


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