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Looks can be deceiving. Just ask Melissa Drake.

The 50-year-old author and consultant from Southern California says she had a good job, owned a home, and was raising a wonderful son. On the outside, her life looked pretty good. But nothing could've been further from the truth.

On the inside, Drake was in a life-and-death struggle with major depressive disorder -- a diagnosis she got at 20 years old.

She admits it's hard to explain what it's like living with this condition. "I often describe depression as 'everything and nothing at once,' because nothing was really wrong, but everything felt wrong at the same time."

Drake is not alone in her feelings.

People often say there's no reason for them to be depressed, but yet they are, says Shawna Newman, MD, a psychiatrist at Lenox Hill Hospital in New York. Some describe major depression as if they are living under a cloud or walking through mud, she adds.

But a closer look uncovers recognizable clues that can signal major depression.

Symptoms of Major Depression

Depression isn't just simply feeling sad or blue. It's normal to feel bad over the loss of a job, the death of a loved one, or another sad event, Newman says. The difference is that symptoms of major depression last at least 2 weeks, run very deep, and are not at all normal for you. Here are some changes you might see in yourself if you have major depression:

Sadness, emptiness, or irritable mood. You can't seem to shake the low mood. You may be irritable too. If you are normally cheerful and you've turned consistently cranky, it could be depression.

Loss of interest. You may stay away from friends or loved ones, or stop doing things you used to enjoy. You may lose interest in sex too.

Sleep problems. You may find it hard to fall asleep, or you could toss and turn all night long. On the flip side, you might sleep much more than usual or nap during the day.

Change in eating habits. You could lose interest in food and lose weight, or you might begin to eat too much and gain weight.

Lack of focus. Work may become difficult because you can't keep your mind on it. Many people describe this as "brain fog." You could also see this loss of focus in your home life, social life, and personal relationships and conversations.

Changes in energy. Overwhelming weakness and exhaustion may make it difficult or impossible to peel yourself off the couch or get out of bed. In contrast, you may be full of energy and feel fidgety or shift in your chair or bed to try to get comfortable.

Hopelessness. You may have a bleak outlook and not see a way out of your depression.

Thoughts of death. These can range from thoughts like "It would be okay with me if I just didn't wake up" to active suicidal thoughts or actions, Newman says. Making a plan to kill yourself or taking action (like buying medication for an overdose) takes these thoughts to the next level. It's not common, but sometimes people with major depressive disorder have homicidal thoughts too.

If you feel like you may harm yourself or others, call 911 right away.

Get professional help if you have symptoms of major depression or are unsure about why you're feeling so bad. Treatments like medicine, talk therapy, and others can work wonders. Opening up to a therapist often gives people a sense of relief right away, Newman says.

Melissa Drake's Symptoms of Depression

Drake's depression at times was severe. "I attempted suicide once, thought about it many other times, was recommended for in-patient hospitalization, and heavily medicated for more than 20 years." Her most pressing symptoms were extreme exhaustion and a general feeling of sickness (malaise).

For 7 years, Drake was practically bedridden, only getting up to go to work and care for her son as a single parent. "There were times when I didn't do laundry or chores for months while piles of mail went untouched for years." Although she spent most of her time in bed, insomnia kept her awake at night and bathing and self-care were nonexistent.

"I was constantly numb, avoiding feelings and stuffing them down with food. I gained weight and ballooned to 307 pounds." 

Drake describes her lowest point to show just how bad her depression was: "I have two dogs that I adore. They are always in bed with me. One day one of them threw up in my bed. As dogs sometimes do, the other dog ate the vomit. I rolled over and went back to sleep. I did not bother to change my sheets -- for weeks."

Drake Finds Peace

The most important decision Drake made was to find a therapist. "It wasn't until I understood and accepted that I had to do the work to recover and start taking steps toward recovery that I began to get better."

She wanted someone who didn't just pay lip service but who held Drake accountable for the better life she said she wanted. "That's what she did and I am so grateful."

Once she was out of the woods, Drake says she began to look for things that she enjoyed. She started to dance. "It was the medicine I needed to heal. It grounded me and put me back in my body."

The year 2020 was especially tough for Drake. But today she's doing well. "Not perfect by any stretch of the imagination, but I've come a long way from being in bed for 7 years. I do work I love; I have a large group of friends; I enjoy dancing and nature," Drake says. "Even through the tough times, my outlook is generally positive."

Show Sources

Photo Credit: Suzana Topita / Getty Images

SOURCES:

Melissa Drake, Fullerton, CA.

Shawna Newman MD, director of child and adolescent psychiatry, Lenox Hill Hospital, New York.