Richard Niolon, Ph.D.
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The symptoms of depression vary widely from person to person. Here's some ways a client may allude to depression:

feeling low	compulsive eating	hopelessness
tense	withdrawn	angry
fatigue	disorganized	like a failure
feeling sad	no appetite	obsessed with the past
agitated	guilty	hoping to die
heaviness	cries easily	unbearable
difficulty with sleep	low self-esteem	hating my life
quiet	hateful	plan to kill self
fear	empty, void	dead inside
helplessness	miserable	excessive worrying
self-critical	apathetic	feelings of loss
body aches	worthless	difficulty concentrating
anxious	alone	no motivation

The typical physical signs of depression are changes (increases or decreases) in weight, sleep, appetite, and energy level. Depression often entails decrements in concentration and memory. Depression can cause a decrease in IQ and achievement test scores as well because the client doesn't have the full resources of their memory available, can't concentrate to solve verbal problems and math.

The typical cognitive signs of depression are hopelessness and helplessness, and Beck's cognitive triad. This entails making attributions that are internal ("It's my fault"), stable ("I can never do any better"), and global ("I screw up everything I do"). Depression also limits the person's memory for positive events and situations, but makes depressive events and situations much more readily available for processing. Thus, they have a hard time recalling the good times, successes, and their strengths, but can very quickly and easily recall negative times, mistakes, and weaknesses.

Depression can result from numerous causes. Here are some psychological causes.

Grieving have there been any recent losses in the family, friends who have moved away, breakups in significant relationships Victimization any fears of victimization, recent attacks or assaults on them or someone close, high crime rate in neighborhood Financial Problems ask about finances, whether housing and other securities of life are at any risk, or any other debts piling up Loss of Structure serious disruptions to life, like loss of a job, introduction of a new child or other relative into the home, increased isolation

Remember that women are almost twice as likely to admit to being depressed as men. Women with three children under the age of six, and who do not work outside of the home, are the highest risk group for depression. Cultural factors can also come into play. Some families and cultures are more accepting of depression, emotional displays of sadness, expressing the depression in more emotional terms or somatic terms, and taking a break versus "jumping back into life" after a crises. You can't really generalize and say "this culture handles depression this way, while that one handles it that way…" Be sure to ask about depression in the family, how the family responds to it, and the degree of family support available.

In addition to stress, depression can have a physical or medical basis. Possible medical causes could be:

endocrine system problems (such as a malfunctioning thyroid) medication interactions acute or chronic stress reactions allergies PMS chronic health problems drug/alcohol abuse or dependence recently stopped smoking recent surgery seasonal affective disorder recent birth of a child

Obviously, asking about medical issues is important.