Depression has been called the common cold of behavioral health conditions. As many as 1 in 5 people will experience a serious episode of depression during their lifetime. This is not just the occasional sadness that we all experience, but is a problem that is severe enough to warrant professional help.

How to Know if you Have Depression

Everyone experiences disappointment and loss at some time. However, when these feelings last for many days and lead to difficulty getting work done, avoiding social activities, and feeling helpless or despair, then it is time to take stock.

Primary Symptoms of Depression

If you are experiencing more than a few of these symptoms and they have lasted for 2 weeks or more, then it is likely that you are experiencing a level of depression that is clinically important.

  • A change in mood. Some people feel sad and may cry often. Others simply do not experience much pleasure – even the things one normally enjoys become uninteresting or begin to feel more like work.
  • Changes in appetite, either not eating much or eating too much.
  • Changes in sleep, often having difficulty sleeping, but could be sleeping too much.
  • Lack of energy and motivation.
  • Difficulty concentrating.
  • Feelings of worthlessness and guilt.
  • Recurrent thoughts of death or suicide.

Depression Screening Tool

Take the Depression Questionnaire. The Patient Health Questionnaire (PHQ-9) is a screening tool designed to help you determine your level of depressive symptoms. Online screening is the quickest and easiest way to check the severity of your depressive symptoms and help you decide whether you should reach out to a professional for help. Your response to this screening tool is anonymous. Your results and additional resources will be shared with you after you click “See my Score.”

10 Things Depression Makes Us Do

Depression is a sneaky mental disorder. It’s difficult to catch during the early stages. Those with this mental disorder feel hopeless, empty or sad, fatigued, irritable, and restless.

Click image to view the video from Psych2Go: 10 Things Depression Makes Us Do

What Depression Looks Like

How do you know if you're depressed? Sometimes it can be hard to tell if you have a clinical depression, or if you have a temporary sadness.

Click image to view the video from Dr. Tracy Marks: Nine Clinical Symptoms of Depression

More Information

For more information about depression and its treatment, visit the National Institute of Mental Health web pages.

If you are currently experiencing a life-threatening emergency where you are at risk of hurting yourself, please call 911. You may also access these resources for help coping with suicidal thoughts:

  • Suicide prevention LIFELINE: 1-800-273-TALK (8255)
  • Crisis Text Hotline (type HOME to 741741)
  • FirstLink: Dial 211 or text your zip code to 898-211 from anywhere in North Dakota or northwest Minnesota

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How Stress Affects the Body

How to Know if you Should Get Help

Depression is a sneaky companion. Very often there are understandable reasons people get depressed. A lost job, stressful relationship, health issues, and a variety of other challenges can lead to frustration, feeling down, and hopelessness. Now consider the symptoms. When you are not sleeping well, have trouble concentrating, have little energy, and restrict your activities there are few opportunities to break out of the slump. It is not only difficult to solve one’s problems when you are feeling like this, but it may seem impossible to see any alternatives. When people are sad, they very often see the glass as half empty. It is easy to assume the worst and give up before even trying to make changes.

Most often depression lasts a long time (maybe months) and does not resolve on its own. The good news is that there are many effective treatments available. Getting treatment from a licensed mental health professional has been shown to improve the mood and lives of individuals much sooner and more completely in comparison to those who do not receive treatment.

Signs and Symptoms

Consider taking the Depression Questionnaire to help you determine your level of depressive symptoms. Online screening is the quickest and easiest way to check the severity of your depressive symptoms and help you decide whether you should reach out to a professional for help. Additionally, according to the National Institute of Mental Health, if you have been experiencing symptoms of depression most of the day, nearly every day, for at least two weeks, then you may be suffering from depression and should consider contacting a professional.

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What to Consider When Seeking Help

Several types of treatment have been shown to be effective in managing depression. These include medication and different forms of talk or activity and behavior-based therapies. Check your health insurance policy for coverage. Consider a recommendation from your primary care provider. Ask questions about what to expect in treatment: how often will you need appointments? What will you be doing during treatment and how will that lead to improvements? Choose a provider that you think will fit your needs.

Most people will do better if they see a mental health professional, but for those without easy access to a health care professional and who are not experiencing suicidal thoughts you might consider some Self-Help Resources.

First Visit with a Behavioral Health Professional

Please note that this video has been made by the University of Nottingham for teaching purposes. The psychiatrist is a real psychiatrist but the patient is played by an actor.

Click image to view a video that can let you know what to expect in a typical visit.

Video link failed to load.

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Types of Treatment

Please note that all the treatment types listed below have been shown to be effective in scientific studies. Despite having a specific name and identified focus, these treatments are all flexible enough to address the issues a particular individual is facing. Also, these are not the only treatments available, but are among the most common.

Activity Change Theory

People who are depressed often feel that their activities are less enjoyable. Low mood and less pleasure also lead to reduced activity levels and result in low motivation, further compounding mood problems. The goal of this treatment is to reduce the number of unpleasant events a person experiences and increase pleasant events. See a sample session in the video-clip below.

Video: Case Conceptualization for Behavioral Activation

Video link failed to load.
Cognitive Therapy

People who are depressed often think about themselves and their circumstances in ways that are not productive. The goal of cognitive therapy is to help the individual become aware of thinking patterns that are not helpful and change them. Learning how to promote more adaptive thoughts will lead to better problem solving and a more positive mood.

Video: A Case Example of Cognitive Therapy

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Interpersonal Therapy

According to the interpersonal perspective, depression results from continued stressful events that occur when interacting with other people. Interpersonal problems can result from failures of communication, unrealistic expectations of others, and inability to cope when the need arises. This can lead to grief, sadness, frustration, and low self-esteem. The major goal of this treatment is to help the depressed person learn to cope with stressful interpersonal relationships and develop more successful relationships.

Video: Case Example and Description of Interpersonal Therapy for Depression

Video link failed to load.
Medication Treatment

When people are stressed there are several changes that occur within the body. Problems with sleep, appetite, energy, as well as anxious and depressed emotions are tied to specific processes in the brain. Medications can be prescribed to address the symptoms of depression. The physician is likely to start out with a small amount of the drug and increase the dosage as needed. The physician may also choose a different drug if the initial medication does not seem to be working. The rationale behind the use of medication suggests that if biological functioning is returned to normal, social and interpersonal functioning will follow.

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What is Mental Health?

Self Help Resources

Most people will do better if they see a mental health professional, but for those without easy access to a health care professional and who are not experiencing suicidal thoughts, you might consider some self-help resources.

Please note that self-help books and programs are not equally effective. Each of these resources were chosen because they were either developed based on an effective research program or they have been demonstrated to be helpful on their own. The books are available from popular online book sellers.


  • Overcoming Depression One Step at a Time: The New Behavioral Activation Approach to Getting Your Life Back, by Michael Addis and Christopher Martell, 2004, New Harbinger Publications.
  • Feeling Good: The New Mood Therapy, by David Burns, 2012, Harper.
  • Feeling Great: The Revolutionary New Treatment for Depression and Anxiety by David Burns, 2020, PESI Publishing & Media.
  • Mind Over Mood, Second Edition: Change How you Feel by Changing the Way you Think, by Dennis Greenberger and Christine A. Padesky, 2015, The Guilford Press.
  • Control Your Depression, Revised Edition (1992). By Peter M. Lewinsohn, Ricardo F. Muñoz, Mary Ann Youngren, and Antonette M. Zeiss. Touchstone.

Centre for Clinical Interventions: Self-help Resources for Looking After Yourself

The Centre for Clinical Interventions (CCI) has produced resources for consumers to assist in providing interventions for depression. The resources provided on this website aim to provide general information about depression, as well as, techniques that focus on a cognitive behavioral approach to managing difficulties.

Freely access workbooks, information sheets, and worksheets to assist with managing depression.

The workbook is designed to provide you with some information about depression and suggested strategies for how you can manage your mood.

Depression: Looking After Yourself

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What is Mental Health?

Where to get Help

The Substance Abuse and Mental Health Services Administration (SAMHSA) has created a webpage where you can enter your home address or zip code and find treatment providers in your area.

    Access the SAMHSA Treatment Locator

For individuals living in North Dakota and northwest Minnesota, FirstLink is a service that offers free and confidential help for behavioral health concerns.

    Visit FirstLink

The Association for Behavioral and Cognitive Therapies offers free information on how to find help, and how to choose the right therapist or treatment provider.

    Learn more about how to choose the right therapist or treatment provider

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Other Web Resources

There are several professional societies and government groups that have informational resources for the public. The following links were included because they provide current, empirically supported, and reliable information about depression and its treatment.

The American Psychiatric Association

This link provides access to a fact sheet about depression with additional information from a medical point of view.

Anxiety & Depression Association of America

This link includes a detailed description of different types of depression, a downloadable brochure, and several webinars on a variety of topics related to depression.

The Association for Behavioral and Cognitive Therapies

Here you will find a fact sheet about depression.

The National Institute of Mental Health

This link includes signs and symptoms, risk factors, and a description of different types of treatments available for depression.

How Psychologists Help with Depressive Disorders

When you see a psychologist for depression, they may approach the problem in different ways. This link provides a description of what to expect when seeing a psychologist.

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Modules describing signs and symptoms of behavioral health conditions are not diagnostic. If you have questions or concerns about your mental well-being, contact My Sanford Nurse at 701.234.5000, 1.800.821.5167, or click here to find a Sanford Health care professional. If you are having thoughts of self-harm, call the suicide prevention LIFELINE anytime at 1-800-273-TALK (8255). If this is an emergency, please call 911.