Most people are taught from an early age not to “wear your heart on your sleeve.” What that really means is it isn’t cool to show your feelings, especially if they might make people around you uncomfortable. It was perfectly acceptable to show happiness, but not sadness, and definitely not depression. As a result, people who experience depression tend to hide it even from their nearest and dearest, and some are not even aware that they are suffering from depression.

Depression is not a feeling, per se. The feelings of sadness and despair are symptoms of depression, a major mood disorder than can have serious consequences if not diagnosed properly. Some people do feel “depressed” when something happens, like breaking up, losing a job, or getting sick. If the feeling of sadness or hopelessness lifts after a little time has passed, then it is not true depression.

However, for 350 million that suffer from depression in the world, the black mood just keeps going on and on. It prevents a person from functioning normally, and may even lead to suicide. Hiding it, or even denying it exists, can only make it worse. It is important to face it head on so that proper treatment can begin.

My Father suffered from depression when we lost his job six years ago. It was a really difficult time because he started to withdraw from us and we did not know how to reach out to him. Next thing we knew, my parents were always quarreling and were always in a “bad mood” and Dad was becoming more and more melancholy each day. It was a heaven sent when my Uncle convinced my Dad to seek medical help. It was only then that we discovered he had depression and found ways to help him pull through those dark times. If we had only known earlier, we could have spared ourselves a lot of heartache.

For those who suspect that they are suffering from depression or have a loved on going through it, here are six latent cues to watch out for:

Changes in sleep patterns

One of the first signs of latent depression is the inability to sleep, or the inability to get up from bed. Sleeping too little or too much (hypersomia) on a daily basis for consecutive days is a cue that something is out of whack.

Hypersomia effects just 15% of depression sufferers, however. Insomnia is far more common, and interestingly enough, it can actually trigger the onset of depression rather than just being a symptom. If insomnia is a problem for you before you start experiencing depressive feelings, you may be able to overcome depression by addressing your insomnia.

Drugs and psychotherapy are very effective therapies for insomnia leading to depression, but you may want to consider what is causing your insomnia in the first place. The most common ones are excessive stress at work or at home, a medical condition such as asthma, acid reflux, or chronic back pain, and lifestyle factors such as irregular sleep schedule or a lack of exercise.

A friend of mine started having problems with sleeping when she began experiencing “pins and needles” sensations in her legs. She ignored it for a long time, even hiding it from her husband. She became irritable and unable to concentrate on her work. I talked to her about it, and she finally told me she hadn’t been able to get more than two to three hours sleep a night for over a year. I urged her to consult with a neurologist, and she was diagnosed with restless legs syndrome (RLS).  She got the treatment she needed and her sleep went back to normal.

Avoidance

People suffering from latent depression try to hide their problems by wearing a mask of happiness all the time. Close friends and family members are the first to see through the mask, so the sufferer tends to avoid seeing them too often. If someone you know suddenly starts making excuses too often from seeing you, it could be due to depression.

Philosophical conversations

Depressed people also tend to become more philosophical than usual, and may bring up “deep” subjects that don’t normally make their way into normal conversation. This could include questions about happiness, life or death. People that express dissatisfaction with their life, or debating the benefits of suicide, may be expressing a cry for help. Be there when it happens, and be ready to provide advice and support.

Changes in eating or drinking behavior

Some people who suffer from depression turn to food or alcohol to cope with it. The expression “I eat when I’m depressed” is actually true for many people, but it can be tricky to identify.

A close cousin, who was a picky eater and as thin as a lathe in her younger days, gained a lot of weight after her boyfriend broke up with her. No one realized it at first, because she kept her game face on. By the time I suspected depression, she had already developed diabetes and high blood pressure from overeating and obesity, and had a succession of failed relationships. To this day, she denies that anything is wrong, so a proper diagnosis was never made.

Other people turn to alcohol, and that is even harder to detect if the sufferer hides it from others. You need to be very vigilant after break ups or other traumatic experiences to look for such changes in behavior, so you can step in before it is too late.

Intense emotional responses

If you notice that tears are never far away, that may mean incipient emotional breakdown. Depressed people often exhibit more intense and uncontrollable responses to emotions. That friend with RLS would sometimes launch into a crying jag while watching the news, a sad movie, or even a commercial! She would also start abusing the supermarket cashier when she moves a little too slowly. It is like watching a pressure cooker letting off steam when it reaches its limit.

You can help alleviate the pressure by letting them talk, and you will eventually get at the heart of the problem, which in this case was a treatable medical disorder.

Pessimism

Finally, be on the lookout for any indications of pessimism in outlook. Non-depressed people tend to have a more positive attitude. For example, a depressed person up for a promotion will calmly enumerate the reasons why he or she will not get it rather than express a hope for a positive outcome. While this may seem like just being realistic, it may also be a cue of latent depression. 

Depression is a serious but common mood disorder, and treatable in most cases. However, the first step in treatment is proper diagnosis. You can help by identifying these 6 cues of latent depression.