Challenging emotions can arise in any situation, from work to relationships. Everyone has good days and bad days — even good years and bad years — but you should be concerned when the signs of depression, anxiety, obsessive-compulsive disorder (OCD), or bipolar disorder seriously interfere with your ability to function.

4 Signs of Clinical Depression

“You determine clinical depression by two measures. One is by time and one is by severity — impact on function. When you have severe symptoms that last at least two weeks and are interfering with fundamental basic functions, it falls into the realm of clinical depression,” explains psychiatrist Jill RachBeisel, MD, associate professor of psychiatry of the University of Maryland School of Medicine in Baltimore.

There are many symptoms of depression, but most common among people with clinical depression are changes in:

Appetite. “In clinical depression you lose your appetite completely, and you stop eating, or you eat very little,” says Dr. RachBeisel.

Sleep. When clinical depression sets in, you may have consistent, severe insomnia and be unable to sleep well almost every night.

The Ability To Concentrate. “Someone might find themselves unable to maintain focus on simple activities like watching a TV program or reading a newspaper article,” says RachBeisel. You may not be able to focus on a recipe for dinner or tasks at work.

Reduced Energy Level. “With severe clinical depression your energy is so low you have trouble getting out of bed in the morning or carrying through your basic activities of daily living. People find themselves lying in bed and staying in pajamas all day long,” RachBeisel explains. This may mean that you no longer care about shaving or styling your hair, for example, or about bigger issues, like caring for your children.

At its most severe, clinical depression can lead to suicide. Having thoughts like “My family would be better off without me” is a warning sign.

Signs of Anxiety

“We all should have a little anxiety at times because, when you think about it, one of the things that helps us perform really well is the tendency to get a little anxious,” says RachBeisel. There are, however, signs that you may need help controlling an anxiety level that’s just not healthy:

No Focus. You can’t follow a conversation or complete a basic task.

Social Fear. You can’t or won’t interact with other people; for example, you avoid using public transportation, attending social events, even leaving your home. You find yourself avoiding family gatherings or office parties due to social anxiety.

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