Sonia Garcia

Severe depression can feel like emotional numbness, crushing exhaustion, and hopelessness - and it can look like withdrawal, flat affect, and a person slowly losing the ability to function the way they used to.

For many people, the hardest part is the confusion. You may still show up, reply to messages, or get through the day on autopilot, while inside everything feels heavy, empty, or unreal. Others might only notice that you seem “off,” quieter, more irritable, or less present - even if you’re trying your best to hide it. In this article, we’ll break down what severe depression feels like and look like - including the emotional and physical feelings it creates and what evidence-based treatment options can actually help.

What is Severe Depression

Severe depression, clinically known as major depressive disorder (MDD), is a serious medical and emotional condition that goes far beyond feeling sad or having a bad day. It changes how a person thinks, feels, and functions in everyday life - often affecting sleep, appetite, energy, motivation, and relationships.

According to the National Institute of Mental Health, major depressive disorder is defined by a persistently depressed mood or loss of interest, combined with other symptoms that last most of the day, nearly every day, for at least two weeks and cause significant impairment in daily functioning.

What Does Severe Depression Look Like

Changes in Behavior

People with severe depression often start pulling away from normal life. Activities that once felt simple, like texting a friend, showering, and leaving the house, can begin to feel exhausting or pointless. This is not avoidance; it is the nervous system under strain.

Social withdrawal can deepen depression, which is why understanding the negative effects of social isolation matters.

Changes in Mood and Personality

Depression does not only affect how someone feels - it changes how they relate to themselves and others. Loved ones often say the person feels emotionally distant, flat, or “not like themselves anymore.”

Common emotional changes include:

• Persistent hopelessness or pessimism
• Emotional numbness or emptiness
• Increased irritability or anger
• Loss of emotional warmth or connection

Someone with severe depression may still laugh or smile occasionally, but underneath, their emotional world feels muted, heavy, or hollow. 

Changes in Daily Functioning

Severe depression doesn’t just affect mood - it begins to interfere with basic daily tasks and responsibilities. Even when someone wants to function normally, severe depression can disrupt the brain systems responsible for motivation, focus, and decision-making. As a result, basic tasks stop feeling automatic and begin to require intense mental and physical effort.

Common changes include:

• Inability to initiate tasks, even when they matter
• Extreme mental effort to complete simple actions
• Difficulty concentrating or making decisions
• Feeling “frozen” when trying to start or finish something

What Does Severe Depression Feel Like Physically

Fatigue and Low Energy

Individuals with severe depression often feel exhausted even after sleeping for many hours. The body feels heavy, slow, and drained, as if it is running on empty. Simple actions like standing up, showering, or walking outside can feel physically demanding.

This happens because depression disrupts the brain systems that regulate energy, motivation, and stress. As a result, the nervous system stays in a depleted state, making rest feel unrefreshing and movement feel difficult.

Sleep and Appetite Changes

Severe depression often throws off the body’s natural rhythms. Some people struggle with insomnia and lie awake feeling restless or wired, while others sleep excessively but still wake up exhausted. Appetite may also change - food can lose its appeal, or eating may become a way to cope with emotional emptiness.

These shifts create a cycle:

• Poor sleep increases fatigue
• Fatigue reduces motivation
• Low motivation worsens mood
• Worsening mood further disrupts sleep and eating

Pain, Aches, and Brain Fog

Many people with severe depression experience real physical discomfort. Headaches, muscle tension, back pain, and unexplained aches are common. At the same time, thinking can feel slow and foggy - like trying to focus through a thick mental haze.

This happens because depression affects how the brain processes pain, attention, and memory. The result is not just emotional suffering, but a full-body experience that makes even thinking clearly feel difficult.

When Severe Depression Becomes a Clinical Condition

Severe depression becomes a clinical condition when it is persistent, intense, and begins to interfere with daily life. Instead of coming and going with circumstances, the low mood, numbness, or hopelessness stay present for weeks or months. People may find it hard to work, connect with others, or take care of themselves, even when they want to.

At this point, depression is no longer just a reaction to stress or loss - it is a disorder of the brain and nervous system. That is what clinicians call major depressive disorder, and it requires professional treatment, not willpower.

Treatment Options for Severe Depression

Therapy and Psychological Support

Therapy helps people with severe depression understand what is happening in their mind and learn how to change the patterns that keep them stuck. Evidence-based approaches like cognitive behavioral therapy (CBT) and trauma-informed therapy focus on how thoughts, emotions, and behaviors interact.

In therapy, people learn how to:

• Recognize distorted or self-critical thinking
• Regulate overwhelming emotions
• Rebuild motivation and connection
• Develop healthier coping strategies

Medication for Severe Depression

When depression is severe, medication can play a critical role in stabilizing mood and restoring basic functioning. Antidepressants work by helping balance the brain chemicals involved in mood, sleep, and energy. When those systems are disrupted, people may feel constantly drained, emotionally numb, or overwhelmed.

Medication does not change who someone is - it helps reduce the intensity of symptoms so the person can think more clearly, engage in therapy, and begin rebuilding daily life. For many people with severe depression, medication creates the foundation that makes other forms of treatment possible. If you want a clearer explanation of how these meds work in the brain, see our article: How do mood stabilizers work?

Structured and Intensive Care

Some people need more support than weekly therapy can provide. Structured care offers a higher level of monitoring, treatment, and stability.

This stepped approach allows treatment to match the intensity of the illness.

How Amae Health Helps People With Severe Depression

Amae Health is a specialized mental health clinic designed for people struggling with serious and persistent mental health conditions, including severe depression. Our treatment offerings go beyond surface-level symptom management - we focus on understanding the whole person and building a treatment plan that fits their unique needs.

We provide psychiatric evaluation, therapy, medication management, and structured services for people who need more than occasional support. Whether someone is newly experiencing severe symptoms or has been struggling for a long time, our team works to create stability, safety, and a path forward.

You can reach Amae Health directly or refer a loved one by contacting our clinic to begin a confidential assessment and explore the right level of care.

More than 1 billion people worldwide are currently living with a mental health disorder, according to the World Health Organization (WHO). While those numbers are global, the experience is always personal - showing up in relationships, families, friendships, and workplaces in ways that can be hard to explain or predict.

When it’s someone you love, helping can feel overwhelming. You might worry about saying the wrong thing, making it worse, or pushing them away. And when you don’t know what to do, fear often turns into silence. If you’re searching for how to help someone with mental health issues, this guide offers practical steps for what to say, what to do, and when to involve professional support.

Why Supporting Someone With Mental Illness Feels So Hard 

Supporting a loved one through mental health struggles can feel overwhelming because the situation is high-stakes, and it’s not always clear what will help. You might freeze, worrying you’ll say the wrong thing, or feel guilty for not noticing sooner. This reaction is common. A scoping review of 92 studies found that family caregivers frequently report psychological strain, social isolation, and practical stressors while supporting a loved one.

Another reason it’s hard: mental health symptoms are often invisible. Your loved one may look “fine” in public, then fall apart at home. That mismatch creates confusion, second-guessing, and mixed signals that make it hard to know what’s really going on.

Common Signs Someone May Be Struggling

Mental health concerns can show up in small, gradual changes. Someone may seem more withdrawn, less engaged, or emotionally distant. In other cases, the shift is more functional - changes in sleep, appetite, energy, or daily routines. When you’re supporting someone with mental illness, the goal is not to label - it’s to notice patterns that suggest they may need help, care, or professional support.

These signs don’t confirm a diagnosis, but they can signal that someone may need support. Look for changes that last more than a few days and affect relationships, work, or self-care. If you’re unsure how to help someone with mental health issues, start by observing what changed, when it started, and what seems to make it worse or better.

How To Talk To Someone About Their Mental Health

Create a Safe, Private Space

When you’re supporting someone with mental illness, the setting matters. Pick a calm time when they don’t feel watched, pressured, or stuck. Privacy reduces shame and defensiveness, which makes it easier for them to speak honestly. Even a simple line like, “Can we talk somewhere quiet for a minute?” often feels safer than a serious, formal sit-down.

Listen More Than You Speak

You don’t need the perfect words - you just need to stay present. Active listening builds trust because it shows you can handle their feelings without panicking or taking control.

What good listening looks like:

• You let them finish without interrupting
• You reflect back: “That sounds exhausting.”
• You ask before giving advice
• You stay calm, even if it’s uncomfortable
• You don’t argue with their emotions

Try open-ended questions like:

• “What’s been feeling the hardest lately?”
• “When did you start feeling this way?”
• “What helps even a little bit?”
• “Do you want support, or just someone to listen?”

Avoid Diagnosing or Labeling

Even if you’ve read a lot online, don’t try to label what others are going through. Guessing diagnoses can make them feel exposed, analyzed, or pressured - and that usually triggers defensiveness. The goal is to protect trust, not prove you’re right.

Labels can also create fear (“So you think I’m broken?”) or shut down (“You don’t get me at all”). Instead of diagnosing, focus on what you notice and what they’re experiencing: “I’ve seen you struggling, and I care.”

How To Support Someone With Mental Illness Day To Day

Offer Practical Help

When you’re supporting someone with mental illness, big speeches usually matter less than small, steady actions. Many people struggle with basic tasks when their mind is overwhelmed, so practical support can remove pressure without forcing them to talk. Keep it simple, specific, and easy to accept - “I can do this for you” works better than “Let me know if you need anything.”

Easy ways to help day to day:

• Bring food or send groceries
• Help with laundry or dishes
• Run one quick errand (pharmacy, mail, store)
• Sit with them while they make a hard phone call
• Offer a ride to therapy or appointments

Stay Connected

Consistency matters. Regular check-ins remind them they’re not alone - even if they don’t respond much. A short message can be enough to keep the connection alive without adding pressure.

Try low-pressure check-ins like:

• “Thinking of you today.”
• “No need to reply - just here.”
• “Want company or space right now?”

Be Patient with Their Progress

Recovery rarely moves in a straight line. If you’re learning how to help someone with mental health issues, one of the most important things is keeping your expectations realistic. Some days they’ll seem okay, then suddenly crash again - that doesn’t mean they’re failing. Healing can be unpredictable, especially when they’re building coping skills or starting treatment.

A healthier mindset is that progress happens in small steps over time. Stay steady, notice tiny wins, and try not to take setbacks personally.

Encouraging Professional Mental Health Support

If you’re worried about someone, bringing up professional support can feel uncomfortable - but it doesn’t have to feel forceful. A simple, steady approach usually works best:

1. Lead with care, not control: Start with what you’ve noticed and why you’re concerned, without pushing them to “fix it” immediately.
2. Use gentle, low-pressure language: Try “You don’t have to do this alone,” or “Would you be open to talking to someone?”
3. Offer clear options, not ultimatums: Therapy can provide emotional support, psychiatry can help with medication guidance (including mood stabilizers, when clinically appropriate), and structured clinical care may help when symptoms affect daily life.

If you’re unsure what level of care makes sense, our breakdown of PHP vs IOP can help you understand the difference between structured outpatient options. You can also help by finding providers, offering to sit with them while they call, or going with them to the first appointment.

What To Do If Things Feel Serious

Trust your instincts if their behavior shifts fast or their functioning drops sharply. Serious warning signs can include extreme withdrawal, hopelessness, risky behavior, or inability to handle basic daily needs. In those moments, don’t try to manage it alone - involve urgent professional support.

Quick checklist:

• They seem unsafe or out of control
• They stop eating, sleeping, or leaving bed
• They isolate completely and stop responding
• They express intense despair or “no way out” thinking
• You feel scared to leave them alone

How Amae Health Can Help

Amae Health is a psychiatry-led mental health clinic that provides structured, compassionate care in person. It’s designed for people who need support for depression, anxiety, trauma-related symptoms, mood disorders, and complex emotional struggles that affect daily life. Care is coordinated across a clinical team, so treatment can include therapy, psychiatric evaluation, and ongoing support based on real progress. 

Remember: supporting someone with mental illness doesn’t have to be alone. If you’re worried about a loved one, you can reach out to Amae Health to explore next steps, ask questions, or help them get connected to care. 

Contact Amae Health today to schedule an appointment or learn about referral options.

In a single classroom, two students navigate the same diagnosis, yet they look worlds apart. One boy spins in his chair, shouting out answers and pulling the room’s attention toward him. Across the aisle, a girl stares quietly out the window, her homework forgotten and her mind miles away.

We already know which student will be sent to the counselor first.

Because symptoms are often quieter in girls, boys are diagnosed two to three times more often. In reality, ADHD affects both sexes with nearly equal frequency. This gap reveals a hidden crisis in modern medicine: when we only look for the loudest symptoms, millions of women are left without the support they deserve.

At Amae Health, we specialize in identifying and treating ADHD in women and men by focusing on these subtle distinctions. We understand that an accurate diagnosis requires looking past stereotypes to see how symptoms actually manifest in daily life.

Understanding the nuances of ADHD in women vs. men is about more than just a label. It is the key to selecting the most effective treatment and finally providing the clarity that so many have been waiting for.

Understanding ADHD: Types and Core Symptoms

The Three Types of ADHD

Attention deficit hyperactivity disorder includes three main types, each of which can occur in any person regardless of gender:

• Hyperactive-impulsive type. It is characterized by a constant need to move, an inability to sit still, and impulsive actions that often occur without considering the consequences.
• Inattentive type. Previously known simply as attention deficit disorder, this type of ADHD manifests itself through difficulty concentrating, forgetfulness, and difficulty organizing daily activities.
• Combined type. This type combines symptoms from both of the previous categories and is the most common form of the disorder.

It is essential to understand that anyone can have any ADHD, but male ADHD is more likely to manifest itself through hyperactive-impulsive symptoms that are easily noticeable to others. At the same time, women and girls are more likely to exhibit the inattentive type, whose symptoms are less obvious and often go unnoticed by teachers, parents, and even doctors.

How ADHD Affects Daily Life

ADHD seriously affects all areas of a person's life, creating difficulties at work or school, in personal relationships, and with self-esteem. In the workplace, individuals with this disorder may struggle to meet deadlines, organize tasks, and maintain attention during prolonged meetings.

In relationships, female ADHD can manifest itself through forgetfulness about essential dates, difficulty with household chores, or emotional instability, which creates tension in the family.

Academic performance also suffers, but in different ways for men and women. Boys with ADHD are more likely to receive behavioral remarks and be referred to specialists. Girls, on the other hand, may underachieve for years, with their problems being attributed to laziness or lack of motivation. Self-esteem declines in all individuals, but women often blame themselves for their inability to meet social expectations of organization and order.

ADHD Symptoms by Gender: Key Differences

Male ADHD Symptoms and Presentation

Male ADHD usually manifests itself through external, obvious behavioral symptoms that disrupt order in the classroom or at home. Boys with ADHD often cannot sit still, fidget constantly, get up without permission, and may even run or climb in inappropriate situations.

Impulsivity is expressed through shouting answers, inability to wait for their turn, and frequent interruptions of others during conversations.

Aggressive behavior and outbursts of anger are also more common in male ADHD, especially when the child or adult is frustrated. Boys are more likely to lose things, forget to complete tasks, and engage in risky behavior, including:

• Reckless driving in adolescence and adulthood
• Alcohol and drug abuse as a form of self-medication
• Involvement in fights or other confrontational situations
• Disregard for safety rules in various situations

These external, destructive symptoms of male ADHD attract the attention of adults and lead to earlier diagnosis, but also create negative attitudes toward the child from teachers and peers.

Female ADHD Symptoms and Presentation

Female ADHD manifests itself in a completely different way, through internal, less noticeable symptoms that often go unnoticed by those around them.

Girls and women with ADHD are more likely to "have their heads in the clouds," immersed in dreams or their thoughts. Their workspaces and personal belongings may be disorganized, but they do not disrupt others or create noise.

Perfectionism becomes an attempt to compensate for internal chaos — women with ADHD may spend excessive amounts of time completing tasks, redoing them over and over again. Emotional sensitivity manifests itself through strong reactions to criticism, frequent mood swings, and a tendency toward anxiety or depression. Social behavior is also different — instead of aggression, women with ADHD are more likely to:

• Avoid social situations for fear of doing something wrong
• Feel a constant sense of inadequacy and guilt
• Procrastinate for fear of not being able to do a task perfectly
• Have difficulty making decisions even in simple situations

These internal manifestations of female ADHD are often interpreted as personality traits rather than symptoms of a medical condition, leading to significant delays in diagnosis.

Why Male ADHD is Diagnosed More Often

Historical Bias in ADHD Research

The study of ADHD began with observations of hyperactive boys in the 1960s and 1970s. This laid the groundwork for diagnostic criteria that focus on male manifestations of the disorder. Researchers focused on external, destructive symptoms that interfered with the learning process and required immediate intervention.

For many years, ADHD in women and men was not studied as separate phenomena, which led to the creation of diagnostic tools that better identify male-type symptoms. Even modern assessment scales and tests are primarily based on behavioral manifestations that are more characteristic of boys and men.

Questions such as "Does the child often run or climb in inappropriate situations?" or "Does the child interfere with other children during play?" better describe male behavior patterns. At the same time, female symptoms remain outside the scope of standard diagnostics.

Societal Expectations and Gender Norms

Societal expectations play a huge role in how ADHD symptoms are perceived in different genders. Boys' disruptive behavior quickly attracts the attention of teachers, who refer them to the school psychologist or recommend that their parents seek professional help.

Quiet, dreamy girls often do not cause problems in the classroom, so their symptoms are frequently ignored or attributed to personality traits.

Social stereotypes also influence the perception of male ADHD and female ADHD. Girls are expected to be more organized, obedient, and capable of multitasking. Therefore, when they do not meet these expectations, those around them often consider it laziness or a lack of upbringing. Boys, on the other hand, are "forgiven" for some chaos and impulsiveness as standard male traits, but when these behaviors become excessive, they immediately cause concern.

The Impact of Hormones and Biology

Hormonal differences between men and women significantly influence the onset and course of ADHD throughout life. Estrogen, the primary female sex hormone, plays a vital role in regulating dopamine and norepinephrine, neurotransmitters that are disrupted in ADHD. Fluctuations in estrogen levels during the menstrual cycle can lead to worsening symptoms of female ADHD on certain days of the month.

Pregnancy and the postpartum period present unique challenges for women with ADHD. During pregnancy, many medications used to treat ADHD are contraindicated, and hormonal changes can either improve or worsen symptoms. Menopause is often accompanied by a sharp decline in concentration and memory in women who have never suspected they had ADHD.

Testosterone in men, on the other hand, may have a protective effect, helping to maintain more stable dopamine levels. However, male ADHD can also change with age — many men report that hyperactivity decreases into adulthood, but attention and organization problems remain.

Diagnosis and Treatment at Amae Health

At Amae Health, we have developed a specialized approach to ADHD diagnosis that takes into account the differences in symptom presentation between men and women. Our team of experts understands that ADHD in women vs. men requires different assessment methods and diagnostic tools. We use extensive questionnaires that include questions about internal symptoms, emotional regulation, and social functioning. This allows us to identify female ADHD even in cases where symptoms have been missed previously.

Treatment at Amae Health is tailored to gender differences. For women, we consider the impact of the menstrual cycle on medication effectiveness and can adjust dosages during different phases of the cycle. Psychotherapeutic approaches also vary — men often benefit from strategies for managing impulsivity and aggression, while women tend to respond better to techniques for addressing perfectionism, anxiety, and self-esteem.

If you suspect that you or someone close to you has ADHD, contact the specialists at Amae Health. Our experience in identifying female ADHD has already helped hundreds of women receive the correct diagnosis and effective treatment, radically changing their quality of life. Don't let gender stereotypes deprive you of the opportunity to get the help you need — sign up for a consultation today.