Why Am I So Sad?

You might be depressed and not know it.

Woman covering face

 PhotoAlto / Frederic Cirou / Getty Images

At a Glance

If you’re feeling sad all the time, you might be depressed. But depression and sadness do not always go hand-in-hand. It’s possible to be depressed without feeling sad, and feeling sad can also be a sign of other mental and even physical health conditions. 

If you’ve ever asked yourself why you feel so sad all the time, you might wonder if it’s possible that you’re depressed. Is it really possible to be depressed and not know it? 

Here are a few things to keep in mind if you’re trying to figure out why you feel sad that can help you pay attention to what your sadness is trying to tell you.

What Is Sadness?

Sadness is a human emotion, but feeling low or “down and out” all the time is a sign that something is off with your emotional well-being. 

Feeling sad does not necessarily mean you’re depressed—sadness is a common human response to all kinds of things that happen in life, like losing a loved one, facing a disappointment in your career, or even seeing a heartbreaking news story.  

If you’re feeling sad most or all of the time, it could be a sign that you’re depressed. 

Sadness vs. Depression

Sadness and depression can hit you suddenly or come on slowly over time. They can be related to a situation in your life or seem to happen for no "reason" at all. It can be hard to tell the signs of depression like sadness or grief. They’re also not necessarily separate experiences—sometimes, feeling sad is part of being depressed, and grieving can turn into depression.

The key difference is that sadness on its own usually does not keep going on and on like depression does.

Can You Be Depressed and Not Know It?

Being sad all the time can be a sign that you’re depressed—but that does not mean it’s a clear sign. Here are a few reasons you might not pick up on the fact that you’re depressed: The following are some reasons why you may not realize that you are depressed:

  • You've been sad for a while: If you have been depressed for a long time, it probably has started to feel “normal” for you. This is often the case for people who have been depressed since early childhood.
  • Your symptoms came on slowly: Depression can develop gradually over an extended period of time. When the changes in mood are subtle and come on slowly, you may not recognize that things aren't the same as they used to be.
  • You feel down about yourself: If you are feeling like you are somehow “bad" or “defective,” it's easy to dismiss what you are feeling as a part of yourself that cannot be fixed. You may even feel like you’re not worthy of feeling better.
  • You have certain beliefs about mental health: Our cultural differences can affect our ability to recognize and acknowledge depression. For example, if the people in your life see depression as something you have to “push through,” you might feel like asking for help would be a sign of weakness.
  • You don't feel sad. Because you may not be feeling particularly sad, you may think it can't possibly be depression. In reality, depression can take more forms than just a feeling of profound sadness. You may feel tired, low in energy, or lack any real sense of joy without necessarily feeling sadness or being weepy.

Even when people think or know they’re depressed, denial and stigma make it hard to accept and reach out for help.

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Some Common Causes of Depression

Symptoms of Depression Besides Sadness

If you've been having several of the following symptoms for at least two weeks, it’s possible you’re depressed:

  • Anger and irritability
  • Anxiety and agitation
  • Changes in appetite or weight (can be either a lack of appetite accompanied by weight loss or increased appetite with weight gain)
  • Fatigue or lack of energy
  • Feelings of sadness or emptiness
  • Feelings of worthlessness, hopelessness, or excessive guilt
  • Loss of interest in activities usually enjoyed
  • Mysterious aches and pains with no discernible cause
  • Problems with thinking, memory, concentration, and decision-making
  • Sleep problems such as insomnia or sleeping too much
  • Slowed thought, speech, or physical movements
  • Thoughts of death and suicide

How to Find Out If Sadness Is Depression

Whether you think your sadness could be depression or not, the only way to find out for sure and get support is to reach out to a provider. Your regular doctor can be a great starting point because they can talk to you about your symptoms and decide what way to go toward making a diagnosis.

For example, they might decide that the next best thing to do is run some blood tests to make sure that there isn’t a physical cause like wonky thyroid hormones causing your symptoms.

They might also ask you questions that are part of a screening test for depression. Sometimes, they’ll just ask you questions in the office or have you fill out a paper or online form. The survey will ask you questions like how many days over the last 2 weeks you’ve felt “little interest or pleasure in doing things” or “down, depressed, and hopeless.” 

If they think you’re depressed, they might feel comfortable talking to you about treatment. If not, or if they’re not sure that you’re dealing with depression, they might want you to see a provider who is trained to diagnose and treat mental health conditions. 

Depression Discussion Guide

Get our printable guide to help you ask the right questions at your next doctor's appointment.

Mind Doc Guide

What If It's Not Depression?

Depression is not the only mental health condition that can make you feel sad. If you feel sad all the time but do not have other signs and symptoms of depression, there are some other causes your provider might want to consider:

  • Mental health conditions: Depression is not the only mental health condition that can make you feel sad. For example, if you have bipolar disorder, your mood can go up (mania) and crash down. During the low part of the cycle of mood shifts, you could have sadness and other feelings of depression. Seasonal affective disorder or “SAD” is another common condition that can, as the name suggests, cause sadness at certain times of the year. The changes in seasons can be an emotional trigger and while going into the darker, colder months of the year is a major one, some people also notice they get sad and depressed during the summer. 
  • Neurodivergence: Navigating the world as someone who is neurodivergent can be stressful and frustrating. Autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD) are linked to depression not just for people who have been diagnosed, but also for people who are undiagnosed. 
  • Hormonal changes: Feeling sad can be a common part of having premenstrual syndrome (PMS) but when it’s severe it could be a sign of premenstrual dysphoric disorder (PMDD). The changes in your body and life associated with trying to get pregnant, being pregnant, giving birth, and adjusting to new parenthood can also be a trigger for sadness and even perinatal and postnatal depression. Going through menopause is another hormonally-triggering time of life, and depression symptoms are something that people going through the transition often experience. 
  • Substances: Misusing alcohol, tobacco, or illicit drugs/prescription drugs can all have a negative effect on your body and mind, as well as negatively affect the most important parts of your life like your relationships, work, and hobbies. 
  • Chronic health conditions: Sadness and feeling low can be a sign of an underlying physical health condition, not just a mental health one. For example, depression can be a sign of thyroid disorders.
  • Medications: Taking certain medications to manage a chronic health condition you have can sometimes affect your mood. For example, mood swings are a common side effect of steroid drugs that treat inflammation.
  • Stress: You might associate stress at home, school, or work with tension, irritability, and even anger, but feeling sad and “down and out” about life is another common way that people respond to being under constant stress. Research has shown that stress that goes unchecked can also contribute to depression.
  • Lifestyle: If your life is not going the way you want—for example, you don’t have time to exercise, you’re not eating enough or are overeating, and your sleep schedule is messed up—it can have a profound effect on your mood. 
  • Isolation and loneliness: During the COVID-19 pandemic we learned just how powerful the effects of being separated from other people can be on our wellbeing. But for disabled people, older adults, and people living in poverty, isolation can be a constant reality that has a lasting negative effect on physical and mental health.

Treating Sadness and Depression

If you’re feeling sad all the time and think you might be depressed, know that there are treatments for depression that can help. You may need to try more than one treatment or even combine treatments to find the most effective way to treat depression—and that’s OK. 

Medications

Many providers will start trying to treat depression and other mental health conditions with antidepressant medication. Here are some different kinds of medications your provider might suggest trying if you’re diagnosed with depression:

SSRIs are by far the most commonly prescribed medication for depression, but SNRIs and atypical antidepressants are pretty common, too. MAOIs and TCAs are less commonly used because they tend to have more side effects. But for some people, these medications are the best choice.

Psychotherapy

Your regular provider might refer you to a psychiatristpsychotherapist, or another qualified mental health professional who specializes in treating mental health conditions. Talk therapy and cognitive behavioral therapy (CBT) are two of the most common approaches to treating depression.

You can either do therapy one-on-one or with a group: 

  • Individual therapy, such as cognitive-behavioral therapy (CBT), can provide you with a safe and supportive place for you to learn about your sadness and depression, explore what’s behind these feelings, and come up with ways to manage them. 
  • Group therapy can be helpful because it lets you spend time with other people who are going through the same thing that you are. Being sad and depressed can make you feel totally alone in the world, so it can be therapeutic to talk to others who feel the same way as you and share how you’re coping. 

There are also many online resources like self-guided programs or support groups that can be part of a depression treatment plan.

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Life Changes

Medication and therapy can help you start feeling better but you may also find that making some changes to your day-to-day life supports the work you’re doing in therapy and even boosts your mood.

  • Sleep: Getting enough quality sleep can do wonders for your physical and mental health. Coming up with a routine for bedtime that you stick to consistently is a self-care strategy you can make a long-term goal.
  • Exercise: You might find that getting outside for a walk or hitting the gym for a workout makes you feel better physically and emotionally. You don’t have to pressure yourself to hit 10k steps a day or beat your personal best lifting—just pick an activity that you like doing and make it part of your routine. 
  • Nutrition: Starting your day off with a satisfying breakfast or having a tasty meal planned for dinner will not only fuel your body and mind but can actually become little things to look forward to. Some people like to cook and find it soothing, but it’s also common to feel overwhelmed by it. You might find meal kits that take the planning and ingredient-gathering parts out of cooking are easier to manage. If you’re struggling to afford what you need to make nutritious meals, your local food pantry can be a great resource. If you’re not able to prepare meals on your own, community programs like Meals on Wheels can help. 
  • Connecting with others: It can be hard to reach out to other people when you’re feeling sad all the time, especially if you’re worried that you’ll be a burden. Try to remember that the people in your life love you and want to support you. If you let them know that you’re having a hard time, chances are they’ll want to help—even if it’s something as simple as sending you a funny text to cheer you up, bringing you a home-cooked meal, or offering to lend a hand with some chores while you catch up on each other’s lives. 

You can experiment with making little changes in your life and see what helps lift the sadness from your days. You may find it hard to start and keep going, especially if you’re feeling very low. But remember: You don’t have to do it all at once. Setting small goals for yourself can help you build up to the changes you’d like to make without getting frustrated and overwhelmed. 

If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. 

For more mental health resources, see our National Helpline Database.

10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Nancy Schimelpfening
Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be.