Sadness is the most universal and widely recognized symptom of depression. And, while sadness is a significant symptom in many cases, individuals can be clinically depressed without being sad.

Depression vs. Sadness: What's the Difference?

The criteria mental health professionals use to diagnose depression include the appearance a depressed mood or loss of interest in once enjoyable activities, plus at least four of these additional symptoms.

  • Disrupted appetite
  • Difficulties sleeping
  • Fatigue
  • Psychomotor agitation
  • Feelings of worthlessness, sinfulness, or guilt
  • Trouble concentrating
  • Thoughts of death or suicide

Furthermore, these symptoms must cause significant distress or impair an individual's ability to function. A patient's physician must also rule out depression caused by side effects of medications, substance abuse, an underlying medical condition, or recent bereavement.

Sadness, in contrast, is the feeling a person has following a major life change that she experience as loss, such as death, divorce, retirement, or major illness. According to the counseling department at Neumann University, sadness is an emotion, and focusing on your emotions allows you to work through them and heal. Avoiding or suppressing painful feelings, however, can eventually lead to depression.

Depression Without Sadness

Some people are more likely to be depressed without being sad. For example, older adults do not always exhibit typical depression symptoms and may even have fewer symptoms. Instead of feeling sad, seniors may complain about physical symptoms for which there is no discernable cause. They're more likely to experience a sense of hopelessness, be worried or anxious, lose interest in personal care, move more slowly than usual, or be unable to find pleasure in life.

Physicians and family members often blame these symptoms on existing illnesses or aging. However, depression is not a normal part of aging and health challenges do not necessarily trigger depression. Untreated depression in seniors is serious. It can aggravate existing health problems and put them at risk for developing other medical conditions. Furthermore, seniors are at significantly higher risk for committing suicide.

Depressed women are more likely to experience sadness, worthlessness, and excessive guilt. Men, on the other hand, are more likely to be fatigued or irritable, have trouble sleeping, or lose interest in activities. Depressed children and teens may exhibit behavioral symptoms, such as irritability or aggressiveness, rather than sadness.

Unfortunately, lack of apparent sadness makes it difficult to recognize depression, so patients may not seek help. Depression is highly treatable. If you observe some of these depression symptoms in yourself (or a loved one), see your physician for an evaluation.


Gallo, Joseph J., M.D., M.P.H., and Rabins, Peter V. M.D., M.P.H. "Depression Without Sadness: Alternative Presentations of Depression in Late Life." American Family Physician. Web. 1 September 1999.

National Institute of Mental Health. "Depression." Web. 2011.

Neumann University. "Sadness and Depression." Web.

Medscape Medical News. "10% of Metropolitan-Area Residents Affected by Low Mood." Web. 7 November 2000.