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Chronic stress or depression? Symptoms are sometimes identical, expert says

Crystal Graham
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(© buritora – stock.adobe.com)

October 10 marks World Mental Health Day, a global effort to raise awareness and the perfect time for a self-assessment for chronic stress and depression.

Symptoms of chronic stress often mimic those of depression and may include:

  • fatigue
  • trouble concentrating and remembering
  • changes in sleep or appetite
  • low motivation

“People under chronic stress often neglect basic self-care, which can worsen mood and cognitive function,” said Adrienne Means-Christensen, the director of the Psychological Services Center at Virginia Tech.

“Chronic stress takes a significant physical and psychological toll. When the sympathetic nervous system stays ‘turned on,’ it can wear down the body and mind,” Means-Christensen said.

“Chronic stress depletes our resources as our bodies go through the stages of dealing with it. During the final stage, the exhaustion phase, several things occur that look a lot like depressive symptoms.”

Some people who have depressive symptoms may believe they have depression, but sometimes it is stress, which can usually be treated with simple lifestyle changes.

“For a true diagnosis of depression, the feeling of being depressed — what we think of as being down, depressed, or blue — or a true loss of enjoyment in things, independent of fatigue, time or energy, are really essential.

“If people don’t have one of those two symptoms, it may be a good idea to look at stress,” she said. “If you’re unsure, check basics like sleep, nutrition and social engagement.”


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A mental health professional can help determine the proper diagnosis and the right approach for treatment.

“Stress may improve with lifestyle changes, while depression often requires therapy or medication,” she said.

Report explores mental illness in America


A new report from Mental Health of America found nearly one in four Americans experienced some kind of mental illness in the last year.

The report also found that the prevalence of mental health concerns among adults in the U.S. remained relatively stable from 2021 to 2024, but the “rates are still unacceptably high.”

In the U.S., 60 million adults, or 23.4 percent of the population, experienced a mental illness, or AMI, in 2024; more than 46 million adults.

In Virginia, 1.5 million people experienced a mental health issue in 2024.

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Crystal Graham

Crystal Graham

A 1999 graduate of Virginia Tech, Crystal Graham has worked for 25 years as a reporter and editor for several Virginia publications, written a book, and garnered more than a dozen Virginia Press Association awards for writing and graphic design. She was the co-host of "Viewpoints," a weekly TV news show, and co-host of "Virginia Tonight," a nightly TV news show, both broadcast on PBS. Her work on "Virginia Tonight" earned her a national Telly award for excellence in television. You can reach her at [email protected]