Social withdrawal
As a result of their feelings of sadness, worthlessness, and lack of interest, patients tend to withdraw from social groups and undergo a progressive impairment in the relationship with their peers and their family members. In their family, they often feel more quiet than normal, and their comments are often negative and may even be a bit rude. As the problem progresses, patients would also refuse to talk and may become brusque and aggressive against those family members who are trying to figure out what’s going on and help.
In their peer relationships, patients reduce their social contact with everybody around them and just go with the minimum they need to keep on being functional. They would do less and less extracurricular activities and withdraw from friends and social activities. As the problem progresses, they become isolated, discontinue extracurricular activities, and spend excessive time alone and behind a screen.