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Depression: Recognizing the Physical Signs

Medically Reviewed by Jennifer Casarella, MD on October 23, 2020

Most of us know about the emotional symptoms of depression. But many people with depression live with chronic pain or other physical symptoms, too.

These aren't "all in your head." Depression can cause real changes in your body. For instance, it can slow your digestion, which can cause stomach problems.

Because these symptoms happen with many conditions, people with depression may never get help for them. They don't realize that their physical problems might be caused by their mental illness. A lot of doctors miss them, too.

Physical Symptoms

Depression seems to be related to improper functioning of nerve cell networks or pathways that connect the brain areas that process emotional information. Some of these networks also process information for sensing physical pain. So many experts think that depression can make you feel pain differently than other people.

Any kind of chronic pain may get worse.

  • Headaches are fairly common. If you already had migraine headaches, they may seem worse.
  • Back pain
  • Muscle aches and joint pain
  • Chest pain. It can be a sign of serious heart, stomach, lung or other problems. But depression can add to the discomfort.
  • Digestive problems. You might feel queasy or nauseated. You might have diarrhea or become constipated all the time. It’s common to either lose your appetite or overeat.
  • Exhaustion and fatigue. No matter how much you sleep, you may still feel tired or worn out. Getting out of the bed in the morning may seem very hard, even impossible.
  • Sleeping problems. Many people with depression can't sleep well anymore. They wake up too early or can't fall asleep when they go to bed. Others sleep much more than normal.
  • Change in appetite or weight. Some people with depression lose their appetite and lose weight. Others find they crave certain foods, like carbohydrates, and weigh more.
  • Dizziness or lightheadedness

Treatment

Tell your doctor about any physical symptoms: Don't assume that they'll go away on their own. Try keeping a symptom diary, which can help you identify patterns.

Sometimes, treating your depression -- with therapy, medicine, or both -- will clear up your physical symptoms. Medicines for depression "tweak" the chemicals your nerve cell networks use to communicate, making them work more efficiently. Some antidepressants, such as duloxetine (Cymbalta), venlafaxine (Effexor), and older tricyclic antidepressants like amitriptyline (Elavil) or desipramine (Norpramin), may help with chronic pain, too.

But you may also need something else. For example, your doctor may suggest an anti-anxiety or sleep aid medicine for insomnia so you can relax and sleep better.

Since pain and depression can sometimes go together, easing your pain may lift your depression, as well. You could try cognitive behavioral therapy. It can teach you ways to deal better with pain.

WebMD Medical Reference

Sources

SOURCES:

Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision.

American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Major Depression."

Fochtmann, L. and Gelenberg, A. Guideline Watch: Practice Guideline for the Treatment of Patients With Major Depressive Disorder, 2nd Edition.

Focus, Winter 2005.

Medscape: Manning, J. The Brain-Body Connection and the Relationship Between Depression and Pain.

Depression and Bipolar Support Alliance: "Finding Peace of Mind: Treatment Strategies for Depression and Bipolar Disorder."

National Mental Health Association: "Depression: What You Need to Know."

David Baron, DO, chairman of psychiatry, Temple University School of Medicine.

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