A continuous low mood is just one possible symptom of depression.
Left untreated, symptoms of clinical or major depression may get worse and last longer.
Recognising the symptoms of depression is often the biggest hurdle in seeking medical advice and to the diagnosis and treatment of depression.
What are symptoms of depression?
Symptoms of depression may include the following:
- Difficulty concentrating, remembering details, and making decisions
- Fatigue and decreased energy
- Feelings of guilt, worthlessness, and/or helplessness
- Feelings of hopelessness and/or pessimism
- Insomnia, early-morning wakefulness, or excessive sleeping
- Irritability, restlessness
- Loss of interest in activities or hobbies once pleasurable, including sex
- Overeating or appetite loss
- Persistent aches or pains, headaches, cramps, or digestive problems that do not get better even with treatment
- Persistent sad, anxious, or “empty” feelings
- Thoughts of suicide, suicide attempts
Depression: Recognising the physical symptoms
Most of us know about the emotional symptoms of depression. But you may not know that depression can cause physical symptoms, too.
In fact, many people with depression feel pain or other physical symptoms. These include:
- Headaches. These are fairly common in people with depression. If you already had migraine headaches, they may become worse if you’re depressed.
- Back pain. If you already suffer with back pain, it may get worse if you become depressed.
- Muscle aches and joint pain. Depression can make any kind of chronic pain worse.
- Chest pain. Obviously, it’s very important to get chest pain checked out by an expert right away. It can be a sign of serious heart problems. But chest pain is also associated with depression.
- Digestive problems. You might feel queasy or nauseous. You might have diarrhoea or become chronically constipated.
- 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 put on weight.
- Dizziness or lightheadedness.
Many depressed people never get help, because they don’t know that their physical symptoms might be caused by depression. Sometimes doctors miss the symptoms too.
These physical symptoms aren’t “all in your head”. Depression can cause real changes in your body. For instance, it can slow down your digestion, which can result in stomach problems.
Depression seems to be related to an imbalance of certain chemicals in your brain. Some of these same chemicals play an important role in how you feel pain. So many experts think that depression can make you feel pain differently than other people.
Treating physical symptoms of depression
In some cases, treating your depression – with therapy or medicine or both – will resolve your physical symptoms.
But make sure you tell your health care provider about any physical symptoms. Don’t assume they will go away on their own. They may need additional treatment.
Since pain and depression go together, sometimes easing your pain may help with your depression. Some antidepressants may help with chronic pain, too.
Other treatments can also help with painful symptoms. Certain types of focused therapy – like cognitive behavioural therapy (CBT) – can teach you ways to cope better with the pain.
Are there warning signs of suicide with depression?
Depression carries a high risk of suicide. For people with severe depression, the lifetime risk of suicide may be as high as 6%. Anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call the Samaritans on 08457 90 90 90. The Samaritans operate a 24-hour service 365 days a year, for anyone in distress.
Warning signs of suicide with depression include:
- A sudden switch from being very sad to being very calm or appearing to be happy
- Always talking or thinking about death
- Clinical depression (deep sadness, loss of interest, trouble sleeping and eating) that gets worse
- Having a “death wish,” tempting fate by taking risks that could lead to death, like driving through red lights
- Losing interest in things one used to care about
- Making comments about being hopeless, helpless, or worthless
- Putting affairs in order, tying up loose ends, changing a will
- Saying things like “It would be better if I wasn’t here” or “I’ve had enough”
- Talking about suicide (killing one’s self)
- Visiting or calling people one cares about
Remember, if you or someone you know is demonstrating any of the above warning signs of suicide with depression, call the Samaritans, contact a mental health professional or your doctor straight away, dial 999 or go to the nearest hospital A&E for immediate treatment.
What are the symptoms of depression in teenagers?
It is common for teenagers to feel unhappy occasionally. However, when the unhappiness lasts for more than two weeks and the teenager experiences other symptoms of depression, then they may be suffering from adolescent depression.
According to the latest figures from the Office for National Statistics, 4% of children aged 5 to 16 suffer from an emotional disorder such as anxiety or depression. If you believe your teenager is suffering from depression, you should seek help from a qualified health care professional.
How is depression diagnosed?
The diagnosis of depression begins with a consultation with a doctor. Because certain viruses, medicines, and illnesses can also cause symptoms similar to those of depression, your GP will want to know when your symptoms started, how long they have lasted, and how severe they are. They will ask whether you have had similar symptoms of depression before and about past treatments you may have received.
Your family history of depression and other mental illnesses is very important, as is any history of drug or alcohol use. Although there is no “depression test” that your GP can use to diagnose symptoms of depression, there are certain features, which they will look for in order to make the correct diagnosis of depression.
How are symptoms of depression treated?
If a physical cause for the symptoms of depression is ruled out, your GP may refer you to a psychologist for psychological evaluation and treatment and may recommend antidepressant therapy. Treatment of depression may include antidepressants, psychotherapy or a combination of both.
Is electroconvulsive therapy (ECT) used to treat symptoms of depression?
Electroconvulsive therapy or ECT is a viable treatment option for patients with symptoms of depression who are unable to take antidepressants or who suffer from extreme depression.
When should I seek help for symptoms of depression?
If symptoms of depression are negatively affecting your life – such as causing difficulties with relationships or work issues or causing family disputes – and there isn’t a clear solution to these problems, then you should seek help. Talking with a mental health professional or your GP can help prevent things from getting worse, especially if these symptoms of depression persist for any length of time.
If you or someone you know is having suicidal thoughts or feelings, you should seek help immediately.
In addition, it’s important to understand that feeling depressed does not always mean you have a depressive illness. However, if you feel you can’t lift yourself out of your symptoms of depression, seek medical help.
by Dr Rob Hicks