Depression and its physical symptoms

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Depression is a mood disorder that affects how someone thinks, feels, and behaves. It may cause them to feel sad, worthless, or numb for prolonged periods. Typically, people experience a loss of interest or pleasure in the things they usually enjoy.

The emotional symptoms are well-known, but depression is also associated with a range of physical symptoms. These include:

• tiredness or fatigue
• sleeping more or less than usual
• an increase or decrease in appetite
• slow speech or movements
• unexplained pain or headaches
• loss of interest in sex, known as a low libido
• constipation or diarrhea

Tiredness or feelings of apathy may also affect a person’s behavior. The person may spend less time than usual on self-care, potentially resulting in changes to their appearance. For instance, they may lose or gain weight or not shower or bathe as often as they previously did.

However, not everyone with depression will have obvious physical signs of the condition. Some affected individuals will carry on with their daily activities without appearing to be unwell.

Research suggests that the physical symptoms of depression likely result from multiple physiological changes that take place in the body.

Appetite changes

A 2019 study on the relationship between major depressive disorder (MDD) and eating behaviors found that disordered eating was more common among those with MDD than those without the condition. In females, the researchers also observed high levels of the hormone leptin, which reduces a person’s appetite.

The authors speculate that changes in appetite-regulating hormones may explain why depression can cause changes in appetite.

Sleep changes

A 2015 review suggests that changes in neurotransmitters and brain function may contribute to disturbances in rapid eye movement (REM) sleep in people with depression.

For example, a study involving people with MDD found that during REM sleep, the limbic and paralimbic systems of the brain exhibited activity similar to that of a person who is awake.

This finding may explain why people with depression often wake frequently during the night. However, sleep is complex, and researchers are still trying to understand the ways in which sleep and depression may affect each other.

Fatigue

A 2018 review notes that a lack of energy and fatigue may be related to certain neurotransmitter systems not functioning as they should. The affected neurotransmitters might include norepinephrine or dopamine, but more research is necessary to understand the mechanisms behind this dysfunction.

Some emotional states and physical health conditions can cause feelings similar to those that people with depression can experience. These include:

Sadness or grief

It is normal to experience sadness or grief in response to difficult situations. Sometimes, these emotional states can also cause physical symptoms, such as feeling tired.

However, sadness and grief are different than depression. Typically, grief does not affect a person’s self-esteem. It may cause emotions that come in waves and involve a mix of positive and negative feelings.

In contrast, depression often causes feelings of insignificance or self-hatred. The emotional changes tend to be consistent, affecting someone most of the time.

Seasonal affective disorder (SAD)

SAD, or major depression with seasonal pattern, is a condition that causes depressive symptoms during fall and winter. People with SAD often feel tired, sleep more, and experience appetite changes. Usually, a person with this condition feels they want to eat more food, particularly carbohydrates.

Experts believe that lower levels of sunlight cause SAD by triggering a chemical imbalance in the brain.

Hormonal changes

Some conditions that affect female hormones can cause a low mood. In some cases, the mood changes can be severe.

For example, people with premenstrual dysphoric disorder (PMDD) can experience depression, irritability, and physical symptoms for 7–10 days before a period. The symptoms typically get better shortly after the period begins.

Premenstrual syndrome and menopause can also come with emotional and physical changes that may resemble depression.

Other conditions or medications

Several other conditions and medications can cause a low mood, along with physical symptoms that could seem similar to those of depression. Some examples include:

• certain vitamin or mineral deficiencies, such as vitamin B12 deficiency
• certain medications, including hormonal birth control, beta-blockers, and corticosteroids
• some neurological conditions, such as Parkinson’s disease

The treatment for depression usually involves a combination of talk therapy and medications. Medications, such as antidepressants, can reduce the symptoms of depression. Talk therapy aims to address the underlying causes and help someone manage their thoughts and feelings.

There are many styles of therapy. People are likely to find that they benefit more from some styles than others. One of the most well-researched options is cognitive behavioral therapy (CBT), which aims to help someone understand the relationships between their thoughts, emotions, and behaviors.

For forms of depression that have a specific physiological cause, such as seasonal or hormonal changes, the treatment may involve additional steps. For example, a person with SAD may benefit from light therapy and safe exposure to sunlight.

The physical symptoms of depression can be challenging. They may cause someone to feel overwhelmed by day-to-day tasks, especially if they are experiencing fatigue, loss of motivation, or pain. Strategies that may help a person cope include:

• Setting priorities: When someone has limited energy, it can help to focus only on the essential tasks. These may include personal hygiene practices, meal preparation, and pet care. A person might find it helpful to write down the most important tasks for each day and put the list on a noticeboard or the refrigerator as a reminder.
• Breaking tasks down: People can make large jobs feel more manageable by breaking them down into smaller steps and focusing on doing one step at a time. For example, instead of trying to clean their home in one go, they can focus on cleaning one small area.
• Setting a timer: If finishing a task is challenging, a person can try setting a timer and focusing on that task for a set amount of time, even if it is just a few minutes.
• Cooking in batches: Preparing multiple servings of a meal allows people to chill or freeze additional portions for later. This can help when a person does not have much energy or motivation to cook. Simple one-pot or slow-cooked meals are useful, as they involve less effort and fewer dishes to clean.
• Reducing cleaning: A few simple changes, such as placing a doormat at the front door or taking shoes off before walking inside the home, can reduce how much cleaning is necessary.
• Enlisting help: Social support is an important part of recovering from depression, both emotionally and physically. A person may be able to reach out to understanding friends, family, or neighbors for extra help.

Depression can make things feel hopeless, but help is available. It is advisable to speak with a doctor or mental health professional if any symptoms are causing concern or difficulty with day-to-day tasks. These professionals will be able to make a diagnosis and talk someone through the treatment options.

There is no need to wait until symptoms become severe before seeking support. However, anyone who is having thoughts about suicide should seek help as soon as possible.

Depression’s physical symptoms can include fatigue, sleep changes, appetite changes, and pain. Research suggests that these changes often occur due to hormone and neurotransmitter levels, which are different in people with depression than in people without the condition.

The physical effects of depression can make it harder to manage tasks, but treatment and other strategies can help a person cope.