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Depression is often thought of as an emotional condition — a disorder of feelings or other symptoms that trouble the mind and (metaphorical) heart. And because people see depression as a mental condition alone, it’s often surprising when they hear that physical symptoms of depression exist.
If you’ve struggled with depression before, you likely know that depression can cause problems from your head down to your toes, but even the depressive disorder veteran may be shocked to hear some of the things that can be associated with depression. And it may leave you asking the same question as the newbies and doctors alike: Why?
The “why” question is important, whether you’re currently experiencing depressive episodes or learning about your partner’s depression for the first time. Asking “why” is how we learn how to help, whether we’re helping ourselves or others.
And we’re here to answer your questions. So let’s start with the most important ones — how and why.
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When it comes to physical depression symptoms, it’s more than just mopey, sleepless nights and drooping shoulders — you can see signs of depression in areas of your life where you might not think a depressed mood would matter.
Symptoms of depression can affect you in the bedroom, the bathroom and even the kitchen. They can hit you in the office or the gym, or anywhere else.
One of the reasons scientists believe that major depression, also called clinical depression, and other forms of depression can cause physical symptoms is that depression shares common neuro-chemical pathways with another unpleasant sensation we dread — physical pain.
Both serotonin and norepinephrine are neurotransmitters that can create powerful chemical reactions in our brain, and it turns out that these neurotransmitters influence the way we experience both depression and pain.
It may be no surprise to you to hear that pain and depression share the same language or currency, but experts believe that the two conditions can even be related (or comorbid, in expert language).
But pain signals aren’t the only things affected by depression. For proof, look no further than irritable bowel syndrome (IBS).
A 2017 study looked at the overlap between IBS and a group of so-called psychiatric comorbidities (psychological diseases and disorders that appeared when IBS appeared). They found a “high prevalence” of conditions like depression and anxiety in patients with IBS.
That’s just one study, though. For a deeper picture, let’s look at the physical symptoms of depression in more detail.
Depression has many physical symptoms, which can potentially affect every part of your body, head to toe and inside and out.
These physical health symptoms of different types of depression can affect your daily life, prevent you from enjoying social activities, mess with your family life and even lead to other mental health conditions.
Can depression make you feel sick? To simplify things, we’ve collected the physical symptoms of depression into groups: pain, gastrointestinal issues, fatigue and sleep problems and weight/appetite changes.
As we mentioned, depression and chronic pain are highly related chemical experiences in your brain. That’s perhaps the best explanation for why body pains like headaches, backaches, joint aches and muscle aches can all increase as a result of depression.
A 2017 study, however, went further — it suggested that not only are pain and depression linked, but that one can aggravate the severity of the other through neuroplasticity, which is your brain’s ability to change its neural networks based on stimuli.
The science on this is still developing (and there are unclear answers about which issues come first or why), but it’s reasonable to infer that aches and pains can get worse with depression, or could possibly be created entirely by it.
We already mentioned the study that found IBS was comorbid with depression. In fact, the authors of that study found that more than two-thirds of the population with IBS had depression as well.
Lastly, they found that the intensity of anxiety was higher in patients with IBS than in controls. While that doesn’t speak to depression numbers, it does apply some context about the frequency at which this physical symptom appears in mental health conditions.
Fatigue and sleep issues are common symptoms of depression, and they can occur in a variety of ways. A person with depression might have insomnia, difficulty staying asleep or struggle to wake up early in the morning. They might also oversleep regularly.
Fatigue can sometimes be a result of poor sleep, but it might also be a symptom of depression itself, which can leave you with a lack of energy levels. And if you’re experiencing the other symptoms of pain and discomfort we’ve already covered, that can snowball into more fatigue.
In the big picture, however, fatigue can also be a mental problem. After all, depression causes emotional symptoms like decreased interest in doing things, a “slowed-down” feeling and general feelings of worthlessness and helplessness. Both energy levels and sleep can be affected by that.
We debated including weight and appetite in gastrointestinal issues, and we also debated whether to include it as part of the fatigue category.
After all, our metabolism and connected bodily functions can greatly affect gastrointestinal system function and our energy levels. But ultimately, weight deserves its own space.
Sudden or gradual changes in weight, diet, appetite and other metabolism-centric traits can often be telltale signs of depression, especially if they present alongside other symptoms.
A 2020 review confirmed not only that depression can cause weight gain, but that conditions like obesity can be a risk factor for depression to deepen which, as you might guess, can result in more weight gain.
So what do you do if you have physical symptoms — do you treat the symptoms, or do you treat the source?
Well, from what research has shown us, the answer is actually both.
A 2004 paper that explored the links between depression and its physical symptoms concluded that treating either the physical symptoms or the depression itself was insufficient.
It turns out that, without treating both conditions, you might enter an incomplete remission — if any remission at all. The idea of depression treatment is to get it done completely, not half-assed, and leaving part of your overall depressive illness untreated can lead to a very poor prognosis.
That means that if you’re going to treat depression, you can’t just leave your aches, pains and uncomfortable gastrointestinal issues to bootstrap themselves out of existence.
A healthcare professional can help you find the right treatments for stomach and digestive issues, muscle pains and other physical symptoms of depression that fit your individual circumstances. That may mean pain medication, dietary changes or other methods of lessening your symptoms.
But ultimately, your depression isn’t going away unless you address the mood disorder itself.
There are several ways to do this:
Medications like antidepressants can help people improve their mood by adjusting certain brain chemicals (called neurotransmitters) that can affect mood and stress levels. Selective serotonin reuptake inhibitors (SSRIs) are a common first-line medication, and these drugs help people with depression to balance their serotonin levels.
It’s also important to note that if your depression comes along with physical pain, your doctor might recommend a type of antidepressant called serotonin-norepinephrine reuptake inhibitors (SNRIs) as your first-line depression medication treatment.
Therapy can help people reorder their thoughts and change the patterns of thinking that keep them in depressive episodes. Forms of therapy like cognitive behavioral therapy teach strategies for identifying and rejecting depressive thoughts and learning to change what’s going on in your head over time.
Finally, lifestyle changes can have a surprising impact on your mental health — and maybe even reduce some of those physical symptoms. Regular physical activity, better eating habits and reductions in tobacco, alcohol and drug use can all help lessen the symptoms of depression. And prioritizing your sleep can both reduce insomnia and better protect your mind from the stressors that can cause depression in some cases.
If you’re feeling depressed, you need to seek treatment. If you’re feeling ailments that we’ve mentioned here in addition to your depression, they may indeed be symptoms of a mental health condition.
They might, however, also be symptoms of other medical conditions besides severe depression. Serious health conditions share some of these physical signs of depression we’ve mentioned, and while we’re not trying to worry you, we do believe that ruling out serious physical illness is the smart thing to do.
So the next thing to do is talk to a healthcare professional about your depressive symptoms and have them give you a professional mental health evaluation for depression.
If you’re diagnosed with depression — or even just feeling some of the symptoms — consider trying therapy with a mental health professional. Our online therapy platform is a great place to start).
No matter what method you choose, it’s important to get help sooner than later — the longer you wait, the more likely it is that your symptoms will become worse and reduce your quality of life.
Depression can ravage your body, but it doesn’t have to be in control. Make treatment of depression a priority, and take that control back today.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.