What Are the Physical Symptoms of Depression?

Ask a Doctor

My father hasn’t been the same since my mother died two years ago. I’m also struggling with her loss, and I know grief is normal. It seems like there’s something else going on with my dad, though. He says he’s fine, but he has constant aches and pains he never had before, doesn’t sleep well, and he’s gained a lot of weight. Could these be physical signs of depression?

Doctor's Response

I don't know how old your dad is, but symptoms of depression tend to be more physical in elderly individuals compared to younger individuals, this puts these individuals at risk for having their depressive symptoms erroneously attributed to medical problems.

Clinical depression is not something you feel for a day or two before feeling better. In true depressive illnesses, the symptoms last weeks, months, or sometimes years if you don't seek treatment. If you are depressed, you are often unable to perform daily activities. You may not care enough to get out of bed or get dressed, much less work, do errands, or socialize.

  • Adults: You may be said to be suffering from a major depressive episode if you have a depressed mood for at least two weeks and have at least five of the following clinical symptoms:
    • Feeling sad or blue
    • Crying spells
    • Loss of interest or pleasure in usual activities
    • Significant increase or decrease in appetite
    • Significant weight loss or weight gain
    • Change in sleep pattern: inability to sleep or excessive sleeping
    • Agitation or irritability
    • Fatigue or loss of energy
    • A tendency to isolate from friends and family
    • Trouble concentrating
    • Feelings of worthlessness or excessive guilt
    • Thoughts of death or suicide

Men and women sometimes show depression differently. Specifically, men are more likely to experience irritability, sleep problems, fatigue, and loss of interest in activities they liked previously as a result of depression whereas women tend to have overt sadness and feelings of worthlessness and guilt when depressed. For people who tend to suffer from an increase in appetite, tiredness, and the tendency to sleep (atypical depression), carbohydrate craving, sometimes specifically for chocolate, may occur. That has been found to sometimes be an indication that the person tends to suffer from irritability and anxiety in addition to depression.

  • Children with depression may also experience the classic symptoms but may exhibit other symptoms as well, including the following:
    • Poor school performance
    • Persistent boredom
    • Frequent complaints of physical symptoms, such as headaches and stomachaches
    • Some of the classic adult symptoms of depression may also be more obvious in children, such as changes in eating or sleeping patterns (Has the child lost or gained weight in recent weeks or months? Does he or she seem more tired than usual?)
    • Symptoms and signs of depression in teens may include more risk-taking behaviors and/or showing less concern for their own safety. Examples of risk-taking behaviors include driving recklessly/at excessive speed, becoming intoxicated with alcohol or other drugs, especially in situations in which they are driving or may be in the presence of others who engage in risky behaviors, and engaging in promiscuous or unprotected sex.
  • Parents of children with depression report noticing the following behavior changes. If you notice any of these, discuss this with your health-care provider.
    • The child cries more often or more easily.
    • The child's eating habits, sleeping habits, or weight change significantly.
    • The child has unexplained physical complaints (for example, headaches or abdominal pain).
    • The child spends more time alone, away from friends and family.
    • The child actually becomes more "clingy" and may become more dependent on certain relationships. This is less common than social withdrawal though.
    •  The child seems to be overly pessimistic or exhibits excessive guilt or feelings of worthlessness.
    • The child expresses thoughts about hurting him or herself or exhibits reckless or other harmful behavior.
  • Elderly: While any of the classic symptoms and signs of depression may occur in elderly men and women, other symptoms also may be noted:
    • Diminished ability to think or concentrate
    • Unexplained physical complaints (for example, abdominal pain, changes in bowel habits, or muscle aches)
    • Memory impairment (occurs in about 10% of those with severe depression)

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References
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