Physical symptoms

Morten Birket-Smith, psykiater

Depression can lead to a number of physical symptoms. If you are depressed, it is quite common for instance for you to have a reduced appetite. You don't feel any pleasure in eating and the food doesn't seem tasty. If you do eat, it is more out of a sense of obligation. You are eating too little and may lose a significant amount of weight, which again can cause you to be even more tired so much so that you don't feel like eating anything. And so the vicious cycle continues.

It may also be that your appetite increases, if you are suffering from atypical depression. Perhaps you feel better when eating, and in such a case your weight may increase. You should therefore be aware that appetite and weight changes without any explanation can be symptoms of depression.

Pain

If you have chronic pain, for example due to rheumatism or a bad back, your pain will intensify when you are depressed. Even if you don't already have chronic pain, depression can cause different pain symptoms such as

• sore muscles and joints
• stomach-ache or other stomach problems
• headache

It is often the pain which makes you go to your doctor. It is therefore important that the doctor keeps depression in mind if you get or have pain which has got worse without any clear physical reason. However, pain and other chronic symptoms can also increase your chances of developing depression.

Tension

Depression makes it difficult for you to relax both physically and mentally. Your thoughts spin around in circles without you being able to make decisions. Your muscles are tense and maybe even sore, and even though you are tired, you are unable to relax and find rest. This tension increases your feeling of being unwell and hence increases your depression.

Tiredness and lack of energy

Most depressed people are tired and complain about a reduced level of energy. Tiredness and lack of energy can be so dominant that you are unable to get up, have a bath or do anything. The tiredness isolates you, as you can't pick up the telephone, have visitors or relate to other people, not even to those closest to you.