More than 16 million Americans over age 18 are clinically depressed. That’s a huge chunk of people who are suffering — and those are only the ones who have been diagnosed. Many people don’t report feeling depressed, and some don’t realize their physical symptoms — such as upset stomach, headache and sleep problems — are actually depression. Men in particular are more likely to report physical symptoms of depression than cognitive effects.
“When doctors rule out all of the possible causes of fatigue, body pain or intestinal problems, it may be time to take a closer look at the mind,” says Amy Williams, Ph.D., a clinical psychologist at Henry Ford Health. “Even if there’s not something physically wrong, your body can show signs of depression in a physical way because your mind and body are connected.”
While the physical symptoms of depression are often vague and easy to miss, these four warning signs many help you spot trouble in yourself or a loved one before depression escalates.
- Sleep problems. One of the classic signs of depression is sleep disturbance. “You might wake up in the middle of the night and can’t get back to sleep or you sleep 10 to 12 hours each night and still want an afternoon nap,” Dr. Williams says. In either case, you tend to feel slowed down and listless, and everything requires Herculean effort. Some sleep changes are a normal part of aging. For example, you wake earlier and tend to sleep in 4-hour increments as opposed to one 8-hour bout. But depression-related sleep disturbance tends to create more pronounced effects. Insomnia, or difficulties getting to sleep, staying asleep, or getting restful sleep, is common. As is the feeling of always wanting to sleep and sleeping more than 10 hours each day and still not feeling rested. The kicker: Without sufficient shuteye, your body doesn’t have time to repair, weakening your immune system and making you more vulnerable to physical disease. Additionally, while depression causes sleep problems, the same sleep problems can lead to or worsen depression.
- Appetite changes. Like sleep, changes in appetite can go one of two ways: Either you’re not interested in food, or you’re hungry around the clock. And as with sleep, appetite changes with age, so it can be difficult to suss out which eating habits are the result of the blues and which are a product of reaching your golden years. Depression can also cause tummy troubles that mimic conditions like irritable bowel syndrome (IBS), Crohn’s disease and even constipation.
- Headaches, muscle aches and fatigue. Depression affects a variety of brain chemicals associated with both physical health and happiness. When your body is low in these “feel-good chemicals,” you may experience physical effects ranging from headaches to joint and muscle pain. Patients sometimes describe the fatigue like walking through molasses or waist-high mud.
- Weakened immunity. “People who are depressed have more inflammatory signals in their body, so they’re more likely to get sick as a result of the depression due to this inflammatory response,” Dr. Williams says. Depression also increases stress hormones in the body, which affects everything from blood pressure to metabolism. What’s worse, when you’re depressed you’re less likely to stay on top of your medications, monitor what you eat and exercise, all of which are critical to attaining emotional and physical well-being.
While the physical signs of depression are well documented, people still have to report some emotional or mental effects (such as brain fog or sadness) to be diagnosed with depression. If your doctor has explored all possible medical causes for your physical symptoms, whether aches and pains or IBS, ask for a referral to a mental health specialist. Help may be easier to attain than you think.