The Physical Effects of Depression

Physical Effects of Depression

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The most well-known symptoms of depression are emotional, including sadness, guilt, irritability, and feelings of hopelessness. Other frequent symptoms, like trouble focusing or concentrating on tasks, are also thought of as being related to one’s state of mind. 

Although depression is a mental illness, it can also cause physical symptoms. Pain, stomach upset, fatigue, and restlessness are just a few potential physical effects of depression. People can have these physical symptoms for a variety of reasons, but they may not realize depression can be among the potential causes. 

Certain treatments used for depression, such as medication, can also have physical side effects like nausea, weight changes, and sexual dysfunction. If you have physical symptoms of depression, your doctor and mental health care provider can help you better understand and manage them. 

Pain

People with depression may have vague aches and pains that affect their joints, limbs, or back. Some people have “all over” body pain which may be chronic and debilitating.

A person with chronic pain certainly may become depressed, but it may also be that physical and emotional pain can stem from the same cause. Researchers are still trying to understand how physical pain and depression are related, as well as how they can influence one another.

One theory is that both can be caused by a dysregulation of neurotransmitters such as serotonin. Some people with depression and pain may feel better if they take an antidepressant that influences the reuptake of serotonin and norepinephrine in the brain.

Another theory is that people with depression may feel pain differently. A 2015 study of pain processing found that people diagnosed with major depression had a lower pain threshold and tolerance compared to people who were not depressed.

A 2017 study found that one of the most common forms of pain in adults, lower back pain, could be directly linked to depression. An earlier study found that people with depression are 60% more likely to have back pain compared to people who aren’t depressed.

Researchers are continuing to explore a connection between depression and pain, including theories related to chronic inflammation, which may also contribute to other physical symptoms of depression. 

Gastrointestinal Symptoms

People with depression may have frequent stomach problems, such as nausea, bloating, diarrhea, or constipation. 

One possible explanation for these symptoms involves a neurotransmitter in the brain and gut called serotonin. The brain chemical is linked to depression because it is believed to help regulate mood, but researchers also know that it also plays a role in maintaining digestive function. 

Most of the body's serotonin is produced and stored in the gut.

Researchers are very interested in the "gut-brain” connection, which they hope could reveal how mental and digestive health influence one another. In addition to serotonin, microbes found in the gut are being explored as potential contributors to everything from mood to immunity—both of which have implications for depression. 

Immunity

Stress can also make a person’s immune system work less optimally, meaning they're more likely to get sick. When someone with a weakened immune system does get sick, it may take longer for them to get better.

Some infections, like the common cold, are generally not serious. However, a weak immune system puts a person at risk for developing complications from an infection or contracting an infection that is harder to treat. 

The relationship between immune function and depression is still being researched. Some studies have hypothesized that chronic stress may cause an inflammatory response that can change how mood-regulating chemicals in the brain work. 

Sleep Problems

When doctors and mental health professionals are considering a diagnosis of depression, sleep disorders are among the “core” symptoms they look for. 

People who are depressed often have trouble sleeping. Problems may range from struggling to fall or stay asleep, being unable to get restful sleep, or sleeping too much.

The relationship between depression and sleep goes both ways, as having trouble sleeping for any reason (such as a medical condition like sleep apnea) increases a person’s risk for depression. 

Some research has suggested that disturbances in circadian rhythm (which can interrupt sleep) may contribute to depression. Understanding and even learning how to alter the sleep-wake cycle is one avenue researchers are exploring as they search for new ways to treat depression. 

Fatigue

People who are depressed often feel that no matter how much they sleep, they never feel rested. They may have a hard time getting out of bed in the morning or struggle to perform activities of daily living, such as bathing or doing household chores. 

Although having low energy can certainly be related to poor sleep, research has indicated that the relationship between depression and fatigue is more complex. 

Fatigue is not only one of the most common physical effects of depression but tends to be one of the more challenging to treat. One study from 2010 found that even after starting an antidepressant, fatigue persisted in around 80% of people with major depression.

Depression and fatigue may become part of a cycle where ongoing low energy and decreased motivation worsen depression. Therefore, adequately addressing fatigue is a crucial part of creating an effective treatment plan for someone diagnosed with depression. 

Psychomotor Symptoms

The term “psychomotor” refers to symptoms that make a person feel as though they are thinking and/or moving at a different pace than usual. 

For example, some people with depression perceive their thoughts as sluggish and feel like their movements seem heavy. Others experience symptoms at the opposite end of the spectrum. They may say that they "can’t sit still," or feel fidgety, restless, and agitated. Mentally, they may experience anxious or even intrusive thoughts.

To some extent, psychomotor symptoms become more common as someone gets older. However, while depression in the elderly is also common, it is not a normal part of aging. For this reason, doctors and mental health professionals need to also consider the possibility that psychomotor changes may be a sign of depression rather than just a part of aging.

High Blood Pressure

People who are depressed may be under stress often or for a long period of time. While it’s not the only cause, chronic stress has been known to contribute to high blood pressure (hypertension).

Chronic stress, in particular, has been linked to elevated blood pressure. In turn, hypertension increases a person’s risk of cardiovascular disease, which includes heart attacks and strokes. Based on the growing body of evidence supporting this relationship, many researchers consider depression a risk factor for cardiovascular disease. 

Appetite and Weight Changes

Depression in and of itself can make someone feel like eating more or less than they typically do. People who are depressed may report they have lost weight without trying or have gained weight without being sure of the reason why. 

One factor that may contribute to weight gain is “emotional eating” which refers to a person using food to self-medicate feelings of depression. These behaviors can lead to weight gain over time. If someone is overweight or obese, changes in self-image, associated health problems, and weight stigma can also contribute to (or worsen) depression. 

The relationship between weight and depression may depend on more than how much someone weighs or their body mass index (BMI). 

For example, a 2019 study proposed a specific link between higher amounts of body fat mass and depression (as the researchers did not find a link between depression and non-fat body mass).

Depression can also cause someone to lose weight. Loss of appetite, low energy, and motivation that makes preparing meals difficult, bowel symptoms, and other factors may cause weight loss in someone who is depressed. People who have eating disorders, such as anorexia nervosa, often also have depression or another mental illness.

Weight loss in eating disorders can be extreme and may cause a host of physical symptoms. Several studies have suggested that malnutrition from inadequate food intake may worsen depression, though additional research is needed to support the theory.

People who do not get enough eat for other reasons, such as those living in poverty, patients with cancer, and the elderly, are also at risk for depression related to malnutrition. Changes in appetite and accompanying weight loss or gain can also be a side effect of antidepressant medications. 

Medication Side Effects

Both prescription and over-the-counter (OTC) medications can come with side effects. While they are usually mild and get better as the body adjusts to the drug, others may be severe and persistent. Medications used to treat depression may have side effects, many of which are physical.

A few examples of common side effects of antidepressants include:

  • Appetite changes, weight gain/loss
  • Blurred vision
  • Difficulty focusing or concentrating
  • Dizziness
  • Dry mouth
  • Fatigue
  • Insomnia
  • Nausea
  • Sexual dysfunction (trouble maintaining an erection, pain with intercourse, inability to orgasm)

If medication side effects are too difficult to cope with, a person is less likely to continue taking it. For someone who takes medication to manage depression, side effects from antidepressants can be a barrier to treatment.

The mental and emotional side effects of antidepressants can be serious and may indicate a medication is not the right treatment for you. If you experience worsening feelings of anxiety and depression and/or thoughts of suicide after starting an antidepressant, seek immediate medical care.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Coping

When you go to your doctor with a physical complaint, they may not initially ask you about emotional symptoms. However, they won’t be able to accurately diagnose depression without it.

Before you can begin to deal with the physical effects of depression, you need an accurate diagnosis. If you have depression symptoms such as persistent sadness, and low mood or loss of interest in doing things that you used to enjoy, make sure you mention these feelings to your doctor. 

Your doctor also needs this information to help them decide on the most effective way to treat depression, so it’s important you let them know about the emotional, mental, and physical symptoms you are having. 

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