Depression: How to Recognise It From Physical Signs and Symptoms

It is hard to talk about depression. So some individuals will not complain of depression but may convert the mental depression into physical symptoms which are more acceptable to society because of the stigma attached to psychiatric disorders. When this happen a conversation reaction is said to have taken place. This phenomenon is not a conscious process as the patient is not aware that it is happening

Depressed patients often display a phenomenon called somatisation. Somatisation is defined as chronic disorder in which the patient complains of numerous physical pains and discomforts. These complaints may last for a long time before the patient seeks help. It could result in substantial impairment of the patient. The physical symptoms are caused by psychological difficulties and usually no underlying physical problem can be identified.

Conversation Reaction: The phenomenon of somatisation is sometimes described as a psychopathological condition during which the patient complains of the presence of bodily symptoms which do not have any discernible physical cause. There is usually some evidence of a psychological conflict in the patient. Some authors call this a conversion disorder.

Many of the signs and symptoms of depression are felt by patients. However theymay never complain of any of those signs but may complain of physical symptoms. The following symptoms are common amongst many depressed people. As a rule professionals looking after such patients need to take detailed case histories and do thorough mental assessments of the patients before coming to any conclusion(s) about the final diagnosis of depression. The following is a list of common physical signs and symptoms encountered by depressed persons.

1. Depressed patients feel tired all the time. Once upon a time I had superior who used to sleep in the office. I did not know what was wrong. It was not long after that she resigned her position. She was feeling all tired all the time. She was obviously very smart but ? ________ – she sought professional help.
2. Some depressed people may not present with any signs and symptoms of depression but they may present as sick and rundown. This is not unusual because it takes a lot of energy to mask depression. In society there is a stigma attached to psychiatric disorders therefore many people put off getting professional help for as long as possible. As stated earlier many depressed patients do not have a good appetite and lack energy to prepare themselves foods which they like.
3. Physical sickness like headaches and muscle pains are a common complaint. Many times lots of time is wasted looking for physical causes for the headaches and muscle pains. Such patients generally have normal blood tests and normal radiological examinations. In depth analysis will reveal the insidious nature of true depression.
4. Some patients who are depressed will complain that their guts are churning all the time. Audible peristaltic sounds may be present. This hyperactive gut is due to the fact that the patient is not eating enough but the physical demands on the body are more because of the restlessness and the anxiety associated with depression.

   

   Churning of the gut in depression is common.
   Photograph by Sarjeet S. Gill.
5. Palpitations in the chest. Anxiety causes some patients to have palpitations in the chest. Most of the times the palpitations occur when the patient is alone, generally. This places a lot of stress on the heart and contributes to the run down feelings exhibited by a depressed patient.
6. Picture: External view of the Heart. Patients may complain of palpations in the chest particularly when trying to get some sleep. Photograph by Sarjeet S. Gill.
7. Patients who are depressed often cannot sleep. The feelings of doom and gloom are real. They also feel helpless and spend lots of time thinking about the problems they are having; real or perceived. Some patients will have been run down by the sleeplessness. When depression finally lifts they may sleep more than usual to get rid of the sleep debt.
8. Poor appetite and weight loss are associated with depression. However, this is not always the case. Physical diseases like TB, AIDS, leukemia, GI bleeding and malignant conditions can also cause patients to present with these physical manifestations. Hence, it is important that a thorough assessment be done before reaching a diagnosis and formally commencing treatment.