Physical effects of depression

Can depression cause physical pain?

Depression often causes emotional symptoms such as low mood, feelings of guilt or hopelessness, and thoughts of suicide. However, despite being a mental health condition, depression can also cause several physical symptoms, including pain in various areas of the body ^[1].

Many studies have found there to be a clear link between depression and physical pain. For example, people who experience severe and chronic pain conditions are significantly more likely to be diagnosed with clinical depression, or major depressive disorder. Similarly, people with a diagnosis of major depression are more likely to experience physical symptoms such as pain, than those without ^[2][3].

Research also shows that people with both depression and physical pain tend to experience more severe and longer-lasting symptoms of depression than those without physical symptoms ^[2][4].

This is likely due to changes in serotonin and norepinephrine. These neurotransmitters are involved in mitigating pain responses as well as impacting mood. As such, if an individual has altered levels of these neurotransmitters, they are more likely to experience both pain and depression ^[2][3].

Additionally, it is common for people with depression to also experience excessive stress or anxiety. Stress is associated with the ‘fight or flight’ response, which causes various changes in levels of chemicals in the body. These changes can result in several physical symptoms, including pain and discomfort ^[4][5].

Physical symptoms of depression

Physical symptoms of depression can affect various areas and functions of the body.

Appetite and digestion

It is common for people with depression to experience a change in appetite. This may include ^[1][6]:

• Not feeling hungry or feeling the need to eat
• Only eating when reminded or prompted by others

or

• Feeling hungry much more than usual
• Eating a lot throughout the day and overeating at mealtimes

Increased hunger can futher impact an individual's mental health, but these appetite changes can impact body weight and the digestive system too, causing physical symptoms such as ^[2][7]:

• Stomachpain
• Diarrhea
• Constipation
• Nausea
• Malnutrition
• Weight gain
• Weight loss

Depression is also linked to an increased risk of obesity and diabetes, due to changes in appetite that cause overeating, as well as inactivity ^[5].

Sleep

Depression can cause significant changes in the duration and quality of sleep. This can include ^[4][7]:

• Struggling to fall asleep, potentially feeling very tired but unable to settle
• Waking up a lot in the night, sometimes with a jolt or a racing heart, and then finding it difficult to go back to sleep
• Waking up very early in the morning, not feeling rested but unable to return to sleep

or

• Sleeping far more than usual, finding it difficult to awaken in the morning
• Sleeping for significantly longer periods than usual overnight, as well as taking several naps during the day

Energy

As well as changes in sleep patterns, it is common for people with depression to experience a change in energy levels, regardless of rest time. This can include ^[4][7]:

• Significantlack of energy, often feeling very tired
• Becoming exhausted much quicker than usual when active and feeling weak
• Feeling as though movements and speech are much slower and require more effort than usual

or

• Potentially experiencingfatigue but feeling restless and the need to move a lot of the time, which could involve pacing, fidgeting, or doing something with the hands

Sensitivity to pain

People with depression can become more sensitive to pain, which may occur without explanation. This can include ^[2][3]:

• Headaches, which may feel like pain or pressure in the head
• Pain or tension in the joints, limbs, and back

Heart

Research shows that depression is associated with an increased risk of heart disease, high blood pressure, and strokes ^[5].

People with depression may experience physical effects such as ^[4][5]:

• Racing heart
• Irregular heartbeat
• Tight chest
• Chest pain

Menstrual cycle

Some people may find that depression impacts their menstrual cycle, such as through a loss of periods or irregularity in the cycle ^[1][4].

How to manage physical symptoms of depression

If you are experiencing physical symptoms of depression, it is advised to seek professional treatment. Although depressive symptoms can sometimes be alleviated without professional help, it is often quicker and more effective to utilize proper intervention. Similarly, untreated depression symptoms can worsen and lead to more severe issues and difficulties in functioning ^[1][8].

Treatment for depression typically includes therapy, medication, and self-care.

Therapy

Physical symptoms often occur alongside psychological symptoms of depression. Psychotherapy can help with managing psychological symptoms, thereby also reducing physical symptoms that can occur ^[4][6].

Psychotherapy can provide an opportunity to explore and discuss emotional distress and the underlying causes of your condition. A therapist can help you to recognize and alter maladaptive thoughts and behaviors, to promote a more positive mindset. They can also teach coping skills to help you feel more able to manage emotional difficulties ^[1][9].

There are various types of therapy available that can help in the treatment of depression, including ^[1][9]:

• Interpersonal therapy (IPT)
• Cognitive behavioral therapy (CBT)
• Family therapy
• Group therapy

Medication

Antidepressant medications may be prescribed to reduce symptoms of depression. Your treatment will likely commence with a type of medication called selective serotonin reuptake inhibitors (SSRIs), such as sertraline, fluoxetine, and citalopram. These medications can help to improve mood and reduce anxiety, although they do sometimes cause physical side effects ^[1][9].

If you are experiencing a lot of pain alongside emotional symptoms of depression, your doctor may wish to start your treatment with serotonin and norepinephrine reuptake inhibitors (SNRIs), such as venlafaxine or duloxetine. This type of antidepressant has been shown to help reduce pain and other physical symptoms of depression, along with helping mood regulation ^[2][4].

Other types of antidepressants include ^[1][5]:

• Tricyclic antidepressants (TCAs), such as imipramine and amitriptyline
• Atypical antidepressants, such as mirtazapine and bupropion

It is advisable to contact your doctor if physical symptoms worsen or if new unpleasant symptoms emerge after starting antidepressant medication. Your doctor will be able to alter your dosage or change your medication to help find a treatment that works well for you, with the fewest side effects.

It is important to take your medication exactly as it is prescribed, to prevent adverse effects. You should also consult with your doctor if you wish to stop or change your medication ^[1][9].

Self-care

Physical and psychological symptoms of depression can be reduced or effectively managed with the utilization of certain self-care techniques, such as ^[1][5][8][9]:

• Eating a healthy diet
• Drinking plenty of water
• Engaging in regular physical activity
• Practicing breathing exercises
• Relaxation and mindfulness
• Avoiding caffeine, alcohol, and drugs