This isn’t the sunniest article you’re going to read today, that I can say for sure. However, I’m not writing it with the intention of making you feel bad. I’m writing it because there are plenty of people out there still who continue to hold a very narrow definition of depression and mental illness in general. I’ve had this conversation a handful of times:
Me: “I suffer from depression.”
Other Person: “Oh yeah? Me too.”
Me: “So you know what I’m talking about?”
Other person: “Oh yeah. I totally get sad sometimes.”
What follows is a heavy sigh and me hiding my face in my hands. (You can also replace “depression” with “anxiety” and “sad” with “nervous” in this conversation and have it be just as common.)
This marginalizing, yet commonly held belief makes it all the more unbelievable when trying to explain that depression is accompanied by physical symptoms that are much more debilitating than a general sadness. These symptoms can make the proverbial bootstraps much harder to pull oneself up by.
Aches and Pain
According to WebMd, depression can cause the neurochemical serotonin to behave abnormally, decreasing an individual’s pain threshold. For this reason, people suffering from depression commonly report back pain, headaches, and cramps. In extreme cases, depression has been linked to the development of fibromyalgia, a disorder that “causes chronic, widespread muscle pain, tiredness, and multiple tender points—places on the body that hurt in response to light pressure.” Medications that treat depression are often SSRIs or Selective Serotonin Reuptake Inhibitors. They work to correct the flow of serotonin across the synapses of the brain.
Fatigue is a prevalent feeling of lacking energy. This symptom can persist even if an individual is taking medication for their depression. On top of the physical symptoms, fatigue can also have detrimental effects on an individual’s cognitive and emotional functions. This can cause an unhealthy amount of apathy which is often seen as off-putting by people associated with the individual. For example, If you tell someone suffering from depression that you got into an ivy league school and they don’t share in your enthusiasm, it’s not because they don’t care. It’s because their emotional reactions are stunted by fatigue.
Lack of Pleasure-Seeking Desire
Depression often comes with a feeling of disconnect from the world. The pleasures that an individual used to relish in will lose their luster if this disconnect sets in. It’s the difference between watching your favorite movie in Imax 3-D plus THX surround sound with a bottomless tub of popcorn and watching that same movie on a 15” black and white television, sitting in the middle of the couch with two people sitting on either side of you having a conversation.
For this reason, individuals with depression will not actively seek out pleasure. Knowing that an activity won’t elicit the same joy that it once used to is discouraging. One of the most common ways this manifests is in a lack of sex drive. If your partner is depressed, don’t take it personally if they don’t seem excited about intimacy. The chemical soup that makes up their brain just doesn’t have the right combination of ingredients for strong arousal.
Insomnia/Lack of Deep Sleep
Depression often causes sleep cycle issues. Specifically, it can create a deficit of deep sleep due to the extended amount of time spent in REM, which doesn’t allow for the quality of rest that deep sleep does. The body requires this period of deep sleep to repair damage to the immune system. Without it, an individual is at higher risk for disease.
Being depressed does not put you directly at risk of disease. It only means your risk is typically greater than someone without depression. Depression and stress often go hand-in-hand and because stress is a contributing factor to heart disease it’s important to be mindful of your heart health when battling depression.
A physician’s role should be to examine both physical and mental symptoms as potential root causes for ailments that are commonly linked to depression. According to an article published by Wake Forest University, “A 2003 study found that patients with depression and arthritis—both common issues in older adults—experienced decreased physical pain, improved physical function, and higher quality of life after receiving antidepressants to improve their mental health.” Meanwhile, the civilian’s role is to be an understanding member of the support system in a depressed person’s life. Even if this means admitting that you have no idea what that person is going through.