When you imagine a depressed person, it’s probably someone who acts very sad and hopeless all the time. Thing is, depression symptoms can be a lot more subtle than that, manifesting not just with emotional signs, but with physical ones as well.
“Depression doesn’t always look like debilitating sadness,” says Richard Kravitz, MD, MSPH, a professor of internal medicine at University of California, Davis, and an expert in identifying depression in primary-care settings. “Patients are reluctant to consider depression as a cause of their symptoms—in part because they may equate it with weakness, but also in part because they simply don’t associate those symptoms with depression.”
Accurately identifying the problem is key, he adds, because the sooner you get treatment, the easier it will be to return your happy, healthy self. Here are the surprising warning signs you don’t want to miss.
1. You’re in pain.
Depression and pain share some of the same biological pathways and neurotransmitters. About 75% of people with depression suffer recurring or chronic pain, research shows. In a Canadian study published in the journal Pain, people with depression were four times more likely to have intense or disabling neck and low back pain than those who were not depressed. “When you’re in a negative state, you’re apt to tune into your body more carefully, and therefore feel any discomforts more acutely,” Kravitz explains. You might also notice stomachaches and headaches, or just experience greater sensitivity to pain in general. A 2008 study in the Archives of General Psychiatry found that when people with depression anticipate pain, their brain activity indicates more emotion and less coping, so they’re less able to handle the hurt.
2. You’ve gained weight.
Where did that extra roll come from? Maybe from all the late-night ice cream you’ve been inhaling? Or from the frozen dinners you’ve been eating because you don’t feel like shopping or cooking? Although comfort food can raise levels of the mood-boosting brain chemical serotonin, over time emotional eating can lead to weight gain and feelings of guilt and shame, plus it does nothing to treat the underlying causes of depression. A new study in the journal Obesity confirms that high levels of stress and depression make it tough to drop pounds and stick to effective weight-loss strategies. On the flip side, some people may lose weight, as depression zaps appetite.
3. You have a short fuse.
If the slightest mishap sends you into a rage, or grouchy is your new normal, you may be depressed. In a 2013 study published in the journal JAMA Psychiatry, 54% of people with depression reported feeling hostile, grumpy, argumentative, foul-tempered, or angry. “Once you’re on the negative side of the house, you’re more accessible to the rooms where other negative moods hang out—irritability, frustration and anger,” says Simon Rego, PsyD, associate professor of clinical psychiatry and behavioral sciences at Albert Einstein College of Medicine and director of psychology training at Montefiore Medical Center. “You’re not directly there, but it’s a short walk.”