By Erika Krull, MS, LMHP
The traditional medical view of depression includes symptoms like persistent sadness, feelings of worthlessness, tearfulness, lack of enjoyment in life, and sometimes thoughts (or attempts) of suicide. If you learned that a friend was showing these symptoms, you might suspect depression fairly quickly.
But what if this friend had aches and pains without an obvious cause? How about trouble sleeping or strong use of cynical and sarcastic language? Most people would find a way to excuse or dismiss these issues without making any connection to depression.
A closer look at these unexpected symptoms can reveal how they are related to depression. Physical, emotional, and functional problems can be spotted if you know what to look for.
Depression can affect the body as much as the mind. Many people report having more physical pain or body aches when they are depressed. Some people become injured more easily because they pay less attention to their surroundings. Insomnia can develop because depression causes people to constantly think about negative thoughts and worries.
Depression affects how a person functions in his or her daily life. Depression amplifies and adds many negative thoughts to a person's mind, making it difficult to remember and concentrate on normal daily tasks. Someone may become a workaholic to distract themselves from their depression. Excessive drinking is another way some people cope with persistent depression symptoms.
Emotions often become unbalanced when a person is depressed. It's not uncommon to report feel nothing or empty most of the time. Someone might also appear sensitive or overly expressive with their emotions. Increased anger and irritability can be key symptoms of depression, especially with men. It takes more than just one or two symptoms for a person to be diagnosed with depression. But when a few of these unusual problems or behaviors appear together, it makes sense to take a closer look.
Older people can have greater difficulty identifying depression because mental health has been stigmatized for so long. Depression symptoms may also be dismissed as stereotypical signs of the aging. Even younger people can struggle to see the signs of depression. When symptoms are mostly physical or could be explained by other circumstances, depression can easily go undiagnosed.
Wendy Davis, PhD, is the executive director for Postpartum Support International. When she helps people who aren't sure if they have depression, she discusses the topic in an open and non-threatening way. "I may talk about how there are times that our bodies and brains find ways to get our attention in unusual ways," Davis said.
"It's actually those unusual depression symptoms that bring people into counseling or to see their healthcare provider," Davis added. "Some people will come to couples therapy asking for help with conflict and anger, and in counseling come to realize that they have been dealing with depression."
"Much of the time, people enter therapy with no language or connection to their feelings," Davis stated. "I think it's important to start where they are, using the language that works for them so they feel understood and safe in the counseling relationship."
No matter how it is discovered, depression needs to be treated as soon as it is discovered. Untreated depression can become more challenging to manage over time. Habits and thought patterns can become engrained as a way of life, making recovery longer and more difficult. Untreated depression can be linked to dementia, a greater mortality rate among older adults, and can deeply impact a person's quality of life.
A visit to the doctor, a psychiatrist or a counselor is a great first step in identifying depression. Medication can be helpful, but so can counseling therapy. Research has shown that the most effective treatment approach involves both medication and counseling.
Don't let unusual symptoms throw you off if you suspect a mental health problem. Depression can show itself in some unexpected ways. When you understand what depression can look like, you can help yourself or a loved one reach out for help.
For more information about depression, read Depression in the Elderly in our In-Depth Guides section and Depression: Signs, Symptoms, Causes, Effects & Treatment in our FundaMENTALs Glossary.
Erika Krull is a licensed mental health counselor from Nebraska. She has also been a freelance writer since 2006, writing primarily about mental health and parenting topics. She currently works part-time at a psychiatric hospital, and lives with her husband and three daughters.