But there’s a whole set of other physical symptoms that are less known but just as debilitating. In fact, depression can literally hurt. According to a study conducted at Massachusetts General Hospital and Harvard Medical School, up to about 76 percent of people who report the typical emotional symptoms also report physical signs, such as stomach problems, headaches, backaches and chest pain.
Depression also is a chameleon. It can look like various other illnesses and conditions, even, for instance, the flu. Which, not surprisingly, makes diagnosing depression tricky, and thereby finding the right treatment a big problem.
Dichelle Connell was sure she had the flu last fall. She felt exhausted, had a constant headache and her muscles ached. She took some over-the-counter meds, curled up under a blanket and waited for it to pass.
After a few weeks, she felt worse, not better. When a sinus infection hit, Connell made an appointment to see her doctor.
“I was as sick as a dog and had no idea what was wrong,” recalls Connell, 39, an esthetician in Charlotte, North Carolina.
The doctor prescribed antibiotics, but the sinus infection and flu-like symptoms continued to plague Connell long after she’d finished the pills. Around the same time, she developed a twitch in her left eye that was so intense she found it difficult to do routine tasks like driving, watching TV or reading. Her ophthalmologist found no medical reason for the twitching.
It was only when Connell complained about her various ailments to her psychologist that she learned all of the physical symptoms she’d been experiencing — from the headaches and intense fatigue to muscle twinges and eye twitches — were linked to depression.
Another woman in the article saw doctors dozens of times in one year for her “headaches, muscle aches, loss of appetite and stomach problems.” She was prescribed anti-nausea medication and told to change her diet. Both she and her doctors believed that each aliment had a different cause and so her treatment reflected that. After she experienced emotional symptoms such as depressed mood, she sought out a therapist, who finally gave her a proper diagnosis: depression.
Why such varied symptoms? Both sets of symptoms may originate from the same root. As one expert said in the article:
“The circuits in the brain that mediate emotional pain are right next to the circuits that mediate physical pain and they share a lot of the same pathways,” explains Stephen Ilardi, PhD, associate professor of clinical psychology” at the University of Kansas whose recent research has focused on neurological and cognitive underpinnings of depression. “[That’s why] someone who is in intense emotional pain can also begin to feel a sense of physical agony.”
Inaccurate diagnoses are not uncommon for several reasons. Many patients simply don’t disclose emotional symptoms to their doctors, either because they gloss over them or because of the stigma. Patients also may focus on a specific set of symptoms depending on who they’re talking to. For instance, you might be less likely to mention your stomach pains and headaches in a therapy session. And inversely, you’d be less likely to reveal your emotional pain to your primary care physician.
Similarly, doctors tend to focus on physical symptoms and mental health professionals focus on emotional ones.
“It’s not that doctors are ignoring obvious complaints,” says Keith S. Dobson, PhD, a professor and director of clinical psychology at the University of Calgary in Alberta. “It’s more a case that they tend to ask more about the physical signs of illness because that’s their focus as family doctors.”
The flip side, Dobson adds, is that mental health professionals tend to focus on psychological symptoms and don’t inquire about physical conditions.
Fortunately, because emotional and physical pain are caused by the same pathways, treating depression with medication and psychotherapy helps to diminish both types of symptoms.
If you’ve suffered from depression, what were your symptoms like?
Were you properly diagnosed? What treatments have helped your various symptoms?