New York — Depression, often associated with profound sadness, can manifest in surprisingly subtle ways affecting both the mind and body. Recognizing these less obvious signs is crucial for seeking timely and effective treatment.
Recognizing less apparent symptoms of depression can be the key to getting necessary help.
- Depression can present with physical symptoms like chronic pain and changes in weight.
- Irritability, emotional numbness, and increased substance use can be indicators.
- Difficulties with decision-making and changes in personal hygiene may signal depression.
- Sleep disturbances, whether too much or too little, are often linked to depression.
Many chronic health conditions are challenging to identify at a glance or through a single symptom. Depression, for instance, extends beyond just feeling sad. There’s a spectrum of often-overlooked mental and physical signals to be aware of.
“Depression doesn’t always look like debilitating sadness,” explains Richard Kravitz, M.D., M.S.P.H., a professor of internal medicine at the University of California, Davis, who specializes in identifying depression in primary care. “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.”
Identifying these lesser-known symptoms can make the difference between prolonged suffering and receiving the support you need.
1. Chronic Pain
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Depression and pain share common biological pathways and neurotransmitters. A 2024 study in the journal Pain found that 56% of individuals with depression or anxiety also experience chronic pain, compared to only 17% of those without these conditions. “When you’re in a negative state, you’re apt to tune into your body more carefully, and therefore feel any discomforts more acutely,” Dr. Kravitz noted. This can also lead to stomachaches, headaches, or a general increase in pain sensitivity.
2. Weight Gain
Multiple studies confirm a connection between depression and obesity. Research suggests that depression can increase the likelihood of weight gain, and conversely, being overweight or obese can elevate the risk of developing depression. However, some individuals with depression experience weight loss as a symptom, due to a diminished appetite.
3. Rage or Anger
Experiencing intense anger over minor issues or feeling persistently grouchy can be signs of depression. These emotions often co-occur with the condition. “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, Psy.D., 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.”
4. Feeling Like a Zombie
A sense of detachment, neutrality, or emotional numbness—often described as feeling like a zombie—is a hallmark of depression. “Most of us have motivations that get us out of bed in the morning, whether it’s work, exercise, socializing, or making breakfast,” says Rego. “But for people who are depressed, those pulls dry up.” Activities that once evoked strong emotions now barely register. This can make individuals appear cold or distant, potentially affecting social support.
5. Drinking More Alcohol
Individuals with depression may turn to alcohol or other substances to self-medicate. While an initial drink might offer temporary relief, subsequent drinks can intensify negative emotions like anger and anxiety, and deepen depressive feelings. The Centers for Disease Control and Prevention (CDC) defines healthy alcohol limits as one drink per day for women and two drinks per day for men.
6. Excessive Online Activity
Engaging in activities like extensive social media use, gambling, or shopping to excess, particularly online, can be a coping mechanism for depression. A review in Psychiatry Research indicated a higher risk of internet addiction among those with depression, and vice versa. This behavior may stem from a perceived lack of real-world connection or an attempt to escape difficult thoughts and feelings. While distinct diagnoses, internet addiction and depression often overlap, with the pursuit of a short-term mood boost being a common strategy.
7. Difficulty Making Decisions
Everyday choices, from waking up to deciding on breakfast, usually feel effortless. However, when depression impacts cognitive function, even simple decisions can become burdensome. “When we’re depressed, those cognitive processes take a big hit,” explains Rego. “Little things we normally don’t think twice about suddenly become weighty decisions.”
8. Neglecting Personal Hygiene
For some, depression can lead to a decline in personal grooming and hygiene routines, even if they were previously modest. An Australian study identified maintaining personal hygiene as a significant challenge for individuals experiencing depression. Rego notes, “It’s a spectrum. Neglecting your physical wellbeing and appearance is only problematic when it crosses over into distress or dysfunction.”
9. Sleep Disturbances
Depression can disrupt sleep patterns in various ways. Many people struggle with insomnia, finding it difficult to fall or stay asleep. Conversely, others may experience hypersomnia, sleeping excessively throughout the night and day. Research published in the Journal of Affective Disorders suggests that both insufficient and excessive sleep are associated with depression.
