By Therese Borchard
Do these questions sound familiar?
- Are you tired or fatigued?
- Do you have trouble falling asleep?
- Do you have little interest in doing things you once enjoyed?
- Do you feel sad, depressed, or hopeless?
They are typical questions asked by a doctor (psychiatrist, general practitioner, gynecologist) or provided in a questionnaire to screen for depression. However, you could be snoozing like a baby, performing at work just fine, and training for a marathon only to have some really bad back pain that won’t go away.
Could it be depression?
In a study published in Dialogues in Clinical Neuroscience, 69 percent of persons who met the criteria for depression consulted a doctor for aches and pains. Mood disorders can show up in surprising symptoms — like migraines, bloating, backaches, or joint pain.
Moreover, these aches and pains don’t go away — and can get downright dangerous — if the depression isn’t treated. A 2007 Norwegian study found that those participants with significant depression symptoms had a higher risk of death from most major causes, including heart disease, stroke, respiratory illnesses, and conditions of the nervous system.
Here are some of the most common physical symptoms associated with depression:
According to Lisa K. Mannix, MD, a board-certified neurologist in Cincinnati who specializes in the treatment of headaches, as many as 40 percent of people with migraine have comorbid depression. There is strong evidence, she says, linking migraine with a variety of comorbid psychiatric and somatic disorders, from stroke to anxiety disorder. A 2009 study at the University of Manitoba, showed that 11 percent of participants who suffered from migraines also experienced one or more kinds of mood disorder, ranging from major depression to panic disorder.
According to one study, people with fibromyalgia are 3.4 times more likely to have major depression than people without fibromyalgia. It’s understandable that someone with chronic joint pain would get depressed — when climbing the stairs hurts, and so does bending down to fill the dog bowl. However, what’s interesting is that the stiffness, inflammation, and damage to the joint cartilage may actually be symptoms of the depression (as well as causing the mood dips).
I wish I had been aware of the connection between digestive problems — bloating, constipation, irritable bowels — and depression when I was a young girl because I would have pursued treatment for both anxiety and depression before hitting bottom in college. Instead I used laxatives and other over-the-counter remedies that only worsened my condition.
The nervous system of our intestines is so complex — it has an estimated 500 million neurons — that neuroscientists often refer to the gut as the second brain. In fact, the nerve cells in our gut manufacture 80 to 90 percent of our body’s serotonin. That’s more than our brain makes. If you are a person who has struggled with stomach and digestion issues like I have, you might be surprised to learn that some depression and anxiety symptoms can be relieved by tending to the gut and feeding it organisms — the right kind of bacteria in a probiotic — that keep it happy.
Also, watch out for foods that stimulate inflammation of the brain (which feels like depression), such as gluten and sugar. These foods might not show up on an IgA blood test for allergies (which measure responses like swelling and breathing difficulties), but that doesn’t mean your body likes them. You may very well be intolerant, which could cause symptoms of anxiety and depression. Renowned neurologist David Perlmutter, MD, points out in his bestseller Grain Brain that people who suffer from mood disorders also tend to be gluten sensitive, and vice versa. Depression is found in as many as 52 percent of gluten-sensitive individuals.
Volumes of research have revealed the intimate connection between depression and cardiovascular health. According to the National Institute of Mental Health, 3 in 20 Americans with heart disease experience depression compared to the 1 in 20 average of people without heart disease. Patients with heart disease who are depressed tend to have more cardiac symptoms than those who are not depressed. A study published in the journal Circulation found that people with heart failure who are moderately or severely depressed have four times the risk for early death, and double the risk for being hospitalized, compared to those who are not depressed. Even people with mild symptoms of depression had almost a 60 percent increased risk for death.
Recent studies show that, just as persons with coronary heart disease are at high risk for depression, those with depression are at risk for coronary heart disease. Depression and anxiety affect heart rhythms, increase blood pressure, elevate insulin and cholesterol levels, and raise levels of stress hormones. Chest pain and a rapid heartbeat could very well be symptoms of both anxiety and depression.
Back pain is also common in people with anxiety and mood disorders. I have absolutely no scientific data to support this claim, but I notice that I slouch a lot when I feel bad. Slouching then leads to back pain. The discomfort also may involve aches or stiffness up and down the spine, sharp pain in the neck, upper back, or lower back. This is where people carry most of their tension. All the stress throughout the day is held hostage in the areas of the neck and shoulders. This is why if you can afford it (I can’t so I don’t know why I’m recommending this), regular massages can help to prevent depression, or at least keep it from worsening into a major depressive episode. At one point, I used my therapy money for a massage once a month. Because I wasn’t in that critical stage where you need to cry in front of someone for an hour, I believe the massage was more helpful. It relieved some of my stress, which is so often my problem.