5 Signs of Depression That Are Easy to Miss

You’ve heard people say mental health is just as important as physical health. We’ll go a step farther: Mental health is physical health.

Take depression as an example. It doesn’t just mess with your mind—it often shows up in your body, too, says Scott Dehorty, LCSW-C, a licensed clinical social worker at Delphi Behavioral Health in Ft. Lauderdale, Florida.

How so? Consider these five signs of depression that affect the body, not just the brain.

1. Your Cold Just Won’t Quit

Both your immune system and your mental wellbeing rely on serotonin, known as the “happy” hormone for its ability to stabilize your mood. When it’s low, you’ll not only be at higher risk for depression, but your immunity will take a beating, too. Result: a cold that never ends.

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A study published in the journal Psychosomatic Medicine looked at how your “emotional style”—positive or negative—affected what happened to participants when given a dose of rhinovirus, a respiratory virus that causes colds. Happier people showed fewer symptoms than those who were depressed, nervous, or angry. 

2. You’re Headed to the Bathroom—Again

About 90 percent of serotonin is made in your gut. So when your gut’s hormone factory goes on strike, you may experience issues like bloating, gas, diarrhea, constipation, and cramping. All the fun stuff!

If you feel anxious or upset about these diarrhea days—and, well, most of us do—that can fire up another hormone called cortisol, which modulates your stress response. Over time, a cortisol spike can leave you feeling exhausted and depletes your serotonin even more, says integrative medicine physician Sara Gottfried, M.D., author of The Hormone Cure.

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“Elevated cortisol, on its own, is linked to depression,” Dr. Gottfried says. “It can also lead to other changes that can put you at even higher risk. For example, it may cause poor sleep and excess belly fat, which both have a ripple effect on your emotional health.” For instance, belly fat can raise inflammation levels, another physical issue that’s been linked to depression.

3. You’re Feeling All Kinds of Aches and Pains

You stub your toe and it feels like someone cut it off. Your lower back aches for seemingly no reason, menstrual cramps are worse than ever, and headaches are debilitating. As much as all of this might sound unrelated to depression, a lower pain tolerance could be a sign.

“When you have depression, there is sometimes a shift that mental health professionals call a vital sense change,” says Dehorty. “That means you actually feel sensations in your body in a different way than you did in the past. “Pain is the biggest example because your brain isn’t releasing chemicals like serotonin and dopamine, which block pain signals,” he continues. “So you feel all of it instead.”

4. The Last Thing You Want to Do: Get Out of Bed

Nope, coffee can’t help with vital sense change. Not even a lot of it. Vital sense change also causes tiredness or, on the more extreme end, fatigue. You’ll feel like you’re dragging, and that leads to overall weakness.

So just rest up, right? Seems intuitive, but lounging in bed too much and sleeping for long periods can make it all worse, says Srijan Sen, M.D., Ph.D., professor of psychiatry and director of the University of Michigan Depression Center.

Dr. Sen’s research shows that a routine that’s out of whack can itself raise your risk for depression. Some degree of rest is fine—and we love a good nap—but erratic sleep can turn into sleep deprivation and mood problems, he says.

“When your sleep is unpredictable in terms of how long or when you’ll be awake, not only can that negatively affect your daily mood, but it can absolutely be a sign of depression,” says Dr. Sen. “It can also make your depression worse over time.”

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5. Showering Has Become Optional

When you’re depressed, your motivation runs on fumes. This goes well beyond the bigger stuff like exercising, seeing friends, and being productive at work. Basic hygiene can end up in the “optional” category as well—particularly if you feel fatigued or generally indifferent, says Dehorty.

Hygiene indicates that you care for yourself and your body, so when that stops being true, it could mean some emotional issues are rearing. How to know something’s up? Check for effects like greasy or oily skin, dandruff and thinning hair, acne, body odor, and potentially even yeast infections.

These physical symptoms can be a concern, but they don’t automatically mean you have depression. Talk with a professional, suggests Dehorty. Sometimes, it’s only when an issue shows up physically that you realize there’s a bigger problem.

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