Depression is a complex mental health issue that affects roughly 21 million adults in the U.S. each year [9]. Itโs more than just feeling sad; itโs a significant struggle for many people, and it can include a wide range of symptoms, including depression brain fog, depression irritability, and depression motivation issues. In this article, weโll cover general, moderate, and severe depression symptoms, different types of depression, and the risks of not treating it. Understanding these aspects is essential for recognizing and dealing with this condition.
General Symptoms of Depression
Depression is a mental health condition that affects individuals differently, and its symptoms can vary in intensity, duration, and frequency [9, 16-17]. If someone experiences several signs and symptoms of depression for at least two weeks, most of the day, nearly every day, they may have depression. It is important to know these signs and seek professional help if needed. Symptoms may include [9, 16-17]:
- Feelings of sadness, anxiety, or a persistent sense of emptiness.
- A deep sense of hopelessness, worthlessness, and a generally pessimistic outlook.
- Frequent episodes of crying.
- Experiencing depression irritability can lead to heightened sensitivity and frustration.
- Loss of interest in activities and hobbies that were once enjoyable.
- Reduced energy levels and persistent fatigue.
- Struggling with depression motivation, making it difficult to find the drive to engage in daily tasks.
- Dealing with depression brain fog, including memory loss, difficulties concentrating, or making decisions.
- Slower movements or speech.
- Sleep difficulties include falling asleep, waking up very early, or oversleeping.
- Changes in appetite or weight.
- Persistent physical discomforts, like unexplained headaches, aches, feeling ill, digestive issues, or cramps.
- Thoughts related to death, suicide, self-harm, or even suicide attempts [9, 16-17].
Depression Severity
Primary care providers often use tools like the eight-item Patient Health Questionnaire (PHQโ8) [17] to assess symptom severity. This questionnaire assigns scores that range from 0 to 24. Scores of 0โ4 indicate minimal or no depression symptoms, while 5โ9, 10โ14, or 15โ24 signify mild, moderate, or severe symptoms, respectively. This scoring system assists healthcare professionals in gaining insights into the extent of distress and functional challenges faced by those grappling with depression. By using these classifications, healthcare experts can better tailor treatment and support to cater to each individualโs unique circumstances.
- Mild Depression: Individuals with mild depression typically experience a limited number of symptoms, which have a relatively minor impact on their daily functioning. Treatment options may include therapy, lifestyle modifications, or a watchful waiting approach [2].
- Moderate Depression: Moderate depression involves a more substantial number of symptoms that significantly affect a personโs ability to function in various aspects of life. Treatment often includes therapy and may incorporate medication, depending on the individualโs needs [2].
- Severe Depression: Severe depression is characterized by a high number of severe symptoms that profoundly disrupt an individualโs daily life. People with severe depression often require intensive treatment, which may involve a combination of psychotherapy and medication [2].
Not everyone experiences depression the same way, and depression can be unique for each person, and not everyone will fit neatly into one of these classifications. Mental health professionals use these classifications as guidelines to assess and provide appropriate care.
Types of Clinical Depression
Depression, a mood disorder marked by enduring feelings of sadness and diminished interest, is classified into several categories by the American Psychiatric Association in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These categories include the following five types [4]:
Major Depressive Disorder (MDD)
MDD, often interchangeably referred to as โdepressionโ or โmajor depressionโ is a common form of depression [4]. Symptoms include:
- Persistent low mood
- Loss of interest or pleasure in activities
- Changes in appetite or weight
- Sleep disturbances
- Fatigue
- Feelings of worthlessness or guilt
- Difficulty concentrating
- Thoughts of death or suicide [4].
- Major depressive episode
Disruptive Mood Dysregulation Disorder (DMDD)
DMDD primarily affects children and adolescents [8]. To be diagnosed with DMDD, specific criteria must be met, such as severe temper outbursts occurring at least three times a week for 12 months or more [10]. Symptoms include severe and chronic irritability, accompanied by frequent temper outbursts, which can manifest as verbal or physical aggression, self-harm, or destructive behavior [8].
Persistent Depressive Disorder (Dysthymia)
Persistent depressive disorder, also known as dysthymia, this condition is characterized by a long-lasting, low-level, and persistent depressed mood [9]; other symptoms include [10]:
- Poor appetite
- Overeating
- Insomnia
- Hypersomnia (excessive sleep)
- Low energy
- Low self-esteem
- Poor concentration
- Feelings of hopelessness
Premenstrual Dysphoric Disorder (PMDD)
PMDD primarily affects women before their menstrual period [4]. It is marked by severe mood swings, irritability, tension, and physical symptoms such as bloating, breast tenderness, and joint pain [4].
Depressive Disorder Due to Another Medical Condition
Depression can result from various medical conditions [1,11-12, 18]. These conditions include infectious diseases, autoimmune disorders, cancer, stroke, neurodegenerative diseases, trauma, interferon treatment, heart disease, Huntingtonโs disease, Parkinsonโs disease, and multiple sclerosis [1,11-12, 18]. Each of these medical conditions may contribute to depressive symptoms due to factors such as immune system activity, brain inflammation, or the emotional impact of the condition [1,11-12, 18].
Other Types of Depressive Disorders
Along with the types listed above, there are other depressive disorders and mood disorders that individuals may struggle with. These include:
- Perinatal Mood and Anxiety Disorder (PMAD): PMAD is a mental health disorder that can develop during pregnancy, after having a baby, adopting, or experiencing pregnancy and infant loss. During these events, people can experience a wide range of emotional, physical, hormonal, and social changes that can trigger depression. Furthermore, PMAD is often broken down into prenatal depression (during pregnancy) and postpartum depression (after giving birth).
- Manic Depression: Also known as bipolar disorder, manic depression is a mental health condition that causes extreme mood swings comprising emotional highs (mania) and lows (depression).
- Seasonal Affective Disorder (SAD): SAD is a type of depression that is directly linked to changes in seasons. For example, as summer ends and fall turns into winter, some individuals may begin to experience depression symptoms that can last until the seasons start to change again.
How Depression Causes Physical Symptoms
Like many mental disorders, clinical depression doesnโt just affect your moodโit can also cause physical symptoms. In fact, clinical depression, also called major depressive disorder, is often accompanied by physical symptoms such as fatigue, headaches, and body aches.
Itโs not entirely clear why depression or other mental disorders cause physical symptoms, but it is thought that even mild depression is related to chronic inflammation, which can also cause somatic and other symptoms. If youโre dealing with physical symptoms of depression or depressive disorders, itโs important to seek help from a doctor or mental health professional. They can help you manage your depression and find ways to cope with your physical symptoms.
There are also some things you can do on your own to help manage your physical symptoms. As we explore the different physical signs, we will also look at some self-care tips that can help.
1. Fatigue and Sleep Problems
One of the most common physical signs and symptoms of depression is fatigue and difficulty sleeping. Fatigue can be caused by numerous culprits when it comes to depression – poor sleeping habits, lack of exercise, and poor nutrition. Fatigue and difficulty sleeping is more than just feeling tiredโitโs a deep exhaustion that doesnโt go away with rest. If youโre dealing with severe cases of fatigue, it can be hard to get through your day-to-day activities. Itโs common to lose interest in activities you once enjoyed and have little energy to do anything about it.
Additionally, depression can cause more severe sleep problems such as insomnia or hypersomnia (sleeping too much). This can be caused by chemical changes in the brain, intrusive thoughts, anxiety, and a host of other factors. To manage sleep problems, itโs important to establish a regular sleep schedule. This means going to bed and waking up at the same time each day – even on weekends.
If youโre struggling with fatigue, itโs important to look at your lifestyle habits and see if there are any changes you can make to help improve your energy levels.
To help manage fatigue and other depressive symptoms, itโs important to get enough sleep. This can be difficult when youโre dealing with depression, but there are some things you can do to help yourself sleep better. Creating a bedtime routine and avoiding caffeine before bed can help you get the rest you need. Exercise can also help reduce fatigue. Even a small amount of exercise can help increase your energy levels. If youโre not used to exercising, start with some simple activities like walking or swimming.
2. Headaches
Headaches can be a pain โliterally. Depression is one of the most common causes of headaches, and they can range from mild to severe. If youโre dealing with headaches, you may find that over-the-counter medications donโt help as much as they used to. The pain can be constant or intermittent and can range from mild to severe.
To manage headaches, itโs important to identify the trigger. If you can avoid the trigger, you may be able to prevent the headache from happening in the first place. Common triggers include stress, bright lights, and long periods of screen time. If you canโt avoid the trigger, there are still things you can do to help relieve the pain.
Coping with headaches:
- Take over-the-counter pain relievers such as ibuprofen or aspirin.
- Apply a cold or hot compress to your head.
- Massage your neck and shoulders.
- Practice relaxation techniques such as deep breathing.
3. Muscle aches and pains
Depression can cause muscle aches and muscle pain, especially in the neck, back, and shoulders. The pain may be constant or come and go. Body aches due to depression are generally characterized by a dull, aching pain. The pain may worsen with stress or anxiety.
To manage muscle aches and pains, itโs important to get regular exercise. Exercise can help reduce symptoms, stress and improve your overall mood. Itโs also important to stretch regularly and practice good posture. If you sit at a desk all day, make sure to take breaks and move around every few hours.
Some other general coping mechanisms include:
- Take over-the-counter pain relievers such as ibuprofen or aspirin.
- Apply a heating pad or ice pack to the affected area.
- Do gentle stretching exercises.
- Take a hot bath or shower.
4. Gastrointestinal problems
Depression can cause gastrointestinal problems such as constipation, diarrhea, and nausea. Many of these symptoms are related to depression but can also be a result of some oral antidepressants that cause GI side effects. When dealing with gastrointestinal problems, itโs important to eat a healthy diet. A diet that is high in fiber can help with constipation. Avoiding triggers such as caffeine, alcohol, and spicy food can help with diarrhea and nausea. Itโs also important to stay hydrated by drinking plenty of fluids. Water is the best option, but tea and clear soups can also help.
Here are some tips for coping with gastrointestinal problems:
- Eat a healthy diet that includes plenty of fiber.
- Drink plenty of fluids.
- Exercise regularly.
- Talk to your doctor about medications that can help with constipation, diarrhea, or nausea.
5. Weight loss or gain
Weight gain or weight loss is a common symptom of depression. The changes in weight can be due to changes in appetite or how the body metabolizes food. Depression can cause a decrease in appetite, which can lead to weight loss. Alternatively, depression can cause an increase in appetite, which can lead to weight gain. Changes in weight can also be due to changes in activity level. Depression can cause a decrease in energy, which can lead to a decrease in physical activity. This, in turn, can lead to weight gain.
To manage weight changes, itโs important to eat a healthy diet and get regular exercise. If youโre not sure how to make these changes, talk to your doctor or a registered dietitian. They can help you develop a plan that is right for you.
Some tips for eating a healthy diet include:
- Eat plenty of fruits and vegetables.
- Choose whole-grain products.
- Limit saturated and trans fats.
- Limit sugar and salt.
Some tips for getting regular exercise include:
- Find an activity that you enjoy.
- Start with small goals and gradually increase your activity level.
- Exercise with a friend or family member.
- Join a gym or fitness class.
- Hire a personal trainer
6. Concentration and memory problems
Difficulty concentrating and memory problems are common depression symptoms. These problems can be caused by the changes in brain chemistry that occur with depression. To manage concentration and memory problems, itโs important to establish a routine. This could include setting aside time each day to work on a specific task. Itโs also important to break down tasks into smaller, more manageable pieces. Some other tips for coping with concentration and memory problems:
- Establish a routine.
- Break down tasks into smaller, more manageable pieces.
- Make lists.
- Use a planner.
- Set reminders on your phone or computer.
- Organize your thoughts and write things down.
- Make sure youโre getting enough sleep.
7. Sexual problems
Depression can cause sexual problems such as low libido, erectile dysfunction, or premature ejaculation. This can be due to the changes in brain chemistry that occur with depression. Sexual problems can also be caused by fatigue, depressed mood, negative body image, low self-esteem, or relationship problems.
To manage sexual problems, itโs important to communicate with your partner. This can help you identify any factors that may be contributing to the problem. Itโs also important to make time for intimacy and to be patient with yourself.
Some other tips for coping with sexual problems:
- Communicate with your partner.
- Make time for intimacy.
- Seek counseling or therapy.
- Join a support group for people with sexual problems.
- Be patient and donโt pressure yourself.
8. Anxiety
Major depressive disorder can trigger symptoms of anxiety or make existing anxiety worse. While anxiety is usually characterized by feelings of fear, worry, and nervousness, it can also cause physical symptoms. Physical symptoms of anxiety can include trembling, racing heart, sweating, and dizziness.
To help cope when anxiety symptoms occur, itโs important to identify the things that trigger your anxiety and to avoid them if possible. Itโs also important to develop healthy coping mechanisms such as exercise, relaxation techniques, and positive thinking. Some other tips for coping with anxiety:
- Identify the things that trigger your anxiety.
- Avoid the things that trigger your anxiety.
- Develop healthy coping mechanisms.
- Exercise regularly.
- Practice relaxation techniques such as yoga or meditation.
- Talk to a mental health professional.
9. Irritability and anger
Like anxiety, depression can cause irritability and anger or make existing irritability and anger worse. Anger and irritability are common symptoms of depression in men. This can be caused by the changes in brain chemistry that occur with depression. It can also be caused by relationship problems, work stress, or other life stressors. The irritability and anger may be directed at yourself or others.
To cope with the anger – like with anxiety – itโs important to identify the root cause. Once you know what is causing the anger, you can develop healthy coping mechanisms. Itโs also important to avoid making decisions when youโre feeling angry.
Some tips for coping with irritability and anger:
- Identify the root cause of your anger.
- Avoid making decisions when youโre feeling angry.
- Develop healthy coping mechanisms such as exercise, journaling, or talking to a friend.
- Talk to a therapist or counselor.
- Join a support group for people with anger management issues.
What Happens if Depression Goes Untreated
Untreated depression can lead to serious consequences, affecting mental health and physical well-being [6]. Without appropriate treatment, depression worsens over time, potentially leading to more severe symptoms [6]. Persistent sadness, hopelessness, and despair can significantly impact a personโs daily life, making it difficult to engage in work, relationships, and social activities [6].
Furthermore, untreated depression is associated with an increased risk of other mental health conditions, such as anxiety and substance abuse [6]. It can also have adverse effects on physical health, potentially contributing to conditions like heart disease, obesity, and diabetes [6]. In extreme cases, untreated depression can lead to self-harm or suicidal thoughts and actions [6].
Finally, the stigma surrounding mental health issues often prevents individuals from seeking the help they need, exacerbating the adverse outcomes of untreated depression [4]. This stigma can adversely affect personal and professional aspects of their lives [4].
Treatment for Clinical Depression
Treating depression often may involve a combination of approaches. Some of the treatments for depression may include:
- Medication: Antidepressant medications, including SSRIs, SNRIs, atypical antidepressants, TCAs, and MAOIs, may alleviate depressive symptoms [13,15].
- Psychotherapy: Certain types of talk therapy, such as cognitive-behavioral therapy (CBT) and interpersonal therapy, plays a crucial role in managing depression. [15].
- Electroconvulsive Therapy (ECT): ECT is recommended for severe cases of depression, especially when other treatments have not been effective [15].
- Transcranial Magnetic Stimulation (TMS): TMS is an FDA-approved treatment for treatment-resistant depression, particularly for patients who have not responded to medication. A recent study evaluated the efficacy of depression treated with brain stimulation therapy and psychotherapy simultaneously which resulted in a response rate of 66% and a remission rate of 56% at the end of the combined treatment [14].
- Esketamine: Spravato (esketamine), administered as a nasal spray in combination with an oral antidepressant, is used for treatment-resistant depression [3,13]. Additionally, if an individual has tried multiple medications, yet failed to experience symptom relief, they may be a good candidate for Spravato.
Seek Treatment for Depression Symptoms
Identifying the signs of depression is a crucial first step in seeking help. Whether itโs persistent feelings of sadness or hopelessness, changes in sleep or appetite, depression brain fog, or thoughts of self-harm or suicide, it is important to recognize symptoms promptly and reach out to a psychiatrist at Neuro Wellness Spa as soon as possible. With the right depression treatment and support, depression can be managed effectively, and you can regain your quality of life.
If you or a loved one is struggling with symptoms of depression, donโt hesitate to reach out for help. Contact Neuro Wellness Spa today to learn more about our evidence-based depression treatments including medication management, TMS therapy, and more and take the first step towards a brighter tomorrow. Your mental health matters and support is just a call away.
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