The 9 lesser known symptoms of depression, explained by a psychiatrist

Priory Group – a provider of mental health treatment in the UK – commissioned a survey of 2000 adults to find out people’s awareness of the different symptoms of depression.

The most recognised symptoms of depression were having a continuous low mood and feeling unmotivated, while finding it difficult to make decisions and unexplained pain were amongst the lesser known.

The below chart highlights people’s awareness of the different symptoms of depression:

Symptoms of depression – Percentage of people aware of symptom

Continuous low mood or sadness – 70%
Having no motivation or interest in things – 68%
Feeling hopeless and helpless – 68%
Feeling anxious or worried – 66%
Feeling tearful – 64%
Having low self-esteem – 63%
Not getting any enjoyment out of life – 63%
Having suicidal thoughts or thoughts of harming yourself – 62%
Disturbed sleep – 58%
Avoiding contact with friends and taking part in fewer social activities – 58%
Lack of energy – 57%
Feeling irritable and intolerant of others – 53%
Neglecting your hobbies and interests – 53%
Finding it difficult to make decisions – 48%
Changes in appetite or weight (usually decreased, but sometimes increased) – 47%
Having difficulties in your home, work or family life – 44%
Low sex drive (loss of libido) – 42%
Feeling guilt-ridden – 37%
Moving or speaking more slowly than usual – 26%
Unexplained aches and pains – 20%
Changes to your menstrual cycle – 14%
Constipation – 10%
None of the above/Don’t know – 5%

The lesser known symptoms of depression were found to be the following:

1 Constipation
2 Changes to your menstrual cycle
3 Unexplained aches and pains
4 Moving or speaking more slowly than usual
5 Feeling guilt-ridden
6 Low sex drive (loss of libido)
7 Having difficulties in your home, work or family life
8 Changes in appetite or weight (usually decreased, but sometimes increased)
9 Finding it difficult to make decisions

The survey results suggest that many people are unaware of the different ways that depression can manifest. Dr Syed Omair Ahmed, a consultant psychiatrist who supports people with depression at Priory Hospital Woodbourne, explains: “All individuals are different. When someone has depression, their different biological, psychological and social makeup affects the symptoms that they experience.”

Dr Ahmed emphasises the importance of understanding all potential symptoms of depression: “When a person is aware of the different symptoms of depression, it puts them in a better position to access treatment faster. When depression is left untreated, a person’s symptoms can worsen and significant health issues can arise.

“Common physical health issues include malnutrition, obesity, heart disease and diabetes. A lack of mobility caused by depression can also cause blood clots to form on the lungs or in the legs. A person may also start to use alcohol or drugs to self-manage symptoms, which can lead to further problems.”

Dr Ahmed has looked closely at the lesser known symptoms of depression and the reasons why they can occur to help increase people’s awareness:

  • Finding it difficult to make decisions – depression can cause certain areas of the brain to decrease in volume and can also disrupt normal ‘electrical connections’. This causes a person’s focus and concentration to diminish, making it difficult for them to make decisions. Depression also leads to sleep disruption and lethargy. This lack of energy can affect a person’s decision-making abilities
  • Changes in appetite or weight – depression can cause changes in our metabolic systems, leading to an increased or decreased appetite. When a person has lower energy levels, they may also be less motivated to prepare food. Conversely, some people may ‘comfort’ eat as a coping mechanism
  • Having difficulties in your home, work or family life – the loss of sleep caused by depression can result in a person becoming irritable, which can impact on those they are close to. A person may also withdraw from others, which can affect relationships. Problems with focus and concentration may also cause work performance to decline, and lead to a demotion or job loss. If a person resorts to self-medicating with alcohol or drugs, this can again exacerbate difficulties at home, work or within the family
  • Low sex drive – people with depression can experience a loss of desire and can experience delayed orgasm. A person’s sexual arousal depends on their ability to experience pleasure. If this is missing due to depression, this will lower their sex drive. Low energy levels and low self-esteem will also contribute to this picture
  • Feeling guilt-ridden – people with depression can struggle to achieve perspective on negative life events. This can make them feel wholly responsible for them, making them feel guilty
  • Moving or speaking more slowly than usual – the slowing of both thought processes and physical movements is a well-established symptom of severe depression. Partly due to decreased energy levels, it is also known that certain chemical and structural changes in the brain can cause this
  • Unexplained aches and pains – people with depression often present with various body ailments including pain. While quite often, there will be no underlying physical cause, the pain and distress is very real. In depression, as emotions are not processed properly, people tend to focus on any physical symptoms they experience rather than underlying emotional problems
  • Changes to your menstrual cycle – during a depressive phase, a hormone called cortisol rises. This sends messages to the brain and the reproductive system, delaying or ceasing ovulation, leading to a delayed or absent period
  • Constipation – if a person’s appetite is adversely affected, and their dietary intake is quite poor, they will lack essential nutrients and fibre. This can lead to bowel disturbances including constipation. Low fluid intake can also worsen constipation. Low serotonin levels in depression have also been shown to slow gut movements

For people who are concerned that they may be experiencing symptoms of depression, Dr Ahmed encourages them to seek help: “Talk to your close friends or family. They can be an invaluable source of support.

“Also, speak to your GP or a psychiatrist, who will be able to help you receive a diagnosis and appropriate treatment. This may include psychological therapy, medication or a referral to specialist mental health services. For additional support, there are mental health charities and organisations that provide people with access to support lines and support groups.”