How that ache may signal depression

by Carolyn Thomas

There is a disturbing link between women’s heart disease and depression. Those suffering depression are more at risk for developing heart disease, and those diagnosed with heart disease are more at risk for suffering depression. The majority of depressed people never get help, however, partly because they don’t know that, along with emotional changes, their physical symptoms might also be caused by depression. Doctors may miss these symptoms, too:

Headaches: if you’re already prone to migraines, may become worse now

Back pain, muscle aches and joint pain: any kind of chronic pain may worsen

Chest pain: can be a serious sign of heart problems, but also common with depression

Digestive problems: queasiness, nausea, diarrhea, constipation

Exhaustion and fatigue: worn out no matter how much you sleep

Sleeping problems: sleep disruption, insomnia, or you may sleep more than usual

Change in appetite or weight: may lose your appetite, or crave high-carb foods

Dizziness or light-headedness

North Carolina psychotherapist Kristen McClure has this to say about physical symptoms of depression in women:

“This is one of the signs of depression in women that is not well studied or understood. Our body and our mind are really not separate. When we are depressed or anxious, our body may get physically ill, and may ache or hurt in ways that we can’t quite explain.

“It is not surprising that efforts to work on this division between mind and body such as meditation, physical exercise and yoga are now components of effective treatment for depression.”

She adds that, just as depression can manifest in physical symptoms, physical exercise has been shown to be surprisingly helpful for those diagnosed with depression.

“One of the most compelling studies done by Blumenthal* of Duke University Medical Center randomly assigned women to take medicine or exercise as treatment for mild to moderate depression, and found almost equal positive results.

“This means that women on antidepressants and women who exercised experienced equal relief from their symptoms.”

Here are some other suggestions for getting through depression:

Pace yourself. Don’t expect to do everything you normally can. Set a realistic schedule.
Don’t believe all of your negative thinking, such as blaming yourself, feeling hopeless or expecting to fail. This thinking is part of depression. These thoughts will go away as your depression lifts.
If you can, get involved in activities that make you feel good or make you feel like you’ve achieved something.
Social supports such as family, friends and support groups can be very beneficial.
Put off doing things that you find too difficult at the moment. Avoid making big
life decisions during a depression. If you must make a big decision, ask someone you trust to help you.
Avoid drugs and alcohol. Both make depression worse. Both can cause dangerous side effects or get in the way of letting your medications work.
Try not to get discouraged. It’ll take time for your depression to lift fully. But treatment works for almost everyone.
Exercise! It not only gives you a distraction but also seems to cause a chemical reaction in the body that may make your mood better. Do it as much as you can. Three times a week for 30 minutes to one hour each time is a good goal, but even less can be helpful.

Source: College of Family Physicians of Canada

According to the Canadian Mental Health Association, depressive illness can change the way a person thinks and behaves, and how the body functions. Get help if the following symptoms are severe, last for several weeks, and begin to interfere with your work, family and/or social life:

feeling worthless, helpless or hopeless

sleeping more or less than usual

eating more or less than usual

having difficulty concentrating or making decisions

loss of interest in taking part in normal activities

decreased sex drive

avoiding other people

overwhelming feelings of sadness or grief

feeling unreasonably guilty

loss of energy, feeling very tired

thoughts of death or suicide

And here are even more disturbing facts about depression. We know that women in general are twice as likely to develop depression compared to their male counterparts.

When the former Globe and Mail reporter Jan Wong wrote about her own journey with debilitating depression in the memoir Out of the Blue, she described the life lessons that depression had taught her:

“The big life lessons are that you can have clinical depression and you can get over it. It’s completely treatable. It has an end. Second life lesson: you’ll probably be stronger when you come out of it than you were before. The third life lesson is you’ll probably be happier because you leave it behind and you will find a new life. The fourth lesson: that family matters. Everything else is extra.”

Women’s higher overall risk for depression, according to Dr. Nasreen Khatri of Toronto’s Baycrest Hospital, is likely due to a combination of factors, including:

biological ones like the effects on the brain of hormonal changes during pregnancy

social factors like the multiple roles women tend to play in modern society

psychological ones like different coping styles

Dr. Khatri adds that many middle-aged women today are also working full-time while caring for both their own children and elderly parents, thus increasing stress levels which in turn can lead to depression.

And depression itself appears to make women two times as susceptible to later developing Alzheimer’s disease, for reasons that are not yet entirely clear. What may not be well known is that seven out of 10 new cases are women, ironically, explains Dr. Khatri, the very people who more often than not take on the major responsibility for caring for dementia sufferers.

* Blumenthal et al, “Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder”. Psychosomatic Medicine, 2007; 69: 587-596