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7 Physical Symptoms That Prove Depression Is Not Just ‘In Your Head’

Managing Depression

Updated July 31, 2023

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by Juli Fraga


Medically Reviewed by:

Nicole Washington, DO, MPH


by Juli Fraga


Medically Reviewed by:

Nicole Washington, DO, MPH


We don’t always pair depression with physical pain but research shows depression can really hurt. Depression can cause body aches, stomach pain, and more.

Depression hurts. And while we often associate this mental illness with emotional pain like sadness, crying, and feelings of hopelessness, research shows that depression can manifest as physical pain, too.

While we don’t often think of depression as physical pain, some cultures do — especially those where it’s “taboo” to openly talk about mental health.

Different cultures may understand depression differently. For example, Asian American people may be more likely to describe and understand depression as physical symptoms. This can influence what treatment they seek and who they seek it from. This is compared with Western understandings of depression as primarily an internal mood experience.

But keeping these physical symptoms top of mind is just as important as the emotional effects.

For one, it’s a great way to keep in check with your body and mind. Physical symptoms can signal when a depressive period is about to begin or clue you in to whether or not you may be experiencing depression.

Physical symptoms demonstrate that depression is, in fact, very real and can be detrimental to our overall well-being.

Here are seven of the most common physical symptoms of depression:

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1. Fatigue or consistent lower energy levels

Fatigue is a common symptom of depression. Occasionally we all experience lower energy levels and can feel sluggish in the morning, hoping to stay in bed and watch TV instead of going to work. Depression fatigue is more consistent and severe than this occasional dip in energy.

While we often believe exhaustion stems from stress, depression can also cause fatigue. Depression-related fatigue can cause concentration problems, feelings of irritability, and apathy.

Dr. Maurizio Fava, Director of the Clinical Research Program at Boston’s Massachusetts General Hospital, points out that depressed individuals often experience nonrestorative sleep, meaning that they feel sluggish even after getting a full night of rest.

However, because many physical illnesses, like infections and viruses, can also cause fatigue, it can be challenging to discern whether or not the exhaustion is related to depression.

One way to tell: While everyday fatigue is a sign of this mental illness, other symptoms like sadness, feeling hopeless, and anhedonia (lack of pleasure in day-to-day activities) may also be present when you’re depressed.

Another challenge is that even during treatment, fatigue can be a residual symptom that continues to pose a challenge. If you’re treating your depression but still struggling with fatigue, try speaking with your doctor about options to address this symptom.

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2. Decreased pain tolerance (aka everything hurts more)

Does it ever feel like your nerves are on fire, and yet you can’t find any physical reason for your pain? As it turns out, depression and pain often co-exist.

One 2015 study showed a correlation between people who are depressed and decreased pain tolerance, while another study in 2010 showed that pain has a greater impact on people who are depressed.

These two symptoms don’t have a clear cause-and-effect relationship, but it’s important to evaluate them together, especially if your doctor recommends medication.

Some research suggests that using antidepressants may not only help relieve depression but can also act as an analgesic, combatting pain.

3. Back pain or aching muscles all over

You might feel OK in the morning, but once you’re at work or sitting at a school desk, your back starts to hurt. It could be an uncomfortable chair, it could be stress, or it could be depression. Although they’re often associated with bad posture or injuries, backaches can also be a symptom of psychological distress.

A 2017 research study of 1,013 Canadian university students found a direct association between depression and backaches.

Psychologists and psychiatrists have long believed emotional issues can cause chronic aches and pains, but the specifics are still being researched, such as the connection between depression and the body’s inflammatory response.

Newer studies suggest that inflammation in the body may have something to do with the neurocircuits in our brain. It’s thought that inflammation may interrupt brain signals and therefore may have a role in depression and how we treat it.

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4. Headaches

Almost everyone experiences occasional headaches. They’re so common that we often write them off as nothing serious. Stressful work situations, like conflict with a co-worker, can even trigger these headaches.

However, your headache might not always be induced by stress, especially if you’ve tolerated your co-worker in the past. If you notice a switch to daily headaches, it could be a sign of depression.

Unlike excruciating migraine headaches, depression-related headaches don’t necessarily impair one’s functioning. Described by the National Headache Foundation as “tension headaches,” this type of head pain may feel like a mild throbbing sensation, especially around the eyebrows.

While these headaches are helped by over-the-counter pain medication, they typically reoccur regularly. Sometimes chronic tension headaches can be a symptom of major depressive disorder.

However, headaches alone aren’t an indication that your pain may be psychological. People with depression often experience additional symptoms like sadness, feelings of irritability, and decreased energy.

5. Changes in vision

Do you find that the world looks blurry? While depression may cause the world to look gray and bleak, several studies suggest that this mental health concern may actually affect the way you see the world.

A 2021 study with 140 people participating found that depressed individuals had reduced contrast suppression. When viewing an object on a textured background people with depression tested lower than controls.

Researchers noted that this is likely not due to a change in eyesight but tied to how the brain processes the information coming from the eyes. This might explain why depression can make the world look hazy.

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6. Stomach pain or uneasiness in the abdomen

That sinking feeling in your stomach is one of the most recognizable signs of depression. However, when your abdomen starts to cramp, it’s easy to write it off as gas or menstrual pain.

Pain that worsens, especially when stress arises, may be a sign of depression. In fact, an article published by Harvard Medical School suggests that stomach discomfort like cramps, bloating, and nausea may be a sign of poor mental health.

What’s the link? According to the article, depression can cause (or be a result of) an inflamed digestive system, with pain that’s easily mistaken for illnesses like inflammatory bowel disease or irritable bowel syndrome.

Doctors and scientists sometimes refer to the gut as the “second brain,” because they have found a connection between gut health and mental well-being. Our stomachs are full of good bacteria and if there’s an imbalance of good bacteria, symptoms of anxiety and depression may arise.

Eating a balanced diet and taking probiotics can improve your gut health, which may also enhance mood, but further research is needed.

7. Digestive problems or irregular bowel schedules

Digestive problems, like constipation and diarrhea can be embarrassing and uncomfortable. Often caused by food poisoning or gastrointestinal viruses, it’s easy to assume that gut discomfort stems from a physical illness.

But emotions like sadness, anxiety, and overwhelm can also disrupt our digestive tracts.

As with many of the other symptoms discussed, the link between depression and digestive problems appears to be bi-directional, and while research notes an elevated risk of experiencing one if diagnosed with the other, it’s unclear exactly how they’re connected.

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Pain is another way your brain communicates

If you feel discomfort identifying and talking about distressing emotions, like sadness, anger, and shame, this could cause feelings to manifest differently in the body.

If you’re experiencing any of these physical symptoms for a prolonged period of time, make an appointment with your primary care doctor or nurse practitioner.

Depression can be caused by a variety of factors, such as genetics, exposure to childhood stress or trauma, and brain chemistry. People with depression often need professional help, like psychotherapy and medication, to fully recover.

So, at your appointment, if you suspect these physical symptoms might be more than surface level, request to be screened for depression and anxiety. This way your healthcare pro can connect you with the help you need.

Read this article in Spanish.

Originally written September 10, 2018

Medically reviewed on July 31, 2023

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About the author

Juli Fraga

Dr. Juli Fraga is a psychologist and writer in San Francisco who’s committed to writing practical, evidence-based mental health content to help readers live life well. Follow her on Twitter.

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