II. Physical symptoms
Psychological symptoms are always associated with certain physical symptoms in depression. The symptoms have to be present everyday consistently for a minimum period of two weeks.
- Sleep disturbances Both loss of sleep and excessive sleep are seen in depression, but loss of sleep in more common. One may find it difficult to get to sleep after he retires to bed and may lay awake till late in the night. Others may have a restless night with frequent awakenings in the night. Many others may be able to sleep at night but wake up early in the morning. Besides the amount of sleep, the quality of sleep is also affected. They describe their sleep as non restorative and unsatisfactory and hardly feel fresh in the morning. Some individuals with depression may complain of excessive sleep and find it difficult to leave the bed. At the same time they complaint that they are not fresh after the sleep.
- Appetite disturbance Loss of Appetiteis more common then excessive appetite. Depressed people are not able to enjoy good food and neither do they feel like having the food. They frequently skip their meals and take the diet in lesser amount. Weight loss is often reported in long standing cases. Increased appetite with cravings for certain foods and weight gain is also seen in some cases of depression.
- Loss of Libido (sexual activity and interests) It is affected early in depression. Both men and women are affected. The person does not show any interest towards the sexual advances of the partner and this may affect the married life.
- Loss of energy and tiredness They complain of early fatigue after small amount of exertion and they appear tired even without any exertion. They have to put up a lot of effort even for a small task. They lack initiative to start any work and tend to leave jobs unfinished as they lose interest in them half way.
- Restlessness and anxiety Some of the depressed people are always in the state of restlessness. They are not able to relax and are breathless, feel their hearts thumping and find their limbs numb / cold.
- Aches and pains Headache, stomachache, backache and other forms of joint pain are frequently reported by the depressed person. Usually such aches and pain are not relieved by conventional pain killers.