We know that the experience of significant childhood trauma makes a person more vulnerable to suffering from clinical depression in later life. Whilst depression usually gives rise to both psychological and somatic (i.e. bodily) symptoms, in this article I intend to focus solely on somatic symptoms.
One such symptom of depression is a constant feeling of extreme fatigue; this, at least in part, is linked to the fact that many individuals who suffer from depression have sleep problems. In fact, four out of every five people with depression report suffering from insomnia, whilst a further 15% report a need to sleep excessively. Lack of energy can have a very drastic effect – for example, it can actually significantly slow down how a person moves (walks etc.) on a day-to-day basis; psychologists refer to this as PSYCHOMOTOR RETARDATION.
Furthermore, there is now increasing evidence that those who suffer from depression are also more vulnerable to heart disease (however, the precise reason for this is not yet fully understood).
Osteoporosis, too, is more prevalent amongst those with a history of clinical depression due to the fact that it causes damaging alterations in a person’s bone mass.
Clinical depression can also reduce an individual’s sex drive (i.e. lower libido). Men may experience impotence, often due to an inability to relax during sex. Also, many depressed people feel so emotionally numb that the idea of sex simply loses its appeal.
Many people who are suffering from clinical depression also often report feelings of bodily pain which has no obvious physical cause. For example, people often complain of an oppressive sense of pressure in their head, or pains in their face, neck, chest and stomach.
Indeed, it is thought that about half of people with clinical depression experience physical pain as a result, and, unfortunately, often both they and their doctors do not realize that depression is the underlying problem.
To make matters even more complicated, it is now thought that a large group of individuals with depression show ONLY physical symptoms (sometimes referred to as ‘smiling depression’, as the person does not report feeling especially unhappy), making it even more unlikely that their bodily problems will be attributed to a psychological cause (i.e. to depression).
The physical brain itself, too, can be adversely affected by serious clinical depression – due to the temporary effects of depression on the death and birth of brain cells, some small regions of the brain can actually shrink; also, research suggests that depression causes alterations to the brain’s blood flow in certain regions.
Whilst it used to be thought that physical complaints arising from depression were due to an individual ‘converting’ their emotional symptoms into somatic ones (referred to as ‘somatization‘), the current view is that clinical depression can actually lead to a malfunction of the pain perception pathways (the nerve pathways that are disrupted are thought to involve the neurotransmitters serotonin and norepinephrine – the actions of both of these neurotransmitters are known to be disrupted by depression).
It follows, therefore, that the somatic symptoms of depression are likely to be best treated by anti-depressants that act upon the neurotransmitters referred to in the above paragraph.
David Hosier BSc Hons; MSc; PGDE(FAHE).