Can Depression Make You Physically Sick?

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Depression is a mental health condition that causes sadness and low mood. We associate symptoms such as feeling down and losing interest in activities with depression, but depression can come with a host of physical symptoms as well.

Read on to see how depression can make you feel sick with symptoms like fatigue, pain, digestive issues, sleep disturbances, and more. Fortunately, treatment can help—learn what it is and when to see a healthcare provider.

An illustration of a depressed person, sitting in bed and looking out of the window.

Illustration by Joules Garcia for Verywell Health

What Is Depression?

Depression is a mental health condition that affects how well a person can function in daily life. Biochemistry, genetics, personality, and environmental factors are believed to play a role in its development.

People with major depressive disorder experience symptoms that greatly affect their previous level of functioning and last at least two weeks. Many of the symptoms are psychological, including persistent feelings of sadness, irritability, a lack of motivation, trouble concentrating, and a loss of enjoyment. But depression can also have physical symptoms such as fatigue, sleep difficulties, and gastrointestinal problems.

Physical Symptoms of Depression

Depression is associated with a wide array of physical symptoms.

Fatigue or Low Energy

Fatigue is a very common symptom of major depressive disorder, affecting over 90% of people with the condition.

Fatigue can be divided into three subcategories:

  • Physical: Symptoms include tiredness, decreased activity, low energy, reduced physical endurance, requiring more effort to do physical tasks, general weakness or slowness, and poor quality sleep.
  • Cognitive: Symptoms include difficulty concentrating, decreased attention, reduced mental endurance, and slowed thinking.
  • Emotional: Symptoms include feeling less motivated, apathy, decreased interest, feeling overwhelmed, feeling bored, and feeling low.

These feelings of exhaustion may be related to:

  • The psychological toll of depression
  • Changes in the levels of neurotransmitters dopamine, norepinephrine, and serotonin that affect energy levels
  • Sleep difficulties commonly associated with depression

Fatigue can also be a side effect of some medications used to treat depression, such as tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

Pain

Unexplained aches and pains, including headaches, back pain, joint pain, and muscle pain, commonly occur with depression. These pains can range from mild to severe enough to impact a person's functioning. The connection is thought to occur because depression and pain share the same nerve pathways and brain chemicals.

Some studies have shown that the worse the physical pain symptoms, the more severe the depression is.

A small study of 54 people, completed in 2015, found that people with major depressive disorder had a lower pain threshold and pain tolerance than their healthy counterparts.

A larger 2017 study suggests that people experiencing depression are approximately 60% more likely to develop back pain in their lifetime than those who do not experience depression. In addition to depression increasing the likelihood of back pain, persistent low back pain was also shown to increase the risk of developing depressive symptoms.

Sleep Difficulties

About 90% of people with depression report some sleep issues. Depression can cause sleep disturbances such as:

  • Difficulty falling asleep
  • Poor quality sleep
  • Getting fewer hours of sleep
  • Daytime tiredness
  • In some cases, very early morning awakening without being able to fall back to sleep
  • Restless legs syndrome

Sleep studies of people with depression have revealed disturbances throughout the sleep cycle. The lack of good quality sleep can impact other depression symptoms such as difficulty concentrating and pain.

Gastrointestinal Symptoms

Depression can cause digestive issues, such as:

The brain has a direct connection to the gastrointestinal tract, making the stomach and intestines sensitive to emotion. The digestive tract can also send signals to the brain. A stomachache may contribute to or be the result of depression, anxiety, or stress.

Cardiovascular Effects

Studies have shown that depression can increase the risk of cardiovascular disease, particularly for those who experience more severe depression symptoms.

This increased risk may be explained, at least in part, by lifestyle habits associated with depression. Certain lifestyle factors that can increase cardiovascular risk tend to be more common in people with depression, including:

  • Smoking
  • Alcohol and substance use
  • Physical inactivity
  • Poor nutrition

Psychomotor Symptoms

A majority of people with depression experience a slowdown in cognitive and motor processing. Studies have found that people with depression display motor symptoms such as slower walking, reduced range of motion, and body swaying.

Slowed psychomotor activity can affect:

  • Speech: A person's speech may have more pauses, be quieter, have less articulation, be more monotonous, and involve delayed responses in conversations.
  • Eye movement: A person may have reduced eye contact or a fixed stare.
  • Facial movement: A person may appear to maintain a flat expression and not react to emotion.
  • Bodily movement: The body may move more slowly, and there may be difficulty with fine motor tasks such as writing, manipulating buttons, or handling money. The person may feel "weighed down" when walking or changing positions and have a slower reaction time. There may also be an increase in purposeless movement, showing as difficulty sitting still, pacing, or fidgeting.

Changes in Appetite

Depression can cause appetite changes and weight loss or weight gain. Depression symptoms such as exhaustion can make meal planning and cooking more difficult. This may make it harder to maintain a nutritious diet.

Depression is also associated with changes to the hormone cortisol, which can affect stress levels. This may lead to "emotional eating," in which a person eats in response to negative emotions. The foods people turn to when emotionally eating tend to be energy-dense and enjoyable to eat.

Reduced Sex Drive

While most people experience fluctuations in sex drive, some people with depression lose their desire for sex completely. This can be due to the lack of energy seen in depression, or the lack of desire to engage in activities a person once enjoyed.

Sexual dysfunction can be difficult or embarrassing to discuss, but if you are experiencing a severe decrease in sex drive that is affecting you or a partner, talk about it with your healthcare provider.

Psychological Symptoms of Depression

Some psychological symptoms of depression include:

  • Persistent low mood or sadness
  • Feelings of helplessness, guilt, and/or hopelessness
  • Irritability
  • Feeling "teary" or crying
  • Lack of motivation
  • Disinterest or lack of enjoyment in things
  • Difficulty making decisions
  • Thoughts of suicide or self-harm

How Are the Physical Symptoms of Depression Diagnosed?

A healthcare provider will likely do an exam and run tests to see if your symptoms may be caused by a physical condition, such as thyroid problems.

If a physical cause is ruled out, your provider will ask about your general health and family history, physical and mental symptoms, and other information that can help them make a diagnosis.

If depression is diagnosed, your healthcare provider will discuss ways in which to manage symptoms, including physical ones.

What Comes First?

Many of the physical symptoms associated with depression can either contribute to depression or be caused by depression. It can sometimes be difficult to tell which came first. Discuss your symptoms with your healthcare provider to find an accurate diagnosis and the most appropriate course of treatment.

When to See a Healthcare Provider

If you experience symptoms of depression—whether psychological, physical, or both—schedule an appointment with your healthcare provider.

Getting a proper diagnosis is the first step in managing depression. From there, you can work with a healthcare provider or mental health professional to find a treatment plan suited to your needs.

If you notice signs of depression in someone else, you can help them by offering patience, understanding, and help. Recognize that depression is an illness, not someone being "difficult." Encourage them to seek professional help and support them in doing so.

Help Is Available

If you or someone you know are having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. If you or a loved one are in immediate danger, call 911. For more mental health resources, see our National Helpline Database.

How Depression Is Treated

A healthcare provider will work with you on a treatment plan suited to your needs. You may be recommended psychotherapy, medication, or both.

Depression treatment is highly personal, and it's normal to test different approaches and medications—try not to get discouraged if your symptoms don't get better right away. Fortunately, there are many therapeutic options available, even for the most severe cases. If you feel like your symptoms aren't improving enough, you may have the option of brain stimulation therapy further into your treatment.

Here's what your healthcare provider may recommend.

Medications

Antidepressants come in many types and your healthcare provider will carefully consider your full health and family history to select the right prescription. Medications typically improve your mood symptoms within four to eight weeks and are prescribed for six to 12 months, though some people take them for much longer.

Antidepressants are typically well-tolerated. You may experience mild side effects like nausea and sleepiness, but these can get better over time. Make sure to speak to a healthcare provider before stopping the medication due to side effects—stopping suddenly can cause additional symptoms.

Psychotherapy

You can learn important behavioral and cognitive skills in talk therapy, and there are many approaches. For example, cognitive behavioral therapy (CBT) is a common approach that helps you become more aware of your thoughts and address harmful thinking patterns. Other types of talk therapy can also help you gain awareness and develop healthy habits.

Summary

Depression is a mental health condition characterized by sadness and low mood or energy. In addition to psychological symptoms, depression is associated with physical symptoms such as fatigue, gastrointestinal problems, and sleep problems. People experiencing physical symptoms should discuss them with their healthcare provider.

19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Psychiatric Association. What is depression?.

  2. National Health Service. Symptoms - clinical depression.

  3. Ghanean H, Ceniti AK, Kennedy SH. Fatigue in patients with major depressive disorder: prevalence, burden and pharmacological approaches to management. CNS Drugs. 2018;32(1):65-74. doi:10.1007/s40263-018-0490-z

  4. Targum SD, Fava M. Fatigue as a residual symptom of depression. Innov Clin Neurosci. 2011;8(10):40-43.

  5. Marsala SZ, Pistacchi M, Tocco P, et al. Pain perception in major depressive disorder: A neurophysiological case–control study. Journal of the Neurological Sciences. 2015;357(1):19-21. doi:10.1016/j.jns.2015.06.051

  6. Robertson D, Kumbhare D, Nolet P, Srbely J, Newton G. Associations between low back pain and depression and somatization in a Canadian emerging adult population. J Can Chiropr Assoc. 2017;61(2):96-105.

  7. Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatmentJ Cell Mol Med. 2019;23(4):2324-2332. doi:10.1111/jcmm.14170

  8. Riemann D, Krone LB, Wulff K, Nissen C. Sleep, insomnia, and depressionNeuropsychopharmacology. 2020;45(1):74-89. doi:10.1038/s41386-019-0411-y

  9. Harvard Health. The gut-brain connection.

  10. Seldenrijk A, Vogelzangs N, Batelaan NM, Wieman I, van Schaik DJF, Penninx BJWH. Depression, anxiety and 6-year risk of cardiovascular diseaseJournal of Psychosomatic Research. 2015;78(2):123-129. doi:10.1016/j.jpsychores.2014.10.007

  11. Penninx BWJH. Depression and cardiovascular disease: Epidemiological evidence on their linking mechanismsNeuroscience & Biobehavioral Reviews. 2017;74:277-286. doi:10.1016/j.neubiorev.2016.07.003

  12. Janzing JGE, Birkenhäger TK, van den Broek WW, Breteler LMT, Nolen WA, Verkes RJ. Psychomotor retardation and the prognosis of antidepressant treatment in patients with unipolar psychotic depressionJ Psychiatr Res. 2020;130:321-326. doi:10.1016/j.jpsychires.2020.07.020

  13. Bogdanova D. Gait disorders in unipolar and bipolar depressionHeliyon. 2023;9(5):e15864-e15864. doi:10.1016/j.heliyon.2023.e15864

  14. Konttinen H, van Strien T, Männistö S, Jousilahti P, Haukkala A. Depression, emotional eating and long-term weight changes: a population-based prospective study. Int J Behav Nutr Phys Act. 2019;16(1):28. doi:10.1186/s12966-019-0791-8

  15. Johns Hopkins Medicine. Low sex drive - could it be a sign of depression?.

  16. National Health Service. Diagnosis - clinical depression.

  17. National Institute of Mental Health. Depression.

  18. MedlinePlus. Antidepressants.

  19. National Institutes of Mental Health. Psychotherapies.

By Heather Jones
Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability, and feminism.