In addition to the classic symptoms of depression (disinterest in activities, fatigue, negative thoughts, persistent sadness, lack of pleasure) there are less known but very frequent manifestations that may even be the only expressions of this disease.
Without being an exhaustive list, nine can be mentioned:
1)
Unexplained physical pain without an apparent medical cause, affecting 30% to 60% of patients. There are several possible underlying mechanisms: neurotransmitter imbalance, dysfunction of the Hypothalamus-Pituitary-Adrenal axis, increase in cytokines – which produce widespread chronic inflammation – and amplification in pain perception.
2)
Digestive symptoms for no apparent reason, such as irritable bowel syndrome. It is worth remembering that almost 95% of serotonin – key in regulating mood – is found in the intestinal tract, as well as that the composition and balance of the normal intestinal flora (microbiota) can be modified by the increase of cortisol and other neurotransmitters.
3)
Compulsive shopping or gambling as a kind of self-medication, either because they are trying to fill an emotional void or because they can release dopamine (which is usually decreased in depression), closely associated with pleasure and which these behaviors increase while they are performed.
4)
Abuse of alcohol, tobacco or other substanceswhich are felt necessary to manage anxiety and depression itself, although in reality they all tend to be depressants of the nervous system, which is why after an apparent relief they inexorably worsen the condition.
Depression leads to consuming and taking refuge in the internet.
5)
Excessive internet use, especially in depressed adolescents or young adults, a period of high vulnerability for the emergence of anxiety and depression. It results in a circular mechanism in which depression leads to consuming and taking refuge in the Internet and excessive use of networks induces the generation of depression.
6)
Overeating or binge eating, with which many obese people are actually depressives masked behind being overweight. Depression tends to induce an increase in the consumption of carbohydrates and fats that provide a temporary feeling of well-being.
7)
Memory loss and increased forgetfulnessespecially in older people, either due to the brain changes that depression entails (especially in the hippocampus), due to neurochemical changes or due to social isolation that tends to reduce the mental stimulation necessary for the preservation of memory.
Work addiction may be aimed at escaping sadness.
8)
Risky behaviors or behaviorssince depression causes so much emotional pain that some people seek any form of escape, even if it is dangerous, as a way to risk their life (micro-suicide attempts?).
9)
work addictionwith the aim of escaping sadness or lack of hope by providing a continuous distraction, at the same time that it can offer a sense of rescuing a purpose in life in the midst of general apathy (it may be the reason why the depressed It happens worse on holidays or non-working days).