Depression affects about 3.8% of the entire world's population,¹ making it one of the most common mental illnesses out there. While there's a lot of necessary discussion about how depression makes you feel emotional, it's less common to hear about the ways it hurts people physically.
Here's what you need to know about the physical signs of sadness, with a real answer for all those times you've asked, "Why does my heart hurt when I'm sad?"
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Depression manifests differently for everyone, so don't think there's a one-size-fits-all list of symptoms you have to show in order to be depressed. Some of the most common physical signs of depression include, but aren't limited to:
People who suffer from depression frequently experience a lack of energy, even if they're eating well and getting adequate sleep.²
Pain in your chest due to depression or other stressors is known as stress cardiomyopathy or "broken heart syndrome."³ It's often described as feeling similar to a heart attack, with shortness of breath and a rapid heartbeat frequently coming with it.
Sore muscles and general body pains can be a sign of depression, as the stress that depression creates takes a big toll on your body.⁴
Stomach issues like nausea, acid reflux, and intestinal distress can all be linked back to depression,⁵ with some cases feeling as bad as food poisoning.
When you're depressed, several things are happening inside your body that cause your symptoms.
In broad terms, depression is caused by stress. This makes the brain release a chemical called cortisol.⁷ Cortisol does a lot of different things for the body, but the easiest way to think of it in relation to depression is that it's like activating your "fight-or-flight" reflex.
Being in a constant state of stress like this takes a major toll on the body. For one, stress is directly connected to your gut, so high levels of stress can cause a whole host of digestive and bowel issues.⁸
Stress also tenses your body, wearing you out even when you're not doing anything particularly stressful. It also makes it harder to sleep and makes what sleep you do get much less restful.²
When it comes to broken heart syndrome, this stress causes the heart to stop pumping as much blood. In particular, it's a part called the left ventricle that starts acting up.³ The extra blood that isn't pumped through and out of the heart makes it feel like there's pain or pressure in your chest.
Out of all of the physical depression symptoms, broken heart syndrome probably sounds the scariest. As bad as it hurts, though, broken heart syndrome will usually pass on its own.
Thankfully, episodes don't tend to last that long. To treat this condition, you'll get the best results by treating the depression that started it.
The most common cause of broken heart syndrome during depression is the sudden loss of a loved one.³ Finding techniques to cope with this loss, such as therapy, will help lessen the frequency of episodes as you adjust to life without this person.
You can also try things like meditation to reduce your overall stress. Additionally, exercise improves your heart function and mood,⁶ which can combat the physical damage broken heart syndrome does to your heart and depression itself.
Blood pressure medication may also help treat related symptoms like high blood pressure. The same goes for the anxiety that frequently comes with depression. You can work with your doctor to find the best solution for these issues.
If you need something to deal with the pain (or the general aches and pains that can happen due to depression), over-the-counter pain medication is most likely all you'll need.
If your pain is so great that this doesn't sufficiently help, you may need to contact your doctor.
For the most part, experiencing broken heart syndrome once or twice isn't going to cause you serious harm. It usually goes away on its own, and the mortality rate is extremely low.³
If this is a frequent symptom of your depression, though, that could be concerning. While broken heart syndrome may not be a heart attack, it can do similar damage over a longer period of time.
Extra strain on your heart isn't healthy, so let your doctor know if you're experiencing frequent chest pains from this or anything else. This goes for other symptoms of depression, as well, be they physical or mental.
While depression is a mental illness, its effects aren't all "in your head." For many, depression can manifest as physical pain that takes just as much of a toll on you as the feelings of sadness, hopelessness, and more that we usually hear about.
Depression releases stress chemicals in your brain, which in turn weaken your body. Living under these conditions can severely lower your quality of life.
If you're experiencing physical or mental symptoms of depression, talk with your doctor to get help for what's hurting you.
Depression | World Health Organization
Depression and the brain | Queensland Brain Institute