Most people with depression also have somatic symptoms such as sleep disturbances, pain, fatigue, upset stomach, poor appetite, panic and shortness of breath, and symptoms of various systems. Patients with insidious depression often do not have typical symptoms such as depressed mood, but have predominantly somatic discomfort. It is characterized by multiple symptoms but is dominated by headaches, insomnia, and especially a tendency to wake up early.
In addition, there is a circadian rhythm of heavy daytime and light nighttime, and a seasonal pattern of heavy spring and fall but light summer, and there is more anxiety, which is exacerbated during menstruation in female patients.
One should be alert to some of the following alarm signals:
1. Often feel bitter and sad for trivial things, even for no reason.
2. Losing interest in past hobbies, even hobbies, and daily activities, and being listless all day long.
3. Life becomes lazy, unkempt, easy-going, and unmotivated.
4. Chronic insomnia, especially characterized by early awakenings, lasts for weeks or even months.
5. The mind becomes slow to respond and has difficulty deciding on matters.
6. Always feel low self-esteem, often blame themselves, always regret the past, and lose confidence in the future.
7. Feeling suspicious, always suspecting that you are seriously ill, and despite constant tests, it is still difficult to clear your doubts.
8. Memory loss, often missing things.
9. Bad temper, impatience, and difficulty concentrating.
10. Often feel panicky and anxious inexplicably.
11. Frequent anorexia, nausea, bloating or diarrhea, or symptoms such as stomach pain, but no obvious organic changes on examination.
12. Some patients have loss of appetite and weight loss without obvious cause.
13. Frequent fatigue, low energy, and inability to do things well.
14. Mental indifference, difficulty taking interest in everything around them, and reluctance to talk or do anything.
15. Feeling headache, back pain, body pain, but no organic cause can be found.
16. Significantly reduced social activity, reluctance to interact with friends and family, or even living behind closed doors.
17. Loss of interest in sexual life.
18. Often you can’t help but feel empty and that you have no value or meaning in your life.
19. Often think about topics related to death.
If any of the above 19 items are particularly severe, or if several of them occur at the same time, it is likely to be a sign of a depressive episode and you should be alert.