Survey shows only few Canadians identify painful physical symptoms of depression

New survey results show few recognize the painful physical symptoms of depression

Although the majority of Canadians believe in a mind/body connection, agreeing how they feel physically is related to how they feel emotionally (87 per cent), only half make the link when it comes to depression.

Depression comprises a broad range of emotional/psychological, behavioural and physical symptoms. While the emotional symptoms of depression, such as hopelessness and prolonged sadness are readily identified by the majority of Canadians, a recent phone survey conducted by Harris/Decima finds that only 52 per cent of Canadians can identify its painful physical symptoms including headaches, back pain and other general aches and pains.

"Very often people with depression don't seek help for their condition because they don't connect their physical symptoms with depression," says Phil Upshall, National Executive Director, Mood Disorders Society of Canada. "It is important to pay attention to all possible symptoms of depression, including bodily aches and pains, as these could be physical signs that you could be at risk of sliding into a depressive episode."

The link between pain and depression

Depression may be associated with painful physical symptoms such as back pain or headaches that may have no apparent physical cause. It may also increase one's response to pain, or at least increase the suffering associated with pain. This is because depression and pain have been shown to share common pathways and chemicals known as neurotransmitters within the central nervous system that are involved in controlling both mood and pain.

According to the survey, Canadians associate emotional symptoms such as hopelessness or despair, social withdrawal and prolonged sadness with depression (91, 89 and 88 per cent respectively), but only half (52 per cent) can identify the painful physical symptoms. Meanwhile, although 62 per cent of Canadians say they know most of the symptoms associated with depression, they identify several erroneous physical symptoms such as hair falling out, frequent urination and gas.

Implications for diagnosis

The level of recognition of depression significantly decreases when patients present primarily with physical symptoms, which may have implications for timely diagnosis and appropriate treatment.

"Too often, the sufferer may not be aware of the true source of the painful problem and the depression may go untreated," says Dr. Tom Janzen, a Canadian family physician who specializes in mental health. "The pain is indeed real, but it likely drives many people to orthopedists or other specialists in the mistaken belief that something has gone awry in their body, and there follows an unproductive search for an organic source."

The good news is that 96 per cent of primary care physicians who have treated depression make the link between depression and physical pain, and they have the tools and resources to help Canadians with depression cope. Treatments may include psychotherapy, peer support groups, psychoeducation and medication. Most people treated for depression make a full recovery.

"We're becoming more sensitized that depression may have a physical as well as emotional symptoms," says Dr. Janzen. "Understanding the mind/body connection is pivotal in the treatment of depression. Management of the disorder should address the full range of emotional and physical symptoms in order to achieve remission and reduce the chance of relapse."