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Old 16-01-2019, 08:46 PM   #1
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Can you be depressed without feeling sad?

I have lots of the physical symptoms of depression.
Fatigue, low motivation, excessive or little sleeping, no appetite, headaches, digestion problems, thinking about death more.

But I'm not sad, or at least I'm not sad much of the time. I usually feel low when I first get into bed to sleep. Suddent stopping makes me feel sad.
If I'm busy I don't feel sad, but I've not felt happiness for a while either.

Can the physical symptoms of depression manifest without the persistent emotional state?

All my recent blood tests were fine. No change to medication etc.

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Old 17-01-2019, 06:00 AM   #2
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I’d say yes you can. The majority of times that I have fallen into a depression I describe it as having no emotions. I don’t really think I’ve ever felt sad while in a depressive episode.

There have also known of people who have been diagnosed with depression via physical symptoms and no emotional symptoms so to speak.

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Old 17-01-2019, 08:25 AM   #3
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Could it be normal for you during different times a years. If I remember correctly you made a post about this in the past. It doesn’t really sound like depression, feeling low is a must symptom to have depression within the iCD. Could you need more exercise to get some endorphins and it will also help you to get more energy. Have you also looked at your diet and sleep patterns?

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Old 18-01-2019, 12:25 AM   #4
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Short answer, yes.

Usually other things like emotional flatness, lack of interest, etc. can signify a low mood instead of sadness.

That said, sometimes a low mood can be more due to something situational than chemical too.

Here's what I found for DSM criteria (sorry I know you all might use the ICD in the UK) but this seemed to sort of explain things better. It does mention that apathy instead of low mood can be used instead, but also mentions ruling out any other medical issues like you said.

Depression DSM-5 Diagnostic Criteria
The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.

1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
5. Fatigue or loss of energy nearly every day.
6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.

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Old 18-01-2019, 07:45 PM   #5
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Cat - that's interesting to know. Thank you.

R - yes I need to do more exercise. I just can't motivate myself and can't be bothered getting started. It's lazy I know but I can't get myself out to exercise.
My sleep isn't great but it's about as good as it's going to get as I don't have a circadian rhythm. I am medicated to try and force a natural cycle but it's never going to be perfect.

Camden - yes we use the dsm but I thi k it's pretty much the same. Of that list I would tick 2, 4 (periodically), 5, 6, 7, 8 (thoughts, no intentions).

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Old 30-01-2019, 03:30 AM   #6
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Some depressed folks just shutdown emotionally. They felt "too much" and a sort of circuit breaker kicks in.

Physically, I recall you were once diagnosed with fibromyalgia. That can cause all sorts of systemic health problems. The condition can follow depression, trauma etc. Headaches, sore joints, IBS, acid reflux, fatigue etc - you name it.

On a somewhat more esoteric note, there is a growing number of people questioning root canals (I recall you had one). Infections can remain unresolved and hidden (nerves are removed etc). I'm not saying that's a cause in your case, but when it comes to idiopathic distresses it pays to investigate. I was sick for 2 years with an infection (Lyme - an epidemic in NY area) doctors weren't aware of. I had all sorts of things diagnosed until I found the root problem.

Alas, its also true people who were traumatized growing-up often have a lot of physical ailments later on.

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