First Glance
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Clinical features of depression What are the symptoms of depression? There are numerous symptoms which have been considered to be characteristic of depression. The clinical features are summarized as:
Sadness of mood is considered to be the key symptom of depression. Sadness when severe may be a desire to weep or crying spells. The person feels extremely sad and cannot extract out of it. Though normally when a person feels sad he can cheer himself up by certain activities or thoughts, a depressed person finds this strategy to be ineffective. The depressed person also feels dejected and disappointed. Another characteristic affective feature is the inability to enjoy or derive pleasure from usual activities which gave him pleasure earlier. Similarly, there is a lack of interest in common day-to-day activities, like reading newspapers, watching television, meeting or talking to people etc. The patient describes himself as sad, gloomy, low in spirits, depressed, miserable, as if a black cloud has come over him. In severe cases this dejection is all-pervading and may be completely uninfluenced by the environment. Some patients describe a qualitative difference between their mood and normal sadness. The mood is unpleasant and patients experience a degree of psychic pain which causes them more anguish than the worst of physical pains. They take no pleasure in anything, and their interest becomes narrowed or lost completely. Depressed mood can be distinguished from normal sadness by its persistence, its tendency to come flooding back after momentary distraction, its painfulness, its relative invariance in response to changing circumstances, and the inability of the patient to divert his thoughts to more cheerful thoughts or memories. Depressed mood can be recognized without the accompaniment of a depressed appearance, but the latter will increase confidence that one is dealing with a pathological state. The face looks sad with the corners of mouth and eyes down turned, deepened nasolabial folds and eyebrows drawn together with the medial ends raised obliquely. The forehead shows vertical ridges with horizontal furrows in the centre. There may be tears or an appearance of dry-eyed sadness. The face may seem frozen or stiff in grief .
These usually manifest as bad thoughts about self, about family, and also about the future. The person feels negatively about self, has low self-evaluation and feels worthless. One tends to blame oneself for minor mistakes and many times there is unreasonable feeling of guilt and sole blame. About the future the depressed person feels pessimistic and hopeless. He also feels terribly helpless. He finds it difficult to make decisions and thus keeps procrastinating. He has a poor self-image and there is disturbance of body image. He might get fed up of life and feel life is not worth living. These might subsequently be replaced by suicidal ideas and a death wish. Depressed mood is particularly associated with lowered self-esteem and hopelessness. The patient may merely feel that he is not as good as other people, that he is of less moral value. In more extreme cases he may feel morally worthless. Associated with this feeling is the tendency to feel guilty. Many mildly depressed patients may feel they are to blame for getting themselves into a state and causing trouble to their relatives. This is to be distinguished from pathological guilt, the essence of which is inappropriate self-blame.
A depressed person is slowed down. He has psychomotor retardation. The depressed individual takes a long time to finish his usual tasks like eating food or doing minor activity. He is slow to take care of his personal hygiene and thus might have a poor appearance and poor personal hygiene. On the other hand, sometimes depressed persons are very restless and agitated. They feel very anxious and nervous. Physical or somatic complaints By and large, most depressed patients in our country suffer from somatic complaints when depressed. This is of special significance for general physicians and medical specialists since the depressed patient is likely to consult them first quite naturally due to their physical distress. Multiple aches and pains are common. There is easy fatiguability and feelings of lethargy and tiredness. The person also feels weak and run down. Other somatic complaints like tingling, numbness and prosthesis might also occur. |
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