Surprising Sources of Depression

1. Achy joints and other unexplained pain

Often people notice that they don't feel well, or that something hurts and don't connect it with depression. "But headaches, back pain, stomach aches, and joint discomfort are actually common signs," says psychiatrist Scott Haltzman, MD, medical director of NRI Community Services in Rhode Island. "And they often resolve when the depression gets better."

2. Gut reaction

Changes in your bowels (constipation or having to use the bathroom more than usual) are telltale signs of anxiety, which in itself is a stealth symptom of depression. This is especially true of women, says Haltzman.

3. Diving into work

Some people stop functioning and don't get out of bed. Others do the opposite, says Philip Muskin, MD, professor of clinical psychiatry at Columbia Unversity, which is one of the screening sites. "Often people push themselves as hard as they can, physically and emotionally—into work, training for a marathon. It's as if they're fighting the depression." While a hard worker might just be trying to score a promotion, Muskin says, when fueled by depression, the drive doesn't have that clear goal.

4. Interviewing, but not getting the job

When you're trying to get hired, depression is an insidious handicap, leeching you of the energy, warmth, and can-do spirit a person hiring wants to see. You may not realize you're running on a low battery, but it's as if the disease creates a palpable apathy. "From the interviewer's perspective," says Muskin, "there's a very real difference when you look somebody in the eye and he doesn't really look back, or his voice doesn't have that quality of I'm really excited to be here, because he's not excited about anything." Also, Muskin points out, when you're depressed it's harder to dress and put yourself together in a way that says, "Hire me."

5. Paranoid thoughts

Haltzman says in about 10 percent of cases, depression may include delusional thoughts. "I had a very bright patient with a PhD," he says, "and she began to think that someone had planted the wires in her house to spy on her." The delusions may take the form of thinking you have a fatal illness. Being convinced you have Alzheimer's, for example, can be a red flag for depression, Haltzman says, because those who actually suffer from it generally aren't aware they're losing their memory.