ABSTRACT
The symptoms of depression and anxiety manifest somatically as well as psychologically. In some cases, they are experienced as bodily symptoms before their psychological origins become evident: this is particularly true for the men in this sample, possibly because men are often less aware than women of their emotional process. We can see the difference between the genders in Lewis Wolpert’s and his wife’s differing views on the trigger for his first depressive breakdown: he attributed it to a new heart drug, she to reminders of his father’s murder (Wolpert, 1999). However, the relationship between the body and the psyche is not clear-cut, and infectious disease and physical pain can independently generate low mood, so that physical illness may be understood as both cause and effect of depression. Cleare (2009) views depression as a condition “exemplifying … the indivisibility of body and mind” (p. 249); thus bodily symptoms, of which the most common are pain and fatigue, can both originate in and generate depression. There is little doubt that in Solomon’s case, physical pain triggered renewed attacks of depression (Solomon, 2014); while for Ann Marie Chiasson, chronic pain from an undiagnosed malformation of one of her kidneys led to her becoming depressed. In her case, her family doctor thought the pain might be a symptom of unacknowledged 48depression, until an organic reason for it was discovered (Chiasson, 2015). For other people such as Kelly (2014) and Wolpert (1999), pain seems indeed to have been an outcome of depression. It turns out that the neural mechanisms underlying the emotional pain of depression and the sensitivity to physical pain are very similar (Wiech & Tracey, 2009). In addition, the part of the brain—the insula—that mediates awareness of body sensations is activated in depression (Wiebking et al., 2010), thus making the individual hyper-aware of body problems.
