My observation is that the patient with a depressive illness, on the other hand, looks inwards and does not notice the weeds in the first place. This is an important difference between the two. Reactive depression often follows when the illness has been present for months or years. The intermittency of the tiredness and the mood swings gradually reduce self-confidence, and make any reasonable or reliable social arrangements. Sleep disturbance, which is sometimes major, is the rule.
Muscle pains are extremely common.
They are severe and described as burning, aching, etc. And one patient even described the as though thousands of tiny bubbles were bursting under her skin. While mainly across the neck and shoulders and in the lumber region, they occur all over and are resistant to analgesics. Sharper neuralgic types of pains also occur in attacks. These may occur anywhere but, if on the left side of the chest or left arm, often result in a rushed trip to the hospital in a ambulance.