Giovanna Spantigati

Reduced libido is one of the first vegetative symptoms to show. In anxiety disorders, on the contrary, patients maintain a discreet sexual functioning.

A depressed person frequently shows reduction of appetite and gastrointestinal symptoms: patients gradually lose all interest in food which seems tasteless, eat less and less to the point of having to be stimulated to eat; they have dry mouth, or complain about bad taste and abdominal fullness. The digestive difficulties and constipation may be due, in addition to antidepressant treatment, to intestinal hypotonia often associated with the clinical picture. Changes in food behavior (less nourishment) can have serious consequences like marked weight loss, states of malnutrition and electrolyte imbalance, which then need real medical emergencies. In some cases there can be hyperphagia with weight gain, due also to the reduction of motor activity.

Sleep disorders are very frequent and insomnia, one of the main manifestations of depression, is characterized by frequent awakenings, especially in the early morning hours. The depressed says he wakes up after a few hours of sleep, not being able to fall asleep again and therefore he is forced to get up several hours earlier than usual time. He spends his periods of wakefulness at night thinking of the misfortunes of his life and the faults of his past. Although insomnia can be mild, the depressed person complains he does not rest. In other cases, the depressive phase may be accompanied by an increase in hours of sleep with hypersomnia, up to a real lethargy. A typical symptom of depression is the alternating day: in the morning the patient feels more depressed and anxious, while as the afternoon and evening come, he shows a slight improvement in symptoms. (Dr. Salvatore Di Salvo) End of Part Four.

Giovanna Spantigati