Is crying a symptom of depression
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Crying as a Symptom of Depression: An Analysis
Crying and Depression Diagnosis
Crying is often associated with sadness, and it might be expected to be a common symptom in depression. However, major psychiatric textbooks and literature reviews do not consistently list crying as a symptom of depression1. This suggests that while crying can occur in depression, it is not a definitive diagnostic criterion.
Crying Frequency and Intensity in Depression
Empirical studies have tested the assumption that depression is linked to frequent and intense crying. Surprisingly, research indicates that crying is not more likely in depressed individuals compared to non-depressed individuals. Moreover, the emotional activation typically associated with crying, such as increased sadness and physiological responses, is less evident in those with depression2. This points to a potential dysregulation of emotional responses in depressed individuals.
Gender Differences in Crying and Depression
Crying is a gendered behavior, with women generally crying more than men. This gender difference complicates the use of crying as an indicator of depression. Men may exhibit other symptoms, such as aggression and irritability, more frequently than crying. Therefore, including crying as a diagnostic criterion for depression could introduce gender bias, potentially leading to underdiagnosis in men3.
Crying in Hospitalized Patients
In a study of hospitalized patients, crying was a prominent symptom in those referred for psychiatric consultation. However, the underlying causes varied, with some patients having psychiatric disorders, others neurological disorders, and some both. The most common psychiatric disorder among these patients was major depression, indicating that while crying can be associated with depression, it is not exclusive to it and can be caused by other conditions4.
Mood Disorders and Crying Behavior
Patients with mood disorders, including depression, report increased crying in response to negative stimuli compared to non-depressed individuals. However, they do not report increased crying in response to positive stimuli. Additionally, depressed individuals report less mood improvement after crying, suggesting that while crying frequency may increase, its emotional benefits are diminished in depression5.
Postpartum Depression and Crying
Postpartum depression (PPD) is associated with increased crying, and this symptom correlates with higher levels of monoamine oxidase-A (MAO-A) in the brain. This enzyme's increased density in certain brain regions during PPD suggests a biological underpinning for the predisposition to crying in these patients6. However, educational interventions aimed at reducing postpartum depression by addressing infant crying have shown mixed results, indicating that while crying is a symptom, it is not easily modifiable through simple educational means8 9.
Crying and Emotional Relief
The relationship between crying and emotional relief is complex. While crying is often thought to bring relief, studies show mixed results. Some individuals experience mood improvement after crying, while others do not. This variability suggests that the context and individual differences play significant roles in whether crying alleviates depressive symptoms7 10.
Conclusion
Crying can be a symptom of depression, but it is not a definitive or exclusive indicator. Its presence and implications vary widely among individuals and are influenced by gender, underlying neurological conditions, and the specific context of the depressive episode. Therefore, while crying may be associated with depression, it should be considered alongside other symptoms and diagnostic criteria to avoid bias and ensure accurate diagnosis.
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Most relevant research papers on this topic
Crying in Depression
Crying is not included as a symptom of depression in major textbooks, despite its common association with sadness.
Crying threshold and intensity in major depressive disorder.
Crying is not more likely in depressed individuals, and crying-related emotional activation is less evident in depressed individuals, suggesting emotions are dysregulated in this disorder.
Non-RCT
Highly CitedCrying as a Gendered Indicator of Depression
Crying should be removed from depression diagnostic criteria due to its gendered status, as it may introduce a gender bias in assessment.
A study of crying in medically and surgically hospitalized patients.
Crying in hospitalized patients can be caused by a variety of neurological and psychiatric disorders, and effective therapy depends on proper identification of the cause.
Observational StudyDo mood disorders alter crying? a pilot investigation
Mood disorders increase the frequency of negative emotional crying and may alter the functions of this behavior, with male patients experiencing greater impact than female patients.
Observational StudyRelationship of Monoamine Oxidase-A Distribution Volume to Postpartum Depression and Postpartum Crying
Greater MAO-A VT in the prefrontal and anterior cingulate cortex is associated with postpartum depression and predisposition to crying, suggesting potential strategies for preventing PPD and its symptoms.
Observational Study
Very Rigorous JournalHighly CitedCrying and health: Popular and scientific conceptions
Crying may provide relief and facilitate emotional recovery, but more systematic and well-designed studies are needed to clarify the relationship between crying and health issues.
Systematic ReviewPreventing postpartum depression using an educational video on infant crying
Watching an educational video on infant crying within 1 week of delivery did not significantly reduce postpartum depression, but was effective for young mothers aged 25 years.
RCT
Large Human TrialPreventing Early Infant Sleep and Crying Problems and Postnatal Depression: A Randomized Trial
An education program reduces postnatal depression symptoms and sleep and cry problems in infants who are frequent feeders, with potential benefits for frequent feeders.
RCTLarge Human TrialHighly CitedMood following emotional crying: Effects of the situation
Crying after watching a film does not necessarily reduce subsequent depressed mood, but it may influence thought focus on the movie.
Non-RCT