Somatic symptoms in depression are not uncommon. There is increased sicidality, poor prognosis, and increased risk of relapse. Neurological and l muscloskeletal symptoms can be explained on basis of increased muscular tension in the body.

An internet search was made using key words muscular tension, SSRIs depression, anxiety, somatic symptoms.

Ninety-eight percent patients reported at least one of somatic symptoms. Forty-five percent reported six somatic symptom. GIT symptoms in 67% patients. Fatigue in 78% % of patients. Weakness in body parts 45% and headache in 43% to 65%. Chest pain more common in male. Patient over 40 showed pain in limbs or joints. Number of symptoms was directly related to severity of depression.

Increased muscular tension is one component of mix anxiety and depression. Main nerves and their branches pass in between muscular bellies. When there is increased muscular tone, it puts extra compression on major nerves and their branches. This will cause dysesthesia in body parts. Stretching of muscles produce pain due to hypoxia. This produces headache, strain neck and backache pain in chest. Fatigue is result of over consumption of energy due to hypertonia. One of their side effect is of SSRIs is muscular hypertonia which will not be very helpful for these symptoms. Drugs like tricyclics, SNRI can have better results when used alone, gabapentine, pregabline tinazidine used as adjunct can alleviate symptoms. Non-pharmacological treatment includes massage, relaxation technique, and warm water therapy.

Somatic symptoms of mix anxiety and depression should be important consideration in its treatment.

The authors have not supplied their declaration of competing interest.