The somatic manifestations of depression are mainly sleep disturbances, appetite disturbances, decreased sexual function, loss of energy, and non-specific somatic symptoms. Sleep disturbances, mainly difficulty falling asleep and early awakening. Appetite disorders, in which the patient’s appetite decreases or increases significantly. Hypogonadism, which may manifest as a lack of sexual desire and difficulties with orgasm. Decreased energy, patients often feel tired, lethargic and reluctant to see people. Non-specific somatic symptoms may include a generalized pain, peripheral discomfort, and there may be manifestations of autonomic dysfunction, such as panic, shortness of breath, chest tightness, frequent urination, urinary urgency, gastrointestinal discomfort, and possibly dizziness, headache, and specific manifestations of anxiety. There may also be symptoms of autonomic dysfunction and motor restlessness, such as fidgeting, rubbing of hands and feet, shaking of limbs, painful muscle tension, and lip tremor.