Dr. M. MAQBOOL DAR & DR AJAZ AHMAD SUHAFF
The word “Depression” has become so common in our local parlance that everyone who uses this word seems to know enough about it and significant percentage of population may use this generally to refer to nearly all psychiatric illnesses, but the question is do we really know what depression is exactly and how easy or difficult, is it to diagnose particularly when it may be in a masked or hidden form. Depression is a common illness worldwide and approximately 280 million people in the world are suffering from this illness. It is estimated that 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years. Feeling down every once in a while is a normal in every person’s life but if these feelings persists and lasts a few weeks or months then you may have depression.
Depression has many faces; sometimes people cry and remain aloof and alone, Sometimes people become cranky, irritable, sometimes we may feel hopeless etc. As it can have varied presentation in many ways so it is not always obvious that someone is struggling with it. Some people who seem to have everything going fine with them but beneath they struggle with this debilitating depression. Some people may hide their symptoms of depression or some may deny that they have depression because of the stigma attached to it.
If the conventional/typical symptoms of depression are obvious to the patient or to the family and friends then taking help from the professionals in easier but if the conventional/typical symptoms of depression aren’t obvious then it is very difficult to diagnose and then treat.
When the person does not have conventional/typical symptoms of depression then it is called as Hidden Depression. It is also referred to as “masked depression,” and the symptoms are usually somatic (relating to the body) rather than psychological (relating to the mind). This diagnosis is not an official diagnosis by ICD-10 or DSM-5, but we should know about it as this will help us to recognize the symptoms that aren’t always associated with depression but having underlying depression.
Signs of Hidden Depression
- Unexplained aches and pains—headaches, backache, and musculoskeletal aches
- persistent stomach cramps, nausea, constipation, or diarrhea
- Chronic fatigue or a lack of energy
- Not being able to sleep, sleeping at strange hours, or sleeping excessively.
- Forced happiness. This is because people who hide their symptoms may put on a happy face when in the company of others. Also known as “Smiling Depression”.
- lack of Concentration
- Getting irritable easily.
- Change in appetite.
- Negative or pessimistic approach to the events and situations.Bottom of Form
Why do people hide their depression?
Stigma: someone struggling with depression may still fear being judged or treated differently by others.
Illusion of control: Unfortunately most of the people have this illusion that they can control their symptoms without any help or some think they can treat depression by self medication.
Cultural norms: some societies believe that seeking help is a sign of weakness.
What to do?
It is very important to recognize the signs and symptoms of Hidden Depression. If yes then you have to speak to the Mental Health Professional.
- Meditation
- Exercises
- positive self-affirmations
- Talk to your friends/family.
- Explore your hobbies.
- Eat a balanced diet.
- Adhere to the treatment by Mental Health Professional.
Role of Family/ Care Givers
- Recognize their change in behaviour.
- Encourage them to speak out their emotions
- Encourage them to speak out their problems.
- Help them in recognizing signs of Hidden Depression.
- Encourage them to talk help from professionals.
- Talk to them
- Be with them whenever they need.
- Encourage them for healthy activities like exercise etc., be part of that.
- Encouraging them to socialize with others
Depression is a common and treatable mood disorder that can affect people of all ages, but sometimes, it can be hard to identify. Not everyone who has depression will appear sad, sometimes, the only signs a person may show are physical, such as fatigue, insomnia, or weight changes. If you feel that someone you love is hiding their depression from you, there is a good chance that they are hiding it from themselves, too. So help them and make them aware about the consequences of this illness.
(Dr. M. Maqbool Dar is Professor & Head, Department of Psychiatry, GMC Srinagar. Dr Ajaz Ahmad Suhaff Lecturer Department of Psychiatry, GMC Srinagar)
