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Psychology

Understanding Masked Depression

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Symptoms associated with masked depression

Masked depression is no longer a formal diagnosis, however some people still use it to describe their symptoms. During the period it was recognized, the physical symptoms associated with masked depression included:

  • chronic pain, especially headache, back pain, and joint pain
  • difficulty sleeping
  • rapid heart rate
  • gastrointestinal problems
  • fatigue

Patients formerly diagnosed with masked depression also reported cognitive and behavioral symptoms as well, including:

  • trouble concentrating
  • sexual disfunction
  • lack of energy
  • difficulties in school
  • social withdrawal

The connection between depression and physical symptoms

Depression can cause physical, cognitive, and behavioral symptoms in addition to changes in mood. Researchers estimate, for example, that around two-thirds of those with depression have long-lasting, unexplained physical pain.

Brain scans show that the areas of the brain involved in regulating both emotion and physical pain are disrupted by depression. Depression has also been linked to the production of chemicals called cytokines, which can cause inflammation and pain.

In the same way, depression and sleep disturbance are also connected. Depression can keep you from getting good sleep, and the lack of sleep can lead to deeper depression. Concentration problems and decision-making difficulties are also considered core symptoms of depression.

Similar terms in current use

While masked depression is no longer used as a diagnosis, you may still hear similar terms used today. The term “hidden depression” can be used to describe the experience of someone with depression who doesn’t show it outwardly.

Other clinical terms used to describe this condition today include:

  • somatic symptoms
  • somatoform disorder
  • somatization disorder

People with “masked” depression may function well in their daily lives and appear to be in good mental and physical health — but they’re concealing the physical and mental symptoms of depression. People sometimes call this condition “smiling depression.”

What you can do if you think you have depression

If you’re experiencing depression symptoms, there are steps you can take to feel better physically and emotionally.

Talk with a health professional about all your symptoms. A doctor, nurse practitioner, or physician assistant can prescribe medication to treat the specific symptoms you’re experiencing.

Antidepressant medications can help relieve pain and inflammation. Some antidepressants, taken at the right dose and time of day, may improve sleep. Antidepressant medications can also improve your ability to think, concentrate, and make decisions.

You can also talk with a health professional about other ways to improve depression symptoms, including:

  • psychotherapy
  • physical exercise
  • natural remedies such as St. John’s wort and kava
  • relaxation techniques such as meditation and yoga

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