Feeling sad, depressed, losing your taste for life… These symptoms are known, they are those of depression. But others, more insidious, can mask the reality of this psychological illness, especially when we are in denial. How to spot the signs of “masked depression” in yourself or a loved one? A psychologist responds to the evening edition.
Depression is a much more common illness than we think. According to the figures from Public Health France from a 2021 survey, one in eight people experienced severe depression in the previous twelve months, among French people aged 18 to 85. That’s around six million people.
But that’s just the tip of the iceberg. In 2007, for example, the same organization estimated that eight million people suffered from depressive symptoms without having been diagnosed as such. A part of the population could therefore experience what is called “masked or hidden depression”. Relatives, colleagues or friends, for whom everything seems to be going well, but whose “social mask” hides real discomfort. And they themselves are often not aware of it.
But what is it exactly? And how can we recognize this psychological illness when we do not feel the most obvious signs? Aline Nativel Id Hammou,pclinical psychologist and psychotherapist practicing in Nanterre (Hauts-de-Seine), explains to the evening edition what hidden depression hides.
Read also: What is smiling depression, this mask of happiness which hides deep unhappiness?
What is hidden or masked depression?
Feeling sad, depressed, losing interest in most daily activities… These are the symptoms of “classic depression”. These known signs generally make it easy to establish a diagnosis. Masked depression is by definition much more difficult to identify. “In this case, the classic symptoms are repressed by a defense mechanism, they arrive in sublayers and the patient is not really aware of them”explains Aline Nativel Id Hammou.
This is the phenomenon of psychosomatization: the person experiences difficulty becoming aware of their psychological pain and has difficulty verbalizing them. It is then the body which takes over by emitting warning signals. “But there are no clear physiological symptoms, continues the specialist. You can do a lot of clinical evaluations in the lab, it won’t do anything because you are fine physiologically speaking. »
Why do we repress this depression?
In most cases, this is a consequence of the defense mechanism of denial. “Becoming aware that you have depressive symptoms is not that easy. It is a pathology linked to mental health which can be frightening. » Especially since we can have difficulty accepting the image of vulnerability and fragility that this illness reflects of us, in the outside world.
According to the specialist, the denial characterizing masked depression comes from “the fear of collapsing, of becoming aware of these symptoms and of others seeing them”. The person unconsciously prefers to wear a “social mask”.
Daily life obligations can also play a role in this phenomenon. Having to manage their children and their professional missions, for example, encourages the person to “stay up and pretend to be fine”.
Read also: Do you know the 85 method, presented as a “miracle solution” to burn-out?
What are the symptoms of hidden depression?
1. Feeling recurring physical pain
Due to psychosomatization, certain parts of the body are frequently painful. “The most classic symptoms are headaches, which sometimes lead to consulting a neurologist, but also back or stomach pain. » Faced with psychological discomfort, the body can also react in the form of muscle cramps, digestive disorders, heartburn, breathing difficulties, hot flashes, dizziness, etc.
2. Being prone to mood swings
Being irritable, having angry outbursts… The excessive and recurring manifestation of these negative emotions can also be a sign of suffering, which is not necessarily easy to diagnose. “It can be interpreted by those around you as hypersensitivity or bad temper, because there is no clear expression of sadness associated with classic depression”warns the psychologist.
3. Being exhausted, not sleeping well
Faced with the hectic pace of daily life, exhaustion and fatigue are not always associated with depression. “But they can mask a well-known symptom of this disease, which is loss of motivational drive. We don’t tell ourselves that we are tired because we don’t want to do things as much. » Not sleeping well or, on the contrary, sleeping too much, can also alert us.
4. Consuming “stimulants” in large quantities
To stay upright, the person may tend to consume excessively coffee, energy substances or vitamin C, or even increase their consumption of alcohol, tobacco or even use drugs. “It’s not in the vast majority of cases, but it can happen”notes Aline Nativel Id Hammou.
5. Being anxious
This is the consequence of the “social mask” that the depressed person wears more or less consciously in order not to collapse. This induces stress and anxiety. “And that leads to emotional and behavioral exhaustion, because in the long run, it’s very difficult to pretend.” »
6. Lose or gain weight quickly
Eating less or taking refuge in food can also be indicative of unhappiness, leading to rapid weight changes. In this case, the symptoms are already more visible, as in “classic depression”.
Why is hidden depression difficult to diagnose?
The answer lies in the multiplicity of symptoms just mentioned. “This explains why the diagnosis is difficult to make by a doctor”, notes Aline Nativel Id Hammou. Very often, the healthcare professional will first carry out multiple clinical examinations which, in this case, generally do not detect anything particular at the physiological level. He will then direct the patient towards psychological treatment with a psychologist, a neuropsychologist or a psychiatrist.
The excessively benevolent reaction of loved ones can also sometimes be counterproductive, when they ignore the signs of depression. “Often, the mistake of those around them is to try to be motivated, in a form of coaching and to reassure the person, by denying the symptoms of discomfort. »
What should you do if you think you may be suffering from hidden depression?
The first instinct is to consult a general practitioner or a psychologist. Once the results of clinical examinations allow doubts to be resolved and depression is proven (and is therefore no longer hidden), only psychotherapy can cure this psychological illness. “We then move on to a multidisciplinary approach with a psychiatrist, a psychologist or a neuropsychologist, who will provide mental health expertise. For symptoms more related to the body, you may need to be followed by an osteopath, a psychomotor therapist and a sophrologist. »
Aline Nativel Id Hammou discusses other currents in the psychological clinic, which can soothe the patient: hypnosis, cognitive-behavioral therapies (CBT), EMDR (“Eye movement desensitization and reprocessing”). through eye movements”), talking therapies, etc. “Sometimes you have to allow yourself to test various psychological orientations to find your own. »
Read also: What sporting activities should you prioritize for your mental health and well-being?
How should those around you react?
The psychologist advises loved ones to listen to their words, support and “envelopment by kindness”. And above all, don’t force things, nor fall into judgment or devaluation. “They can offer things without being obliged, blackmailed or threatened. If their loved one goes for a walk, that’s already good, if they can’t go to a restaurant, that’s no problem. In short, they must follow him and accompany him little by little. » Carers can also seek advice from professionals and participate in consultations or discussion groups about the disorders their loved one is suffering from.