What Is It and More I Psych Central

Jennifer E. Engen

Masked depression isn’t used as a diagnosis anymore, but some people still use the term to describe their symptoms.

There is much that researchers have yet to understand about depression. For example, not much is known about what causes the condition.

While there are common symptoms such as depressed mood and loss of interest in activities, depression can look and feel different from person to person.

“Masked depression” was a term used long ago to describe a type of depression. Many think masked depression refers to hiding or masking depression symptoms from others, but it doesn’t.

While many people with depression do try to conceal their symptoms from the people around them, which is known as smiling depression, masked depression is not the same.

The term “masked depression” was widely used in the 1970s and 1980s. It described a condition in which someone with major depressive disorder experienced physical symptoms rather than, or more than, psychological symptoms.

These physical symptoms couldn’t be explained with a biological cause, according to the American Psychological Association (APA).

It’s a special form of depression with atypical features, meaning that symptoms aren’t noticeable.

Masked depression can often be confused with hidden depression or smiling depression, but these aren’t the same.

The symptoms of masked depression often mimic the physical and psychological symptoms of depression.

Common physical symptoms include:

Common psychological symptoms include:

  • difficulty sleeping
  • poor concentration
  • changes in appetite
  • sexual dysfunction

If you have masked depression, you might experience little to no psychological symptoms or experience them secondary to the physical symptoms.

You may also experience some psychological and mood symptoms, such as:

  • loss of pleasure in your usual activities
  • irritability
  • feelings of worthlessness
  • anxiety

Depression is a mood disorder that can affect how a person thinks and feels. It’s often characterized by psychological symptoms, such as:

  • depressed mood
  • loss of interest in activities
  • feelings of sadness

Depression can also lead to a variety of physical symptoms, including aches and pains, which are often unexplained. Both emotional and physical symptoms can interfere with daily life.

Vague aches and pains are often the first symptoms of depression, according to a 2016 study. In fact, many people with depression report only physical symptoms, which can make it difficult to find a proper diagnosis.

One explanation of the link between depression and physical symptoms is the dysregulation of the neurotransmitters serotonin and norepinephrine, which can be linked to depression and pain.

For this reason, serotonin-norepinephrine reuptake inhibitors (SNRIs) might be prescribed to treat the psychological and pain-related symptoms of depression.

Masked depression is no longer used as a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

A 2018 survey determined that masked depression was commonly misdiagnosed due to the predominance of physical symptoms. The lack of awareness among doctors might also explain why the term isn’t as widely used today as it was in the 1970s and 1980s.

The term “masked” was considered to be in conflict with the diagnostic criteria. Since depression is often unobservable, it’s masked in a sense, but doctors still need to observe, describe, and diagnose it.

These problems, which make it difficult to diagnose masked depression, help explain why masked depression is no longer used today as a clinical diagnosis.

An accurate diagnosis for depression and other conditions is essential for proper treatment. A wrong diagnosis could worsen your problems.

Masked depression is no longer used today, but you might still hear similar terms, such as:

These terms aren’t intended to replace masked depression, though.

Some describe disorders that heavily focus on somatic, or physical, symptoms. Others describe the tendency to hide or mask symptoms of depression.

If you think you have depression, talking with a healthcare or mental health professional is usually the first step. Being open and honest when discussing your symptoms will help you get an accurate diagnosis.

There are many treatment options to manage symptoms of depression. Antidepressant medications can help relieve both the physical and psychological symptoms of depression. Other treatment options include various forms of psychotherapy, other types of medications, self-help strategies, and lifestyle changes.

Physical health conditions can also exist alongside depression. Describing your symptoms to a healthcare or mental health professional can help determine the underlying cause of your pain. It’s possible that unexplained aches and pains may be due to some other cause.

Depression isn’t the same for everyone. Some people experience different symptoms and at different intensities. Experiencing more physical symptoms of depression than psychological ones can be confusing.

Though masked depression is no longer used as a clinical diagnosis, some people still relate to the term.

Getting the right diagnosis can help you get closer to experiencing relief. Help is available to support you in your search for answers and the appropriate treatment.

Like any other condition, depression requires support — whether it’s from friends, family, health professionals, or trained volunteers. There’s no shame in feeling the way you do, and the sooner you seek help, the sooner you may experience relief.

The following resources may be good starting points for seeking help:

It might also help to check out our find a therapist tool for more resources and support.

https://psychcentral.com/depression/what-does-masked-depression-look-like

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