Woman sitting alone with her hand on her head, looking depressed

Sandhya is a tireless chatterbox at the office. She constantly regales others with her witty and astute comments. She always has something to laugh about, and often, most of her jokes are at her own expense. At home, she usually keeps to herself, eats often and sleeps at odd hours. In fact she barely sleeps, and often spends hours lying in bed, struggling with insomnia. Her family thinks she is absolutely normal.

Sandhya suffers from hidden depression. Most of us have some idea of the symptoms of depression—those persistent feelings of sadness, loss of interest in people and activities, a negative mindset toward situations, decreased appetite and sudden weight loss. What is less known is that several people suffer from severe depression without showing any of these signs. So, how do we recognise if a loved one is suffering from hidden depression?

Here are some characteristic features that could indicate that a person you know and care about needs help:

Enforced Joie-de-Vivre

Like Sandhya, such people always put on a happy face for the world. However, this is a façade. Deep down, they are suffering with feelings of utter desolation, which is so unbearable and unthinkable that they prefer to escape into a world of forced gaiety. If you are perceptive and observant, you will notice fleeting moments when the façade vanishes and you get a glimpse into the dismay that the person may actually be experiencing.

Erratic sleeping and eating patterns

Most people with hidden depression have an odd relationship with food. You will often find them constantly eating, as though trying to fill up the void in their life with food. They will be especially drawn toward cakes, chocolates, or other sugary foods that create a temporary feeling of happiness and wellbeing.

Most people with hidden depression have an odd relationship with food. You will often find them constantly eating, as if trying to fill a void

They also suffer from fitful sleep patterns. Most of them are likely to be night owls, staying up till the wee hours and falling asleep with great difficulty. While they function reasonably well in the daytime, they may, on holidays, sleep through the entire day to make up for the lack of sleep.

Super-busy lifestyle

They are constantly busy doing something. They are often energy powerhouses, flitting from one task to the other with a focus that may seem too intense to others. Keeping busy is a convenient way of keeping your feelings and emotions at bay, and these people have honed this art to perfection. Thus, you may find them taking on excessive responsibilities at work, at home and also having a full social calendar.

Elusive aches and pains or chronic fatigue

They often complain of vague aches and pains—headaches, backaches and stomach upsets being the most common. Or they may be in a state of perennial exhaustion, ready to crash physically at a moment’s notice.

Reckless behaviour

Play with fire is what people with hidden depression often love to do. They are casual, careless and flippant about their health, their safety and even their life. You may often notice them drinking excessively, clubbing or partying too much, driving too fast, spending too much, and generally treating themselves with a care-damn-attitude.

Keeping busy is a convenient way of keeping your feelings and emotions at bay, and these people have honed this art to perfection

Uncharacteristic emotional outbursts

If your friend is normally a calm and grounded person, and has suddenly started having frequent and intense emotional outbursts, it could be an indicator that he or she is suffering from masked depression. Because these people typically run away from facing their emotions, there is usually an intense build-up of negative emotions, especially sadness and feelings of loneliness and emptiness. They may, at times, burst out at the slightest provocation, usually in the form of tears, or extreme rage and anger.

How to help

What should you do if you suspect someone you know and care about may be suffering from masked depression?

Suggesting to them that they might be suffering from depression may result in an outright denial and a further hardening of the mask. People with masked depression often have a hard time acknowledging their feelings and may be very ambivalent about seeking help or even admitting that they have a problem. In their weak moments, they may break down and admit to feelings of sadness, but in a short while, when the feeling has passed, they revert to the veneer that is so familiar. Let us look at some behaviours, actions and suggestions that you can offer, to help bring these people closer to the truth, and eventually, to getting the help they need:

  • Model expression of emotions. Talk about your occasional negative feelings to them, thus silently communicating that it is okay to feel so.
  • Whenever you notice the mask slipping, talk about it. If the person talks about something wistfully, encourage him or her to go on talking about what feelings are being experienced.
  • Don’t allow them to distract you by their gaiety. If you notice them laughing at themselves, or making fun of themselves, calmly mention that it is not funny, and that there is no reason for them to deride themselves all the time.
  • Provide unconditional positive regard and acceptance. This is one of the most fundamental of human needs. Making them feel good about themselves and their lives will go a long way in helping them feel supported.
  • If it is a close family member, gently urge them to slow down. Offer to help them with the busy schedules they have created for themselves. Help them create free time in their routine; this will force them to stop and think about where they are headed emotionally.
  • Encourage them to take up a hobby. Music, yoga, running, painting… Any of these, if pursued with a passion, are deeply meditative and centring activities, and will help them in a big way to get in touch with their emotions.
  • Finally, when they are ready, urge them to seek professional help. Help them to understand that depression is not a sign of weakness; it’s a medical issue that requires intervention. Support them as they take their first steps toward recovery.

As you can see, hidden depression is, in some ways, more challenging than overt depression. Getting the person to acknowledge deep feelings of sadness and emptiness, helping them understand that this is a problem that needs help and getting them the help are issues that can create challenges. Yet, with the right support and encouragement of family, friends and loved ones, this mask can be torn off and the inner demons can be faced, fought and defeated.

A version of this article was first published in the May 2016 issue of Complete Wellbeing.


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