Depression is one of the most common mental illnesses and has become the leading cause of disability worldwide. The World Health Organization estimates that nearly 280 million people have depression. There has been an increase in public awareness about the signs and symptoms of depression, but can you be depressed without knowing it? Is there a silent depression? Here are 5 factors may be playing a large role in undiagnosed depression.
1. Depression looks different for everyone
One misunderstanding surrounding depression and other mental illnesses, is that symptoms are universal and everyone has the same experience. This is not the case. For example, one person suffering from depression can have symptoms of insomnia, loss of appetite, and motivation to do their regular activities and hobbies while another person may have symptoms of physical pain such as chest pain, muscle spasms, suicidal thoughts and self-harm.
Depression looks different for everyone, and symptoms aren’t always easy to spot. It is very possible to be depressed without being sad, and symptoms can manifest in many other ways. That’s why you could be depressed without knowing it.
2. There’s no ‘real reason’ to feel depressed
Many people assume that they need a reason as to why their depression developed, but that’s where the tricky, and sometimes scary, part of depression comes in. Symptoms can develop without any warning or particular trigger. Genetics, as well as current and past environment can predispose you to developing the mental disorder. If you’re experiencing periods of sadness and hopelessness that last longer than two weeks, it’s best to talk to a mental health professional and get help as soon as possible to avoid worsening symptoms.
3. Your symptoms may not feel like depression
Many people wonder what ‘qualifies’ as depression. People often expect depression to bring about feelings of sadness however, depression doesn’t automatically mean sadness — in fact, it could make a person feel more numb. Numbness can cause a loss of motivation in activities that once were fun and exciting, which leads depressed people to engage less in socializing and hobbies — the very thing they often need most. Some symptoms of depression can even go completely unnoticed including insomnia and a loss of appetite.
4. Depression can appear gradually
Depression tends to appear gradually, making it difficult to notice specific changes in behaviour, mood, and emotions. A slow onset can make depression feel like our normal reality, making symptoms unnoticeable. That’s why it’s so important to pay attention to changes in lifestyle and general disposition. Mood fluctuations are common in our everyday lives, but when they’re recurrent, severe, and long-lasting, depression can become a serious risk to your health.
5. We don’t see ourselves as depressed
You could be depressed without knowing it because of your self-concept. Although there has been more awareness surrounding mental illnesses, there are still elements that prevent people from accepting the fact that they’re depressed. Stigma is one of the biggest barriers to getting help and the shame and guilt that comes from stigma can make it near impossible for some to admit they aren’t feeling their best. The severity of stigma can vary based on multiple factors including culture, gender, and family dynamics. These barriers prevent a depressed person from accepting that they’re suffering — leading them to disregard the changes they’ve been noticing.
Masking depression — why you can have depression without feeling sad
You could have depression and not know it. Depression isn’t always easy to spot, and in many cases, people can go to great lengths to hide their mental illness and its symptoms — from both themselves and from others. Someone with depression can seem happy, content, and productive but still be struggling with their thoughts, feelings, and physical health. This is also known as ‘smiling depression’. Although smiling depression is not a diagnostic term, it’s mainly attributed to those who are high-functioning and able to uphold their social lives, full-time jobs, and regular activities while still masking depression.
How do you know if you have depression? Symptoms can differ from person to person, which can make it more challenging to notice depression in yourself or someone close to you. Some common symptoms of depression can include:
- Sadness that persists longer than 2 weeks
- Losing interest and motivation to engage in activities and hobbies
- Drop in self-esteem
But the hidden symptoms of depression can be harder to notice.
Hidden symptoms of depression
- Irritability, grumpiness, and being extra-sensitive
- Problems with concentrating and memory
- Physical pain or gastrointestinal problems
- Fatigue and lack of energy
- Substance use
- Weight gain or loss
- Feelings of hopelessness and guilt
- Lower libido and loss of interest in sex
Hidden or concealed depression have many similar features to Major Depressive Disorder. As it can occur to anyone and at any point, it’s essential to keep track of any changes in your behaviours. Keeping track of your patterns helps you and your mental health professional pinpoint potential triggers and causes. If you’re experiencing any symptoms of depression – even if you believe you can ‘soldier’ on and make it through the day — take the signs seriously and speak with a professional. If you suspect that someone close to you is hiding their struggles, it can make all the difference to reach out and let them know they’re not alone.
Why people hide their depression
One of the stigmas surrounding depression is that it’s a sign of weakness. Those who feel embarrassment will do everything they can to conceal the mental illness. And when it persists and they can’t ‘shake it off,’ that only reinforces the embarrassment and stigma.
Feeling guilty for no apparent reason is one of the prominent symptoms of depression. The same can be said for hidden depression, which causes you to be depressed without knowing it. Those experiencing hidden depression may believe that they have nothing to be depressed about. And so they experience guilt about their emotional state. But depression knows no reason or logic. The sooner someone understands that there’s no shame or guilt in their mental illness, the sooner they can begin the healing process.
Fear of burdening others
Those with hidden depression tend to feel more guilt and shame when it comes to their experience with other people. They don’t want to burden others with their problems or don’t know how to ask for help — which leads to suffering in silence.
The most difficult part of depression is understanding that you need help and actively taking steps to seek it out. Even if you don’t realize you have depression, your doctor will be able to come to a diagnosis once they get to know you, your medical history, and the symptoms you’ve been experiencing.
Treatments for Hidden Depression
Treatments for depression depend based on the severity of the condition. Some treatments can include:
Movement releases feel-good endorphins that relieve pain, reduce stress, and improve your well-being. Exercise can mean a wide range of activities. This includes running, swimming, playing basketball, but also gardening and walking around the neighbourhood. It’s important to find something you enjoy and can stick to it.
Counselling, psychotherapy, or talk therapy allows you to learn about yourself with the guidance of a mental health professional — including your past and what could potentially be the cause of your depression. Therapists are equipped to help with any mental health situation by teaching you techniques to overcome challenges. They can even catch silent mental illnesses, helping you recognize if you’re depressed without knowing it.
Brain Stimulation Therapy
In cases of extreme depression diagnosis, brain stimulation therapy, such as electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), and vagus nerve stimulation (VNS), can be used to treat the illness.
- Electroconvulsive therapy: A medical procedure that involves sending a mild electric current through the brain, causing a short seizure, is mainly used in severe, treatment-resistant instances of depression. Recent research suggests that ECT should be the first-line therapy for depression, as it has positive effects for relieving depression in severe circumstances.
- Transcranial magnetic stimulation (TMS): A non-invasive treatment in which a magnetic coil influences your brain’s natural electrical activity. TMS targets specific parts of your brain, especially those related to emotions, decision-making, and feelings of pleasure.
- Vagus nerve stimulation (VNS): Alters the activity of the nerves. It involves implanting a device that sends mild electrical pulses to your brainstem through the vagus nerve in your neck. VNS is primarily used in extreme circumstances, like in individuals who have epilepsy or treatment-resistant depression.
Antidepressants have become one of the most common forms of treatment for depression. They can be effective in treating moderate to chronic depression, especially when paired with lifestyle changes and counselling. They regulate emotions, sleep cycle, and daily moods — making symptoms less uncomfortable. It’s important to remember that there are many types of antidepressants, and it might take a few tries to find one that works for your body. Be sure to consult with your doctor to find one that is right for you.
Physical symptoms of depression
Having depression can be a serious risk to your health if left untreated, especially when it’s high-functioning and hidden. The symptoms of depression are hard to deal with, and oftentimes people can be depressed without knowing it due to subtle symptoms. Additionally, denying the fact that you may be experiencing mental illness means denying yourself the tools and resources that can relieve the heavy mental burden. Symptoms don’t just go away. In fact, they can manifest in misuse of alcohol and other substances, physical pain, social isolation, conflict in relationships, and much more. That’s why it’s so important to seek help early.
Ease the discomfort of depression
Can you be depressed without knowing it? It’s very possible to struggle with depression without obvious symptoms. Opening up to people you trust can alleviate the burden of going through hidden depression. If you’re used to concealing your feelings, and it may feel uncomfortable at first, but talking about your struggles can be a significant first step. Talking with a counsellor helps you identify the patterns in your thoughts and belief systems that may be contributing to depression. You shouldn’t have to struggle with depression in silence. Our counsellors are here to help every step of the way.