Depression in disguise

(Credit: Unsplash)

This article was exclusively written for The European Sting by Ms. Siddhi Khushalani, second year MBBS student of GMERS Gotri Vadodara, India. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

“Illusion is needed to disguise the emptiness within”

-Arthur Erickson

Depression is a Mental state disorder, which causes persistent feelings of sadness and loss of interest in most or all normal Activities. Ordinarily, depression is quite evident due to its symptoms which are mostly:

  • Feelings of sadness/emptiness
  • Loss of interest in most normal Activities
  • Anger outbursts on small matters
  • Sleep disturbances
  • Suicidal thoughts/suicide attempts
  • Unexplainable physical problems, etc.

But, just like some physical diseases are asymptomatic, depression can also be asymptomatic and not evident.

Close ones/loved ones, may help those who are suffering from symptomatic depression; but those people for whom getting out of bed and going through life’s motions is possible, but inwardly they may be struggling with highly challenging symptoms, invisible to those who know them.

People suffering from asymptomatic depression, may laugh and pretend to enjoy their life, hence no one could actually tell what that person is going through, but there have been many cases, where happy seeming people suicide or have sudden panic attacks, etc.

Some people conceal their symptoms so well that it is difficult for even themselves to recognize. That is why this kind of depression is known as ‘smiling depression’, they seem happy, content and productive; their relationships and work life seem fine; for an instance; a teenager, who was experiencing lack of appetite since quite a few days, his mom noticed the changes of his eating habits and finally took him to a doctor; and the whole scenario at the conclusion after several follow ups;  revealed that the teenager was suffering from silent depression as, in front of his mom, he was able to hide all the other specific symptoms of depression, but just a minor symptom of lack of appetite eventually led to the diagnosis. Thus, sometimes,  patients of silent depression are so expert at hiding the symptoms that even counselors/doctors couldn’t recognise the disease on their first visit.

According to a study, it is estimated that in the US, around two thirds of all cases of depression are undiagnosed.

Undiagnosed/untreated depression eventually increases the chances of risky behaviours such as drug and alcohol addiction.

Without proper treatment, including antidepressants and psychotherapy,  untreated depression can last for weeks, months or years; and it is the most dangerous in terms of silent depression, where people mostly take sudden actions, like suicide.

To keep a flushed body and mind, people shall go for routine checkups. There is already awareness amongst people to have routine checkups of the body – glucose profile, lipid profile, CBC, etc. But, there is lack of awareness about routine Mental checkups, due to various biases and problems:

  • Society biases – tagging mentally ill patients as ‘crazy’, ‘lunatic’, etc. Leads to isolation of the patients.
  • Lack of financial support
  • Lack of education
  • Low self esteem of mentally ill patients
  • Not taking Mental health diseases as seriously as diseases like diabetes, hypertension, etc.

If these problems/biases are subdued, and as people have started going for routine physical health checkups, they’ll start going for routine Mental health checkups too, and then diseases like ‘smiling depression’ can be taken care of.

As an individual, if we come across anyone with a past family history of mental/substance abuse disorder; family history of physical/sexual abuse; having attempted suicide previously; have family members who have attempted suicide previously, etc. And still on the surface they seem fine, help them as soon as possible by getting them in contact with a Mental Healthcare facility, because these are very strong history points.

As a society, we shall fight for the rights of mentally ill patients and spread more awareness about Mental health; shall create that society, wherein people without hesitation shall have routine Mental health checkups, so that silent depression and other disguised diseases can be treated.

As an individual suffering from silent depression, share the problem to a close/loved one, or if we can’t share it with anyone, contact the Mental Healthcare facility directly.

All this is arduous but not impossible; because society has a crucial role to play, hence let’s all come together in Unity and fight for the ‘Depression in disguise’.



About the author

Siddhi Khushalani, second year MBBS student of GMERS Gotri Vadodara and an active member of MSAI and IMA; along with that I’m working as a content writer at TEDx Prahladnagar. I’m interested in the field of psychiatry and desire to persist residency in the same. Besides, my hobbies include writing songs/articles/poetries which have been successfully published in magazines and blogs; sports; academics, etc.  A golden point is that I have attended IFM camp held in Germany(2017) which included visit to Hitler’s Dachau camp and was a very fruitful experience.


  1. Depression is a tricky condition because the signs may not always be clear. It’s good to know these signs and, more importantly, which steps to take toward improvement.

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