I was prompted to write this article by the observation that nowadays depression in its classical manifestation is not always found. Very often, a person is practically not bothered by sadness, apathy, melancholy, slowing down of thinking and movements, but problems with physical health come to the fore in the form of increased fatigue, constant fatigue, pain, autonomic disorders and other unpleasant sensations. Often there is an inability to enjoy those things that previously brought it, insomnia, and forgetfulness. In childhood and adolescence, depression can manifest itself in the form of increased irritability and aggressiveness. In these cases, depression seems to put on a mask, which is why experts call it “masked.” How does a person suffering from this type of depression behave? It is easy to guess that he begins to visit general practitioners in an attempt to find the reasons for his poor health. The diagnostic measures carried out in this case often do not find signs of pathology at the physical level, and the prescribed treatment does not bring relief. A person is often accused of excessive attention to his health, hypochondria. What “masks” can depression wear? A mask of pain and other unpleasant sensations in the body. Characterized by causeless pain in the heart, head, abdomen and other parts of the body. In addition to pain, a person may experience other unpleasant sensations - compression, distension, pulsation, burning, etc. Vegetative mask Symptoms of so-called vegetative-vascular dystonia occur: changes in blood pressure, dizziness, palpitations, interruptions in heart function, a feeling of lack of air, sweating , diarrhea or constipation, itchy skin, low-grade fever. Sexual dysfunctions may also be observed. Mask of sleep disorders Insomnia - difficulty falling asleep, shallow sleep, when a person instantly awakens from the slightest rustle. Increased, unexplained drowsiness, difficulty waking up are also sleep disorders. Mask of appetite disorders Worsening of appetite, sometimes aversion to food lead to weight loss. In this case, constipation is often observed. Mask of intoxication Periodic use of alcohol, narcotic and psychotropic substances in order to alleviate one’s condition is also a common sign of depression. And although in these cases a person in a state of intoxication does not experience euphoria and joy, such “treatment” can very quickly lead to the formation of a serious chemical dependence. The mask of neuroses It happens that depression is disguised as a neurotic disorder in the form of fears, obsessive states, anxiety attacks, panic attacks attacks, constant irritability, weakness and fatigue. What diagnoses are most often given to people by general practitioners? Vegetative-vascular dystonia; Transient hypertension; Spinal osteochondrosis; Vertebrobasilar insufficiency; Migraine; Cardioneurosis; Gastric neurosis; Dysmenorrhea of ​​unknown origin. Please understand that these diagnoses do not necessarily indicate that depression is the cause. Sometimes these are independent diseases. How to suspect the presence of masked depression? In most cases, it is accompanied by a number of characteristic signs: Complaints do not fit into the typical clinical picture of a specific somatic disease; A person is very worried about a possible serious illness that doctors cannot diagnose; There is a tendency for the nature of complaints to change over time time; Seasonal dependence of disorders (usually in spring, autumn); Presence of somewhat depressed mood, even if not reaching the level of full-blown depression; Mood fluctuations during the day, usually improving in the evening; Indecisiveness, decreased social activity; Lack of effect from what doctors prescribed general treatment practice. What to do if you suspect “masked” depression? Diagnosis of this condition is quite difficult. The psychotherapist must evaluate in detail