“Hidden” depression. Clinical manifestations

The latent depression is a group of psychopathological conditions in which the symptomatology testifying to depressive disorders recedes into the background, and different kinds of somatic complaints, indicating functional deviations in the activity of organs and systems take the leading place in the clinical picture. In some cases this drug helps: https://pillintrip.com/medicine/ksalol.

Synonyms: “somatized depression”, “masked depression”, “depression without depression”, “latent depression”, “major depression”, “vegetative depression”, “exhaustion depression”.

A large num

ber of people go to outpatient clinics to a neurologist, cardiologist, urologist, gynecologist, not realizing that their illness is caused not by a physical illness, but by a neuropsychiatric disorder of latent depression.

In manifestation of “latent” depression, somatic (bodily) and vegetative (tension, shivering, sweating, palpitations) symptoms “masking” depression and anxiety proper come to the fore. In some cases, there are no complaints of a lowered mood, but more often, excitability and anxiety are revealed.

Patients undergo numerous examinations, which reveal no disorders, and if any somatic disorders are found, they do not explain the nature and degree of severity of the symptoms, the severity of the patient’s condition and the anxiety he or she exhibits. Patients with unexplained somatic symptoms in the first place should be considered at risk for depression.

In a large proportion of masked depressions, emotional disorders overlap with organo-neurotic ones (the syndromes of vegetative vascular dystonia, hyperventilation, irritable bowel, etc.). There are also agripnic (intermittent sleep with unpleasant dreams, early awakening with a difficult, demanding volitional effort of an excruciating rise) and anorectic (morning sickness, absence of appetite and aversion to food, associated with weight loss, constipation) variants of masked depression. In cases of masked depression, sleep disorders may sometimes be the only manifestation of the illness. “Disrupted” sleep or early morning awakening, along with decreased urges and a decreased capacity for emotional resonance, can also be an indication of the presence of depression in the absence of a dreary mood. However, the reverse is also possible, where the patient feels increased sleepiness, or increased appetite with carbohydrate-rich food consumption and increased body weight. These clinical variants act as “depressive equivalents.”

The most common “mask” of depression in general medical practice is depressive pain syndrome. Chronic pain as a manifestation of masked depression can localize to any part of the body. In cardiological practice, the most frequently observed pain symptoms are cardialgia – nagging or pinching pains in the apical or pre-cardiac area of moderate intensity, lasting up to several hours. They are often accompanied by feelings of “piercing” of the same localization, as well as burning in the heart area, pain in the intercostal spaces. Persistent abdominal pain may also act as “masks” of depression. These pains are of a diffuse dull constant sensation, involving several parts of the abdomen. In 700/0 cases, the pain is accompanied by intestinal motility disorders (constipation, diarrhea). Chronic daily or tension headaches – aching, pulling, pressing or constricting – are also often among the “masks” of depression, facial pains – throbbing, drilling, aching sensations, unilateral or bilateral, localized around the mouth, in the jaw, forehead, cheeks – can also “mask” depression. In case of muscle pain (including various pain symptom complexes localized in at least two points), the probability of depression (up to 8094).

Inconsistency of patients’ complaints with the data of objective examination is characteristic. The above features of the course of depression, as well as clinical symptoms, such as: increased irritability; constant fatigue, increased fatigue, lack of energy; difficulties in making decisions; reduced capacity for work; sleep disturbances; decreased appetite and body weight (or increased); deterioration of well-being in the morning and some improvement in the evening (circadian rhythm) help to qualify these states as part of endogenous depression.

Depressions are the most widespread and most somatized mental disorders, in which interaction of mental and somatic components of human nature is evident. They are all diverse in their severity and manifestations, but the leading and constant among them remain the symptoms of low mood. The risk of suicide always exists in depressed patients. It increases with severe pain disorders and a number of other factors that worsen the prognosis of the underlying disease.