Psychiatrist Prof. Dr. Nevzat Tarhan stated that masked depression, also known as atypical or covered depression in popular psychology, is more commonly seen in women. “This depression is also called smiling depression. There are no other depression symptoms like sorrow, grief, and sadness. The person is doing their daily work, is cheerful, but is experiencing depression through organ language. In our culture, it is very common among women,” he said. Prof. Dr. Nevzat Tarhan noted that anger emerges in men experiencing atypical depression and emphasized that sometimes the cause of forgetfulness is stress hormone in the brain. Tarhan used the expressions, “Depression is a wound within a disease. One who hasn't experienced it cannot know. Due to societal prejudices, people suppress depression. As a society, we do not let them express it.”
“Smiling depression is more common in women”
Üsküdar University Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, made evaluations regarding depression and its types.
There are 8 main symptoms in depression!
Psychiatrist Prof. Dr. Nevzat Tarhan noted that in classic depression, the person has a depressive mood, and is filled with sadness, sorrow, and grief, drawing attention to the 8 main symptoms of depression. Prof. Dr. Nevzat Tarhan said, “In classic depression, the person has a depressive emotional state. They complain of being unable to taste or enjoy anything. These two main symptoms are important. Other symptoms like sleep disorders and appetite disorders may also emerge. These sometimes increase and sometimes multiply. There is a decrease in energy in the person.”
Thoughts of death emerge
Prof. Dr. Nevzat Tarhan, stating that another symptom of depression is thoughts of death, warned, “Thoughts of death frequently come to the person's mind. They may think about death 10 times a day. There is also a decrease in the person's interest. Their interest in life, normal routines, daily habits, and normal daily activities decreases. A decrease in attention and concentration, and a slowness in comprehension and perception emerge.”
Work efficiency is not disrupted in mild minor depression
Prof. Dr. Nevzat Tarhan also spoke about the depression called “mild minor depression,” saying, “The person is unhappy, but sometimes certain things have no effect. However, if asked, ‘In the last 3 months, were you happy more often or unhappy more often?’, and the person says they were unhappy more often, it is called minor depression. The person is in a mildly depressive mood, cannot enjoy anything, but their work efficiency is not disrupted. These are things that impair the quality of life.”
Prof. Dr. Nevzat Tarhan also touched upon bipolar depression, which is a mood disorder, saying, “In bipolar depression, there is a period of depression, and the person becomes depressed. In another period, the person enters mania.”
Smiling depression is seen more in women
Prof. Dr. Nevzat Tarhan, stating that masked depression, also called atypical or covered depression in popular psychology, is commonly seen, said, “This depression is also called smiling depression. The person lives through organ language. There are no other depression symptoms such as sorrow, grief, and sadness. The person is doing their daily work, is cheerful, but is experiencing depression through organ language. In our culture, it is more common among women. A person experiencing atypical depression often goes to the doctor, has examinations, and nothing is found, but there is an underlying unhappy, depressive state. They cannot express depression directly. Emotional blindness can emerge. These people generally cannot express their emotions, and emotions are expressed inversely.”
Prof. Dr. Nevzat Tarhan noted that a scale is applied to identify atypical depression, saying, “When we apply this scale, we try to understand the symptoms of the illness in individuals. Is the person experiencing depression in the background? Are they expressing their emotions through organ language? We are trying to understand this.”
Men experience depression in the form of anger
Prof. Dr. Nevzat Tarhan also drew attention to atypical depression, which is also seen in men, saying, “Here, too, the man does his work, rushes around, laughs when he's supposed to, but is very angry. He experiences depression in the form of anger. The person gets angry at everything, makes excuses like 'Why is this doorstep here?' or 'Why did you chop the tomato so big?'. Generally, those around them fear these individuals; they tend to be violent. When these people enter depression, their anger increases. This is one of the masked depressions.” Prof. Dr. Nevzat Tarhan added that some men see depression as a weakness.
In smiling depression, there is a storm in the person's inner world
Prof. Dr. Nevzat Tarhan noted that despite appearing cheerful in smiling depression, the person experiences sadness and turmoil in their inner world, saying, “The person is quite cheerful, smiling, but is entirely playing a strong role to the outside world. In their inner world, there is a tremendous battle and doomsday. In situations we call smiling depression, the person is cheerful, lively, and energetic. You wouldn't believe these people are depressed, but there is a storm in their inner world, a storm in their brains. So much so that these types of people have a high risk of heart attacks. Sudden deaths can be seen at an early age. After such people, it is usually said, ‘He was very cheerful, made jokes, and made everyone laugh.’”
Beta wave is high in atypical depression
Prof. Dr. Nevzat Tarhan noted that with developing technology, these movements in the brain can be observed through brain imaging methods, saying, “Our American colleagues developed new software for the brain. They created a new database. In the normal database, the normal database for each age group of the brain is known. There are wave groups in the brain such as fast, alpha, beta, theta, delta. This is the most common method of brain mapping. When we measure a person's brain function wave, in some, the beta wave appears high. A high beta wave indicates an acceleration of energy flow and information flow in their brains. Serotonin decreases because the brain cannot retain it. In such situations, the person plays a strong role outwardly, but there is depression in the brain.”
Prof. Dr. Nevzat Tarhan noted that the brain's operating system works with a network model, saying, “For example, in our brains, we have 'who, what, when, where, why, how' networks. What we know as 5W1H is actually known as the 6 faithful effects of memory in our brain. The networks in the brain interact with each other. For people who know several languages, for example, there is an English network, a French network, a Turkish network. As they speak these languages, the brain works in that direction. Our brain has such an extraordinary system.”
Forgetfulness due to depression can be seen
Prof. Dr. Nevzat Tarhan noted that the longest nerve in our body is the vagus nerve, saying, “This nerve is connected to all organs. Messages go from all organs to the brain. Which organ is working slowly, which is working fast, which has a rhythm disorder. Messages go to the brain. The brain receives it, sends a message to relax, calm down chemically, and the organs relax. In treatment, there is a special system called Vagus Stimulation. It tries to treat the brain by stimulating the vagus nerve. It is also used in the treatment of epilepsy. There is a magnificent system in our brain. Our body has enough neural network to go around the world, and in the brain, they constantly communicate with each other. In depression, the chemical communication substances serotonin, dopamine, and noradrenaline in these neural networks decrease. When these decrease in individuals, comprehension, perception, and understanding in the brain decrease. For example, in a person who comes with a complaint of forgetfulness, you see that their forgetfulness is due to depression, secondary forgetfulness, meaning the person does not have Alzheimer's. The person thinks they have Alzheimer's but they don't. Because the brain is in depression, and the energy flow has slowed down, it cannot adequately perform comprehension, understanding, and perception. Depression experienced as forgetfulness is also one of these atypical depressions. When depression is treated, the person's forgetfulness also improves.”
Stress in the brain can lead to forgetfulness
Prof. Dr. Nevzat Tarhan stated that sometimes the cause of forgetfulness is stress hormone in the brain, saying, “Sometimes too much stress hormone is secreted. There is chronic stress in the brain. With antidepressant medication, the brain relaxes, and forgetfulness decreases or disappears. The cause of forgetfulness can be atypical depression. Atypical depressions experience depression emotionally, express it, express it inversely.”
Prof. Dr. Nevzat Tarhan noted that significant differences were found when the cerebrospinal fluid of people who ended their lives by suicide and those who died naturally was measured, saying, “A study conducted in the 1980s shows that this is a brain disease. There are important studies on the brain's inability of those who commit suicide to metabolize serotonin. It was at the end of these studies that third-generation drugs emerged.”
One who hasn't experienced depression cannot know
Prof. Dr. Nevzat Tarhan noted that there are societal prejudices particularly about depression and that patients are greatly affected by this situation, warning, “Depression is a wound within a disease. One who hasn't experienced it cannot know. Due to societal prejudices, people suppress depression. As a society, we do not let them express it. They live like this. If individuals cannot cope or if their philosophy of life is conducive to it, they can very easily attempt suicide.”
Prof. Dr. Nevzat Tarhan noted that it is not difficult to understand people with depression, saying, “While they previously never talked about death, these people now talk about death. Or they make preparations as if they are going on a long journey. They act as if they are saying goodbye. We don't believe that smiling people are depressed. If a person has depression, makes statements about death, says goodbye, and questions and researches such topics extensively, one should seek expert help immediately.”
Atypical depression can be seen in children!
Prof. Dr. Nevzat Tarhan, stating that depression can be seen in children as well as in adults, said, “Atypical depression can emerge especially in children suspected of having attention problems. Children's emotional expression skills are not developed. They cannot express, 'I'm sad about this right now.' If a child lives under pressure in the family, the child experiences it behaviorally. They wet the bed, damage objects. There is school refusal. The child enters an inverse identity. If they are experiencing gender identity disorder, there is an underlying depressive disorder. The parents get angry. The child relieves themselves with a completely unconscious action. There is childhood depression experienced as laziness against parents who highly value studying. The child is not happy, is not studying. They express themselves through not studying and school refusal. We call this behavioral adjustment disorder. What we call behavioral disorder in adults is atypical depressive disorder in children. When evaluating them, the reasons causing their depression are often investigated, taking treatment into account. It is investigated whether there are childhood traumas.”