مطالعه کیفی تجربه زیسته بیماران مبتلا به افسردگی پنهان

سروش جلالیان; بهزاد رحیمیان

Authors

Soroush Jalalian Department of Clinical Psychology, University of Guilan, Rasht, Iran Author
Behzad Rahimian Department of General Psychology, University of Mazandaran, Babolsar, Iran.

Keywords:

hidden depression, lived experience, emotional concealment, mental health stigma, thematic analysis, semi-structured interview

Abstract

This study aimed to explore the lived experience of patients with hidden depression and to identify the psychological, relational, and social components involved in concealing depressive symptoms in everyday life. This qualitative study was conducted using an interpretive phenomenological design. Participants were 18 patients with hidden depressive experiences living in Tehran, Iran, who were selected through purposive sampling with maximum variation in gender, age, marital status, and educational level. Data were collected only through semi-structured interviews. Interviews continued until theoretical saturation was achieved; saturation occurred at the sixteenth interview, and two additional interviews were conducted to confirm data adequacy. After obtaining informed consent, interviews were audio-recorded, transcribed verbatim, and analyzed using reflective thematic analysis with the support of NVivo 14 software. Data analysis led to the extraction of five main themes: functional masking and maintaining appearances, the body as the silent language of depression, shame and fear of labeling, relational loneliness and emotional exhaustion, and help-seeking conditional upon psychological safety. Participants reported that although they experienced low mood, fatigue, emptiness, loss of meaning, and internal exhaustion, they continued to present themselves as competent, calm, sociable, or even cheerful in family, occupational, and social contexts. Concealment helped them temporarily preserve their social image, but over time it intensified isolation, delayed help-seeking, and increased psychological pressure. Hidden depression is not merely a silent mood disturbance; it is a complex lived experience shaped by impression management, emotional silence, fear of judgment, and cautious searching for safe support. Clinical interventions should therefore address not only depressive symptoms but also stigma reduction, selective disclosure, emotional literacy, and the creation of safe interpersonal spaces for expressing psychological distress.

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