Such patients do not complain of low mood, stating that they do not feel any mood at all, that the mood is completely absent. With sufficiently pronounced depersonalization, the actual depressive symptoms are covered up. facial expressions are more absent than sad, hypomimia is common, the eyes are not dull, sunken, as in melancholic syndrome, but shiny, sedentary, slightly exophthalmic. During a conversation, patients may smile a polite, familiar, expressionless smile, which sometimes misleads the doctor about the depth of depression and the danger of suicide. There is no distinct psychomotor retardation. The feeling of affection, love, and warmth towards loved ones, especially children, disappears, which further enhances the feeling of mental pain caused by the lack of emotions.

Everything around stops being touched, it is perceived as if through a film, somatopsychic depersonalization manifests itself in the absence of a feeling of hunger, satiety, the urge to defecate, a feeling of relief after it, the absence of a sense of sleep, partial or complete analgesia. Still, in most cases, depersonalization does not reach such a degree as to completely block melancholy, and patients, along with insensibility, may also experience a fairly pronounced decrease in mood. In addition, they often experience various unusual tactile sensations, which, together with somatopsychic depersonalization, serve as the basis for the emergence of hypochondriacal ideas. With a fairly severe melancholic or anxiety-depressive syndrome, phenomena of auto- and, more often, somatopsychic depersonalization are almost always detected, but they do not dominate the clinical picture.

All the patients� experiences are colored only in pleasant tones. Patients are carefree and have no problems. Past troubles and misfortunes are forgotten, negative events of the present are not perceived, the future is painted only in rosy colors. True, the cheerful and friendly mood of patients at times, especially under the influence of external reasons (patients� reluctance to obey the instructions of staff, disputes with others, etc.), gives way to irritation and even anger, but these are usually just outbreaks that quickly disappear, especially if you talk to sick in a peaceful tone.

Patients consider their own physical well-being to be excellent, and the feeling of excess energy is a constant phenomenon. The opportunities to realize numerous plans and desires seem unlimited, and they see no obstacles to their implementation. Self-esteem is always increased. It�s easy to overestimate one�s capabilities�professional, physical, related to entrepreneurship, etc. Some patients can be dissuaded for some time from the exaggeration of their self-esteem. Others are unshakably confident that they are truly capable of making a discovery, implementing important social measures, occupying a high social position, etc. This is most often observed in mature and elderly patients. Typically, delusional ideas are few in number, represent a statement of fact, and are only relatively rarely accompanied by any evidence.