A patient with depressive illness repeatedly presents to her doctor with persistent fatigue, vague abdominal pain, and headaches, insisting these physical symptoms are her only concern; only on specific, direct questioning about her mood does significant sadness and loss of interest become apparent. What is this?

This is somatisation: a mood disturbance experienced and expressed largely through physical bodily symptoms rather than the emotional language of sadness or low mood, with depressive features becoming apparent only with specific, direct enquiry, exactly as described. It is not denial, since somatisation differs from denial in that the person is not refusing to acknowledge distress, but rather is genuinely experiencing and presenting it primarily through the body — she is not denying anything, but channelling her genuine distress through physical symptoms. It is not an abnormal emotional reaction, which concerns disproportionate intensity of a recognisable emotional reaction to a real event, not depression being channelled through physical complaints. And it is not hypochondriasis in the broader sense, a preoccupation with having a serious illness, which is a different pattern from depressive mood being expressed bodily.