What You Need to Know About “Smiling Depression”

“How are you? Really?” This is my mom’s standard line of questioning any time I dye my hair darker. In her mind, darker hair is equivalent to a darker mood. She’s on to something, but in my case, she has it backwards. I’m best at hiding my depression when I’m blonde. When I’m brunette, I feel authentic. I literally let a little more of my darker side show. When I’m blonde, I’m bubbly, social and easy to get along with. When I’m blonde, I’m the face of smiling depression.

What is Smiling Depression?

Smiling depression involves appearing happy to others and smiling through the pain, keeping the inner turmoil hidden. It’s a major depressive disorder with atypical symptoms, and as a result, many don’t know they’re depressed or don’t seek help. People with smiling depression are often partnered or married, employed and are quite accomplished and educated. Their public, professional and social lives are not struggling. Their façade is put together and accomplished.

But behind the mask and behind closed doors, their minds are filled with thoughts of worthlessness, inadequacy and despair. They’ve usually struggled with depression and/or debilitating anxiety for years and have had some experience with therapy or medication. Many don’t disclose their depression due to fear of discrimination from loved ones or employers. “Oftentimes, I am the only person in this individual’s immediate circle who is aware of how he or she is feeling on the inside,” said Dina Goldstein Silverman, Ph.D., a licensed psychologist and assistant professor of psychiatry. 

Why is it dangerous?

According to Silverman, there’s a troubling connection between smiling depression and suicide. In contrast with a patient who has little energy to even get out of bed, chronically depressed patients who report a surge of energy might be more likely to initiate a suicide attempt. Significant traumatic life changes—such as a recent job loss or divorce—are often predictors of suicide attempts, particularly in men. In some cases, having young children or being devoutly religious may serve as protective factors. But many of us know exceptions to that.

One of the deaths that shocked my community the most was the suicide of a Sunday school teacher and youth counselor. Active in our church and several nonprofits, he mentored many and loved connecting people. Was he disheveled, withdrawn and a downer to be around? Absolutely not. He was encouraging, thoughtful and went out of his way to attend and organize events. Often in a suit and always put together, he was who we aspired to be when we grew up. Did we ever ask him how he was doing, if he was hurting or if he needed someone to listen to him for once? No. We bought in to the façade and couldn’t see the pain hiding under the surface.

His life was one-of-a-kind, but unfortunately his story is not. Many who have felt the impact of a friend’s suicide say the same thing: “I had no idea he was suffering. He was the last person I would have expected to do this.”

How can we help?

Create awareness to de-stigmatize mental illness

Many people struggling with smiling depression are perfectionists, or they don’t want to appear weak or out of control. The more we can shift the conversation to show positive role models living with depression—those who advocate for the mix of therapy, exercise, medication, sleep, diet—the less shame and stigma will be associated with it.

Pay more attention to your loved ones (especially the warning signs)

If you have a friend who suddenly stops responding to phone calls or texts or cancels plans, don’t hesitate to ask them what’s going on and if they’re feeling okay. Let them know that they are heard and are not alone. Also, it’s vital to notice if a loved one begins giving away possessions (often a symptom that someone is considering suicide), or begins to isolate and withdraw.

“As a therapist, I try to encourage [my patients] to develop authentic social relationships, so he or she can experience the relief of being heard, understood and validated by friends and loved ones, and build genuine connections,” Silverman said.

If you think you might be depressed:

On the days when your brain seems to be fighting you for your life, remember that you are enough, you are worthy, you are loved and you are not alone.

Find activities and pursuits that are meaningful to you and make you feel productive and accomplished. Try your best to be present in these activities. Silverman says that “mindfulness is the opposite of perfectionism in that it focuses on a balance without judgment, and it’s an important set of skills that someone can learn in therapy.”

Reach out to someone you trust and consider contacting a therapist. Let these influential roles in your life help you to create a more positive state of mind. Rather than become “submerged in a vortex of negative, self-defeating thoughts,” Silverman encourages her patients to learn self-compassion. Above all, please don’t give up. Please don’t let depression win. You are not alone.

** A variation of this blog previously appeared on The Mighty http://themighty.com/2016/05/smiling-depression-what-you-need-to-know/

Laura is a writer and non-profit fundraiser who lives in Dallas. She has a journalism degree from Texas A&M University, and is active in The Writer’s Path at Southern Methodist University. Laura loves music and travel, and tries to combine the two whenever possible. She’s also mildly obsessed with her 2-year-old Corgi mix, Corbin. If Aaron Sorkin wrote it, she’s probably quoted it. Never met a pun she didn’t like. Read more from Laura at https://betweengriefandhighdelight.com