What does depression look like?
If you picture a depressed person as someone who can’t stop crying, who is exhausted, who doesn’t want to socialize, or who has stopped taking care of their health or appearance, you may be right. However, depression can also look like an A student, a social butterfly, or a consummate professional. The most pulled-together, on-top-of-everything, energetic gregarious person you know could be suffering from depression.
How is it possible that someone could be depressed without showing any symptoms? This is what is called “smiling depression.”
You could also think of it as high-functioning depression. People who have smiling depression do experience symptoms, but they mask or internalize the symptoms so that they’re not obvious to others. Take a look at some statements that people who have smiling depression will understand.
1. “I Don’t Want to Upset Anyone Else”
People with smiling depression may feel responsible for other people’s feelings as well as their own. For example, a teen with smiling depression may not want their parents to feel worried or their friends to feel burdened or bored by their problems. Keeping up the smiling façade doesn’t do anything to alleviate the depression, but it does seem to keep others around them happy.
Very often, people with smiling depression are also people who are perfectionists, people who take on heavy responsibilities, and people who are held to high standards, either by themselves or by someone else. They may fear disappointing others, failing to live up to their own standards, or being seen as weak, disappointing, or unreliable. These fears cause them to hide the signs of depression that other people are likely to recognize. However, they still experience distressing symptoms like anxiety, loss of appetite, sadness, fatigue, fear, insomnia, or intrusive thoughts. They just don’t show or talk about them.
2. “I Want to Feel as Happy as I Look”
Smiling depression could be an attempt at a “fake it till you make it” approach to depression. That is, the person may believe that by smiling, laughing, and going about their day-to-day life as if everything were OK, they can eventually force themselves to feel OK.
“Fake it till you make it” can be an effective strategy in certain situations. In therapy, this is sometimes referred to as acting “as if”. For example, if you want to be more confident, you can act as if you were more confident by doing what a confident person would do in a given situation – say, introducing yourself to a stranger at a party or boldly talking up your accomplishments and skills in a job interview. And in those scenarios, acting as if often works. Acting as if you’re happy when you’re feeling a little down or having a bad day can also work – smile enough and you may eventually boost your own mood.
However, there are also times when acting as if, or faking it, doesn’t work at all. For pervasive, long-lasting depression, it takes more than just acting happy to actually bring on feelings of happiness. Faking it also tends not to work when the person is doing it more for other people than for themselves. Acting happy just to please the people around you or make them more comfortable can actually be quite isolating, and that feeling of isolation may make depression worse, not better.
3. “I Don’t Know If My Smiling Depression Is Real”
Smiling depression could be a deliberate attempt by the depressed person to hide their true feelings, but it can also be unintentional. Sometimes, people with smiling depression don’t know why they keep smiling, and they may not trust their own feelings. They may not even recognize that they are depressed.
Because someone with smiling depression often seems well-adjusted, happy, and content, they also often receive complimentary feedback on these characteristics. Being told that they’re “so cheery!” or “so successful!” or “so motivated!” when they don’t feel cheerful, successful, or motivated can be confusing. They may view themselves as negative, worthless, or lazy for not feeling like they live up to the appearance they’re presenting to others instead of realizing that it’s depression that’s responsible for the disconnect between the way they appear and the way they feel. This can lead to doubling down on keeping up appearances rather than reaching out for help.
4. “I Want to Tell People How I Feel, but I Can’t”
Hiding or masking a serious problem like depression is like building an invisible wall between the depressed person and the people around them. The longer it goes on, the higher and more impenetrable the wall becomes. A person with smiling depression may recognize that they need support, but feel unable to get the words out when they have the chance to.
A person who has smiling depression may feel like they will have to explain their outwardly happy behavior if they confess to feeling depressed, and they may not feel up to the task – or necessarily even understand it themselves well enough to explain it. The longer they go on presenting a smiling face to the world while inwardly suffering from depression, the harder it may feel to explain.
If a person with smiling depression does attempt to speak out about it and is met with skepticism and unhelpful comments like, “you don’t seem depressed,” they may withdraw even further, feeling that they won’t be believed or understood. They might doubt their own feelings. They may feel unable to press the issue further or seek out someone else to talk to.
Learn How to Recognizing the Signs of Smiling Depression
Smiling depression is deceptive. While people with smiling depression may look like they’re going through their lives successfully, they’re still experiencing all of the negative effects of depression. Smiling depression can lead to other health problems, it can lead to self-harming behaviors, and it can also lead to suicide. Compared to other forms of depression, which tend to leave sufferers without much energy, smiling depression may put sufferers at greater risk of suicide because they’re less likely to receive help and support and because they have the energy to act on suicidal thoughts. Recognizing subtle signs of smiling depression can help ensure that the person with depression gets the help they need.
Dr. Nalin is a Licensed Clinical Psychologist, and Founder and Executive Director of Paradigm Treatment Centers, who has been a respected leader in the field of adolescent mental health for more than 20 years. He received his undergraduate degree from the University of Southern California, his Master’s degree from Loyola Marymount University, his Doctoral degree from Pacific University’s APA approved Clinical Psychology program, and completed his training at the University of California, San Diego’s APA approved psychology internship program.
Dr. Nalin has provided training and mentoring to students entering the field of psychology at institutions of learning including Pepperdine University’s Graduate School of Education and Psychology, UCSD, Pacific University, and Santa Monica College. He was also instrumental in the development of the treatment component of Los Angeles County’s first Juvenile Drug Court, which now serves as a national model.
Dr. Nalin has appeared as an expert on shows ranging from CBS News and Larry King, to CNN, The Today Show and MTV. He was also featured in an Anti-Drug Campaign for the Office of National Drug Control Policy (ONDCP).
Dr. Nalin is a Diplomate of the National Institute of Sports Professionals and a Certified Sports Psychologist as well as a Certified Chemical Dependency Intervention Specialist. He lectures and conducts workshops nationally on the issues of teen mental health, substance abuse prevention, and innovative adolescence treatment.
In 2017 Dr. Nalin was awarded The Sigmund Freud Foundation and Sigmund Freud University’s Distinguished Achievement Award in recognition of his work with youth in the field of mental health over the course of his career.