Depression What Is Smiling Depression? Why Some People With Depression Look Happy on the Outside By Amy Morin, LCSW, Editor-in-Chief Updated on November 29, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Carly Snyder, MD Medically reviewed by Carly Snyder, MD Facebook LinkedIn Twitter Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments. Learn about our Medical Review Board Print Verywell / Laura Porter Table of Contents View All Table of Contents Signs and Symptoms Reasons for Hiding Suicide Risk Treatment How to Help Although “smiling depression” isn’t a clinical diagnosis, for many people, it's a real problem. Typically, smiling depression occurs when individuals who are experiencing depression mask their symptoms. They hide behind a smile to convince other people that they are happy. Consequently, this type of depression often goes undetected because when most people imagine a depressed individual, they think of someone who looks really sad or cries a lot. And while it's true that sadness and unexplained bouts of crying are common characteristics of depression, not everyone looks sad when they’re depressed. Individuals with smiling depression often look happy to the outside world and keep their depression a secret. Signs and Symptoms Whether you’re the one who works hard to pretend you’re happy when you’re not, or you have a loved one that you suspect might be hiding their pain, understanding smiling depression can help you take positive action. Here's an overview of the signs and symptoms of smiling depression. The World Health Organization (WHO) estimates that almost 265 million people around the world have depression. Individuals with smiling depression may experience many classic symptoms of depression, including profound sadness, low self-esteem, and changes in their everyday lives. Some of these symptoms may be observable to others, while other symptoms may be kept private. It's not uncommon for people with smiling depression to work really hard to disguise their symptoms. For this reason, it's important to look for other less-obvious signs that something is wrong, like changes in their habits, fatigue, and a loss of interest in things they once enjoyed. Here's a list of possible signs to look for: Changes in appetite: While some people overeat when they’re depressed, others lose their appetite. Weight changes are common with any type of depression. Changes in sleep: Some people struggle to get out of bed when they’re depressed because they want to sleep all the time. Others can’t sleep and they may report insomnia or exhibit major changes in their sleep habits, such as staying awake at night and sleeping during the day. Feelings of hopelessness: Guilt, worthlessness, and feelings of hopelessness are common. Loss of interest in activities: Individuals with smiling depression may not be interested in the activities they usually enjoy. Despite these signs and symptoms, individuals with smiling depression are still likely to appear high-functioning. They may hold down a steady job and continue to maintain an active social life. They may even appear cheerful and optimistic. For this reason, it's important to talk about mental health issues in an open way. Doing so may give them the courage to open up about their feelings. Why People Hide Their Depression It's not uncommon for people to keep their depression private. From wanting to protect their privacy to fearing judgment by others, there are many personal and professional reasons why people hide their symptoms of depression. Here's a closer look at why people keep depression a secret. Fear of Burdening Others Depression and guilt tend to go hand-in-hand. Consequently, many individuals don’t want to burden anyone else with their struggles. This fact may be especially true for people who are used to taking care of others rather than having others take care of them. They simply do not know how to ask for help, so they keep their struggles to themselves. Embarrassment Some people believe depression is a character flaw or a sign of weakness. They may even believe the lie that they should be able to "snap out of it." When they cannot, they think there's something wrong with them. Consequently, they may feel embarrassed about having depression because they think they should be able to handle it themselves. Denial Smiling depression may stem from a person’s denial that they feel depressed. They may think that as long as they’re smiling, they must not have depression. Many people cannot admit that there might be something wrong with them. It's easier for them to pretend like they're fine than it is to open up about how they truly feel. Fear of Backlash Sometimes people worry about the personal and professional ramifications of having depression. For example, a comedian or lawyer may be concerned that their employer will doubt their ability to do their job. Or, someone may worry that a partner will leave them if they reveal that they have depression. So, rather than risk being judged or punished for being depressed, they hide behind a smile. Concern About Appearing Weak People with smiling depression often fear that others will take advantage of them if they reveal they have depression. Not only do they worry that others will see them as weak and vulnerable, but they are concerned that others will use their depression as leverage against them. They would rather put on a tough exterior than admit that they need help. Guilt Because guilt tends to accompany depression, sometimes people don’t feel as though they should be depressed. They might think they have a good life and shouldn’t feel bad. They also feel like they must be doing something wrong or that they're somehow to blame for being depressed. Consequently, they feel guilty and sometimes even ashamed of their depression. So they keep it hidden behind a smile. Unrealistic Views of Happiness Social media portrays happiness in an unrealistic way. Many people scroll through social media and see pictures of happy people. Consequently, they grow to believe that they’re the only ones struggling with mental health issues. They may feel more isolated than ever and it could cause them to hide their struggles. Perfectionism Perfectionists have often mastered the art of looking perfect. And, for many, that means disguising any pain or problems they are experiencing. As a result, admitting to depression would mean that their lives are less than perfect and they just cannot bring themselves to do that. Depression Facts Everyone Should Know Risk of Suicide Depression often causes thoughts of death and suicide. But sometimes, people with clinical depression lack the energy to create a plan and follow through on completing suicide. While anyone with depression is at risk of suicide, individuals with smiling depression may be at especially high risk because they are high-functioning. Individuals with smiling depression often have enough energy to follow through on their suicidal thoughts. What's more, individuals with smiling depression often go untreated as well. And untreated depression may get worse over time and increase the likelihood of suicide. Treatment for Smiling Depression Someone with smiling depression might officially be diagnosed with depression with atypical features. For instance, looking happy isn’t typical of someone who feels depressed. But just like other types of depression, smiling depression is treatable. Treatment may include medication, talk therapy, and lifestyle changes such as diet and exercise. If you think you may be depressed, talk to your doctor. Explain that you haven’t been feeling yourself lately and describe some of the symptoms that you’re experiencing. Your physician can rule out physical health issues that may be contributing to your symptoms and can assist with referrals to other treatment providers, such as a psychotherapist or psychiatrist. Press Play for Advice On Dealing With Sadness Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring best-selling author Helen Russell, shares how to accept and embrace your sadness. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts How to Help Someone Else If you think someone you know has smiling depression, share your concerns. Normalize mental health issues and talk to them about how they can get help. Offer emotional support as well as practical support. For example, you might offer a ride to a medical appointment, or depending on the nature of your relationship, you might even offer to attend an appointment with them. Direct them to community resources as well. Tell them about mental health services that may be available to them. If a loved one refuses to get help, you might consider talking to a therapist yourself. Talking to someone can help you manage your own stress while also reinforcing strategies you can use to help someone you care about. If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. A Word From Verywell People with smiling depression often mask their sadness with a smile and an external facade, which are designed to hide their inner turmoil and suffering. If you or a loved one is experiencing symptoms of depression, but are hiding it from everyone else, you need to know that there is help and there is hope for the condition. Take the first step and reach out for help. With the right treatment and support, the smile you have on the outside will soon match how you feel on the inside. 7 Common Types of Depression 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. World Health Organization. Depression. Shetty P, Mane A, Fulmali S, Uchit G. Understanding masked depression: A clinical scenario. Indian J Psychiatry. 2018;(60)1:97-102. doi:10.4103/psychiatry.IndianJPsychiatry_272_17 Pulcu E, Zahn R, Elliott R. The role of self-blaming moral emotions in major depression and their impact on social-economical decision making. Front Psychol. 2013;(4):310. doi:10.3389/fpsyg.2013.00310 Rössler W. The stigma of mental disorders: A millennia-long history of social exclusion and prejudices. EMBO Rep. 2016;17(9):1250-3. doi:10.15252/embr.201643041 Shensa A, Sidani JE, Dew MA, Escobar-Viera CG, Primack BA. Social media use and depression and anxiety symptoms: A cluster analysis. Am J Health Behav. 2018;(42)2:116-128. doi:10.5993/AJHB.42.2.11 Centers for Disease Control and Prevention. Mental health conditions: Depression and anxiety. Additional Reading National Alliance on Mental Illness. What you need to know about "smiling depression." By Amy Morin, LCSW, Editor-in-Chief Amy Morin, LCSW, is the Editor-in-Chief of Verywell Mind. She's also a licensed clinical social worker, psychotherapist, and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk, "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.