What Is Smiling Depression?

Why some people with depression look happy on the outside.

A woman with smiling depression hides her emotional pain.

 Taxi / Getty Images Plus / Catherine Ledner

In This Article

Although “smiling depression” isn’t a clinical diagnosis, for many people, it's a real problem. It occurs when individuals who are experiencing depression mask their symptoms. They hide behind a smile to keep other people believing that they feel happy.

Consequently, their depression often goes undetected because when most people imagine a depressed individual, they think of someone who looks really sad. And while sadness is the main characteristic of depression, not everyone looks sad when they’re depressed.

Individuals with smiling depression often look happy to the outside world as they keep their depression a secret.

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.

Symptoms

The World Health Organization estimates that 300 million people around the world have depression. But some of these individuals work hard to disguise their symptoms.

Individuals with smiling depression may experience many classic symptoms of depression. Some of these symptoms may be observable to others, while other symptoms may be kept private.

Here are some of the possible signs of smiling depression:

  • Changes in appetite – While some people overeat when they’re depressed, others lose their appetite. Weight changes are common.
  • 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 symptoms, individuals with smiling depression are likely to appear high-functioning. They may hold down a steady job and continue to maintain an active family and social life. They may appear cheerful and optimistic.

Why People Hide Their Depression

There are many personal and professional reasons people may want to keep their depression private. Here are some examples:

  • They don’t want to burden anyone else. Depression and guilt tend to go hand-in-hand. Consequently, many individuals don’t want to burden anyone else with their struggles. This may be especially true for people who are used to taking care of others rather than having others take care of them.
  • They’re embarrassed. Some people believe depression is a character flaw or a sign of weakness. They may feel embarrassed about having depression because they think they should be able to handle it themselves.
  • They’re in denial. Smiling depression may stem from a person’s denial that they feel depressed. They may think as long as they’re smiling, they must not have depression.
  • They fear backlash. Someone may 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.
  • They don’t want to appear weak. Someone might also fear that others will take advantage of them if they reveal they have depression.
  • They feel guilty. Since 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.
  • Social media gives unrealistic portrayals of happiness. 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.
  • They’re perfectionists. Perfectionists have often mastered the art of looking perfect. And, for many, that means disguising any pain or problems they may be experiencing.

Risks

While anyone with depression is at risk of suicide, individuals with smiling depression may be at an especially high risk.

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.

Individuals with smiling depression, however, may have enough energy to follow through on their suicidal thoughts.

Individuals with smiling depression often go untreated as well. And untreated depression may get worse over time.

Treatment

Someone with smiling depression might officially be diagnosed with depression with atypical features (looking happy isn’t typical of someone who feels depressed).

Just like other types of depression, smiling depression is treatable. Treatment may include medication, talk therapy, and lifestyle changes (like 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.

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 it’s a loved one who refuses to get help, you might consider talking to a therapist yourself. This can be especially helpful if your partner, parent, or child has depression. Talking to someone can help you manage your own stress while also reinforcing the strategies you can use to help someone you care about.

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