Do You Suffer From Smiling Depression?

People with smiling depression find it difficult to feel as happy as they try to appear to others. (Photo: Marcos Mesa Sam Wordley/Shutterstock)

If you spend the majority of your day smiling at others while feeling sad and depressed on the inside, you may have a condition called smiling depression. If this is you, the two most important things you need to know are that you're not alone, and you can get help.

The traditional image of a person with depression is a person who's noticeably sad and disengaged. So surely, a person who smiles frequently can't be depressed, right?

You smile all day long — at work, with your kids, with your partner, and even at the doctor's office. You smile, you laugh, and you look happy. Yet you can't seem to shake the fear, loneliness, and sadness that brews directly below your surface.

This is smiling depression, also known as perfectly hidden depression. According to Thai-An Truong, a mental health therapist at Oklahoma's Lasting Change Therapy, the symptoms of smiling depression are similar to those of depression: low mood, sadness, hopelessness, low self-worth and suicidal thoughts. The difference, Truong adds, is that people with smiling depression "put on a happy face in front of others," hiding their vulnerability and even using laughter as a means to disguise their pain.

In a survey conducted by Women's Health magazine and the National Alliance on Mental Illness, 89 percent of the 2,000 respondents who said they suffered from depression also noted that they keep their inner turmoil hidden from friends and family.

As you might expect, social media exacerbates the symptoms of smiling depression. People with the condition look at others' posts about their seemingly perfect lives, perfect kids, and perfect homes and feel pressured to keep up appearances. They may even post their own perfect shots with captions that don't match what's really going on in their lives. Then they feel guilty about the fact that they can't find happiness even though society tells them they have everything they need to achieve it.

Golden on the outside, dark on the inside

sad girl looking at cell phone
Don't be fooled by appearances. Just because someone posts seemingly happy photos on social media, doesn't mean they aren't suffering. (Photo: Antonio Guillem/Shutterstock)

As clinical psychologist Dr. Margaret Rutherford explains it, "You can have blessings in your life. And feel their weight. Just because you are admitting that doesn’t mean you are not grateful for those same blessings."

Women's Health even asked women to re-caption posts in which they may have been hiding feelings of smiling depression. Here are a few examples:

"What perhaps makes (smiling depression) so scary is that these people are likely not seeking help because they feel even more insecure or self critical that they are depressed when they 'should feel happy' or 'seem to have everything going for them,' so they silence their owner inner turmoil causing greater degrees of guilt and shame which contributes to worsening depression," says Carrie Krawiec, a marriage and family therapist at Birmingham Maple Clinic in Troy, Michigan. Krawiec added that even though people with smiling depression tend to have a strong network of supporters, those supporters may not even know that their loved one needs help because he or she is functioning so well.

The fact that people with smiling depression look put-together on the outside is the very reason sufferers avoid getting help. They may feel like their depression isn't "bad enough" to warrant reaching out because they can still hold down a job and make dinner for the kids and sit on the board of their kid's swim team. But left untreated, smiling depression can lead sufferers to self-medicate (with alcohol or drugs) or even try more radical means to escape their situation. More than half of the women who confessed to having smiling depression in the Women's Health survey admitted that they have considered suicide.

Help is close at hand

For those who suffer from smiling depression, the good news is that help is closer than you think. Your first step is to acknowledge that this is what is going on in your life. Next, talk to someone you trust — whether that's a family member or a co-worker or a mental health professional — to let them know what's going on. If they discount your feelings, find someone else. Self-care changes (eating a better diet and getting daily exercise) can help, too. So can therapy.

Similarly, if a friend or family member who seems to have it all turns to you for comfort, don't blow them off by telling them to be grateful for what they have. "Others can help by listening to the pain in their words instead of the smile on their face as they throw out jokes about how their life sucks'" said Truong. "Let the person know that they're there to listen and support them."

Don't let smiling depression rob you of the true joys of life. Isn't it time that your inside matched what you show on the outside?