What you need to know about ‘smiling depression’

We get asked the question, “How are you doing?” all of the time. Some of us can honestly answer we are fine or even great and mean it, but that doesn’t hold true for everyone. The National Institute of Mental Health estimated 16.1 million adults in the United States had at least one major depressive episode in 2015 – that’s 6.7 percent of all U.S. adults.

Someone with depression is typically depicted as a person who can’t get out of bed and feels helpless, but that’s not the case for all depressed individuals. There are people who often appear to be happy and motivated that are still dealing with a type of depression that isn’t well known called smiling depression.

What is smiling depression?

According to Psychology Today, “Smiling depression is appearing to be happy to others, literally smiling, while internally suffering with depressive symptoms.”

“Depression can present itself differently in individuals,” says Dr. Debra Haley, a psychologist at Advocate Lutheran General Hospital in Park Ridge, Ill. “General signs of smiling depression might be expressions or statements of inappropriate guilt, feelings of worthlessness or inadequacy that contradict performance. Other signs might be a marked change in behavior from past behavior or withdrawing or isolating behaviors. Individuals with smiling depression are often perfectionists with unrealistic standards for themselves and often for others.”

Dr. Haley recommends these four coping tips to help you or a loved one who might have smiling depression.

1. Be assertive. It is important for family and friends to talk about changes or concerns with behavior in a direct and caring manner. Don’t be afraid to ask difficult questions and to really listen to the answers. If you feel like you have smiling depression, talk with someone you trust to listen to you without judgment and tell them how you are really feeling.
2. Be attentive. If you know the person has recent or ongoing stressors in their life like an illness, death in the family, job loss, foreclosure, etc., understand that would challenge anyone in that position. Make sure to check in with them to see how they are doing.
3. Be a listener. Validate their feelings, and if appropriate, share your own past struggles. Offer hope and encouragement and reach back out to them over time.
4. Be involved. It is helpful to seek professional help in situations like this. Offer to go with your loved one to the doctor, a psychologist, or a support group if it makes sense for you to be there. For individuals who feel like they have smiling depression, find a professional whom you can connect with and trust. It’s helpful to talk about how you feel in order to feel less alone, to experience validation, and to look at your thoughts and feelings from a different and more hopeful perspective.

“Just remember, don’t give up on yourself or loved ones with depression or other types of mental illness,” she says.