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Smiling Depression: What You Need to Know

Medically Reviewed by Jennifer Casarella, MD on July 14, 2020

You won’t find smiling depression listed in the official diagnostic manual for mental disorders. But it’s a very real condition. Mental health professionals use the term when you’re depressed or anxious but look and act happy.

If you have smiling depression, you might tell others that you feel fine and power through your daily activities as usual. So your family and others may not realize you may need help.

Who Is Most at Risk?

Smiling depression is like a high-functioning form of this mood disorder. You may be more likely to have smiling depression if you tend to be a perfectionist or are ambitious. Keeping up appearances is important to you. You may be very good at faking. Smiling depression can mimic the manic phase of manic depression. You might overdo the laughter and stay highly productive at work.

But on the inside, you may actually feel like a fraud. At the same time, you may feel ashamed about feeling down. The stigma in turn may prevent you from confiding in others or getting medical help.

Symptoms and Consequences

One way that smiling depression differs from other types of depression is that it’s often invisible. Others may be unaware that you’re depressed, and you may not realize it yourself.

That’s one reason smiling depression sometimes can be more dangerous than the “classic” form of depression. Suicide is a big risk. People may not know you need help without the common signs of depression such as withdrawal, low energy, or lack of pleasure. People with smiling depression mask all those feelings well.

You also have the energy to plan and follow through with a plan to die by suicide. On top of that, your type of depression may make it especially hard to deal with a major setback like a divorce or job loss.

Smiling depression shares some of the same hallmark signs of depression. They include feeling sad or down, loss of enjoyment, and difficulty concentrating. People with smiling depression also may:

Treatment

The good news is that smiling depression is very treatable. If you think you might have it, first see a psychiatrist or another mental health professional. Many people with smiling depression keep a false front even with therapists. That makes it more difficult for you to get the help you need. It’s important to open up and honestly share how you feel. Your doctor or therapist will help you decide if antidepressant medications may benefit you.

Other things that may help include if you:

  • Share your feelings with a trusted friend or loved one. It may lift the weight of hiding your true feelings.
  • Spend time outside with nature.
  • Exercise -- even just 10-15 minutes a day be enough to lift your mood.
  • Listen to music, make art, or do other activities you enjoy.
  • Meditate.

Being your authentic self can be an important first step toward recovery from smiling depression.

WebMD Medical Reference

Sources

SOURCES:

Mayo Clinic: “Depression (major depressive disorder),” “Depression and anxiety: Exercise eases symptoms.”

Rita Labeaune, PsyD, Los Angeles.

Gordon Flett, professor of psychology, Canada research chair, Personality and Health, York University, Keele, Canada.

National Alliance on Mental Illness: “What You Need to Know About ‘Smiling Depression.’”

 

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