What on earth is smiling depression?

I’ve heard it called many things, but “Smiling Depression”? Come on, it can’t be real. Or can it?

Have you ever heard of smiling depression?

Coloured female with psychotic depression smiling at the psychiatrist
Is this smiling depression? Image by Unsplash.com

No, me neither. I came across it while researching for a completely unrelated post. I was actually trying to find the words to describe a mental health professional’s fake smile. However, the more I read about smiling depression, the more it resonated with me, and I thought it might interest you.

What about the lady in the picture (right)? Is this a real smile or is it covering something else? Would you be able to tell the difference?

I remember several occasions, being depressed and so angry with my now ex, and having to put a bright face on for my sons’ birthday parties. Once the soggy streamers were binned, the guests had gone on their merry way and the boys were comatose, my mood immediately plummeted down to my little size three’s. I bet most of you have had something like this occur?

Depressive Disorders

The most common and typical form of depression is the depressive episode, but there are other subtypes of major depressive disorder. When the depressive episode recurs we speak of recurrent depressive disorder. Then there is Dysthymia which is characterized by milder severity of depressive symptomatology compared to depressive episodes or recurrent depressive disorder. We have manic depressive disorder, atypical depression and psychotic depression, and last but not least seasonal affective disorder. And then, of course, there is smiling depression.

Think about someone with depression for a few moments

Typical example of seasonal depression. Crying and blowing nose.
Sad and crying —Image by dlpng.com

Did you imagine someone who always looks miserable, down or sad? Someone who’s sat in their pj’s, wrapped in a duvet, crying on the sofa all day? Someone who can’t be bothered to attend to their hygiene needs or their scraggy bed hair? You might have thought any of that.

However, and unfortunately, some people with what’s known as smiling depression don’t have those obvious symptoms of depression. They often come across as happy, upbeat, and look cheerful or even on top of the world, on the outside. Yet, they might feel dreadful, like they’re just treading water, sad, hopeless or worthless on the inside.

So, what is smiling depression?

Severely depressed subject hides face behind cardboard while struggling with feelings of sadness.
Struggling with sadness Image by Pixabay.com

According to Medical News Today, smiling depression is a term doctors use to describe when a person masks their depression behind a smile.

While smiling depression isn’t a technical term that psychologists use, it’s definitely possible to be depressed and to successfully mask your symptoms. Also, though it’s not a clinical diagnosis, trust me, smiling depression is real. Surprisingly, it affects more people than you might think.

Likewise, people living with smiling depression are in all probability, perfectionists, high achievers and very successful. Their mood is likely to worsen considerably if they don’t meet their own impossibly high standards.

What are the risks of having smiling depression?

.Despite the worldwide prevalence of mental ill health, it’s still really difficult for some people to open up and ask for help. Furthermore, current research shows that harmful stereotypes about mental illness often prevent people from seeking treatment or speaking out at all (Olivia Singh, Insider, 2020).

Sadly, these people who can’t or don’t talk about their feelings might be more vulnerable to suicidal ideation. And because spotting the signs of smiling depression isn’t easy, it can be missed.

People with a major depression sometimes feel suicidal but many don’t have the energy to act on these thoughts. But someone with smiling depression might have the energy and motivation to follow through (T.J. Legg, Insider, 2018)

Who might have smiling depression?

Quote saying Sometimes the prettiest smiles hide the deepest secrets
Quote of the day

Absolutely anyone! It could be someone you know who, when you greet them, they smile brightly and engage in conversation.

It might be a family member who when you call, they sound chipper and tell you everything’s going well. How about that annoying colleague who’s always, always cheerful, who brings in homemade goodies for everyone and tells you how wonderful life is?

Despite how they appear or sound, you might want to watch and listen just that little bit closer. You could notice that the lips smile but there are no creases around the eyes, or that their smile fades too quickly. Maybe their body is tense or their shoulders are up round their ears. And you could get the “Oh, yes, I’m fine.” with a great big hearty grin but would you be smiling if you just felt fine?

Someone with smiling depression might sound ecstatic but does it sound over the top, cos we quite often overcompensate for feeling down by trying too hard? Listen for the heavy huff or puff at the end of their sentences which may be incongruent with their cheerful quips. Pay attention if they’re less interested in spending time together or they don’t communicate as much as they used to, despite what they tell you.

Do I have smiling depression?

Alcoholism is a common mental illness among subjects with chronic depression
Image by mgg-vitchakorn at Unsplash.com

It’s possible? Only yesterday we were visiting friends for a bbq and all morning I felt absolutely awful, almost to the point of cancelling. Even throughout the drive there I was having suicidal ideation.

Yet as soon as I walked in the door and saw my friends I was all smiles and hugs (okay, I get the social distancing thing). The afternoon was terrific, with scintillating conversation, food that was amazingly different and cold sparkling wine to wash it all down with.

Then crash, and without warning, my mood nosedived. I felt it immediately I put my first foot out the door, amidst the goodbyes and more hugs. Then I cried silent tear all the way home and I remain low, tearful and hopeless today as I type. I know this particular bout of my persistent depressive disorder is situational and reactive so hopefully it will pass, soon.

Final thoughts

I know that we can’t all be happy every minute of every day, it’s almost impossible, but it’s certainly not normal to feel blue or sad all the time either. It feels excruciatingly exhausting and it’s where I am right now. It’s taken around seven hours to write this post, reread and edit lol.

Over to you

Large red question mark with white character of a man leaning against it

What do you think about the term smiling depression. Is it just another elaborate term dreamt up by our silver-spooned or pretentious psychologists? Do you think maybe you or someone you know is experiencing smiling depression? I look forward to reading your comments and will answer any questions.

You might want to read about depression, 10 thinking errors of depression here. Or a guest post about a fellow blogger’s depression and anxiety here.

Related: Data-driven subtypes of major depressive disorder (1). The dangers of smiling depression (2). Let’s talk depression (3).

Author: mentalhealth360.uk

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

21 thoughts on “What on earth is smiling depression?”

  1. Smiling depression..!!
    I haven’t thought of something like that.
    In India…day before yesterday an actor committed suicide and after reading this…I think he must be going through the same ‘smiling depression’.

  2. Rather than thinking of smiling depression as its own entity, I tend to think of it as varying degrees of ability to mask. There have been times when I’ve been able to mask, and other times when I’ve had affective flattening and couldn’t mask even if I wanted to.

    1. I get what you mean Ashley. It’s like ‘it’s out of the box now, and it won’t go back in’, there’s times I can’t possibly hide it either, so I keep away from people. Like this is my third day tucked up in my crappy one bed flat but it’s a better option right now.

    2. Yes. It is very difficult to mask it at times. I am grateful that many of the symptoms I have right now, are from my schizophrenia. I never thought I’d say something about gratitude and symptoms in the same sentence, but there you have it.

  3. Yeah I can relate to the whole smiling depression thing because that’s exactly the kind of depression I have. I am very high functioning, seem quite social and do stuff apart from sitting in my pj’s being sad all day lol. When I tell people I suffer from anxiety and depression they usually are very surprised to hear that. Unfortunately, not everyone who suffers from depression is the stereotypical depressed person we see on TV shows/movies but that’s what people always expect.

    1. I feel for your Pooja and I can imagine how it might feel for you. I can’t believe I lived like that for so many years. I’m the same for you, it’s exhausting, being high functioning and depressed at the same time!

  4. I don’t really believe in the term ‘smiling depression’ I think it’s maybe due to a severe disconnection between interior and exterior, which occurs with depression.
    It is definitely not normal to be quite sad most of the time but depression makes it more normal as you live longer with it. That is my experience anyways.
    What I do believe that certain people are capable of hiding the symptoms, the sadness, but it comes to the surface. When feeling depressed, you also want a life no? So forcing yourself to go to that party or to do something may seem like it also can be a good thing to lift your mood, to have a change of scenery. But it costs a lot of energy and effort and the ‘down’ is even harder felt than. (that is the case in my experience). Interesting post!

    1. I’d never heard of smiling depression until that recent article lol.
      I know what you mean Kacha, the longer we live with it…… And yes, I had to hide it all from my sons; keep smiling and carry on and I couldn’t wait til they’d gone to bed. By the time we’d finished their bath and stories or activities as they got older, I was ready to flake out on the sofa and just cry due to the sheer exhaustion of hiding my feelings.

      Yes, I did go out from friends sometimes, when the boys were with their dad or grandparents. And I’d have a good time but the minute I got home, the rotten feelings would return. And yes, the down was awful cos when out, I’d seen so many ‘happy’ people thinking that’s how I want to be. But hey, they might have been depressed like me? x

      1. We never truly know do we? Sometimes we discover when it’s too late. I sometimes think being sad (the normal kind) is a little taboo sometimes.

      2. That can be very well the case. It can be uncomfortable when we’re not able to ‘fix’ things or to console someone right away. But true friends can handle that.

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  6. I agree with ashleyleia that “smiling depression” seems like more of a scale than a distinct condition. Some people may mask without really thinking about it because they’re so used to covering up their emotions for work, delicate family situations, good example for the kids, etc. I imagine many people in customer service learn to smile brilliantly even when they are sick and tired of everything and just want to go crawl into bed. If someone with that skill also has depression, it’s natural that they would apply it to their condition.

    Other people may try to mask but only be successful to varying degrees. In the book version of her blog Hyperbole and a Half, Allie Brosh talks about how when she began her struggles with depression, she tried to act “normal” but found it very hard to produce genuine-looking “yay-faces” without equally genuine emotion. Often people noticed something was off, even if they didn’t quite understand what. Is that smiling depression or just someone with depression trying to keep up appearances?

    1. I agree with Ashley too 😉 I’m sure you know I had to cover/mask my mental illness for many years. But after I’d been to counselling and learned more about emotions/feelings – it felt like I’d been opened up and let it all out.

      But what I found to be an issue was that once I’d allow myself to feel anger/rage, sad/down and so on, I couldn’t stop………. I was always in tears at the drop of a hat. And that lasted a couple of years lol.

      I’ve got that under control now

      That book (I’ve heard of the title) sounds interesting ‘Ceridwen’. And I’m sure people (who didn’t know me so well) noticed something was off. Some eventually became good friends and all told me they’d thought I was a little standoffish when they first met me. But once I let my guard down and let them in, they got to know me better. It was my mask, I suppose.

      Yes, ‘smiling depression’ is an odd term and it’s not a diagnosis but it almost feels like it fits.

      Not that I’d want to see it become a diagnosis either – how do you tell if it’s real or not? lol. Thanks as always, for your well-thought out comments and questions. Caz x

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