Depression doesn’t look the same in everyone. You can smile and appear content and still have depression.
While you might think that you’d notice signs of depression in someone, that’s not always the case. If you experience smiling depression, you may appear perfectly happy from the outside but have symptoms of depression behind closed doors.
While you may relate to the term smiling depression, it’s not technically a type of depression as far as diagnoses go. Nevertheless, if you identify with it, that’s valid.
Learning more about your mental health — the symptoms you have, potential causes, and treatments for depression — can help you improve your overall well-being.
Have you heard of smiling depression? If not, that’s probably because smiling depression isn’t an official condition in the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5). Still, some people may relate to smiling depression more than a clinical condition name.
Smiling depression is likely to be diagnosed as major depressive disorder (MDD) with atypical features (aka atypical depression).
It’s considered “atypical,” because usually when someone has depression, there are noticeable symptoms. Whether that’s difficulty getting out of bed in the morning, changes in appetite, or a general loss of interest in things you previously enjoyed, depression typically causes noticeable changes in your behaviors.
But this isn’t the case if you’re experiencing smiling depression.
As its name suggests, smiling depression is a type of depression where you have depressive thoughts like worthlessness, hopelessness, and sadness, but you’re able to hide them through a happy external appearance.
You wear a smile — regardless of what you’re going through inside.
In depression with atypical features, you may also feel temporarily better when good things happen. But this is brief throughout a depressive episode. This is what makes atypical depression “atypical” — because you can actually feel momentarily cheered up.
This can also lead to beliefs or patterns where you constantly seek out experiences to lift your mood in order to avoid depressive symptoms.
If you have smiling depression, you probably seem accomplished and “put together” to those around you. You may also worry that sharing your feelings will cause others to judge you.
This is a very common sentiment in anyone who experiences this particular mental health condition, but you have no reason to be ashamed.
Smiling vs. high-functioning depression
They may sound the same, but high-functioning depression and smiling depression are terms describing different depression diagnoses. High-functioning depression is more commonly diagnosed as a chronic type of depression called persistent depressive disorder (PDD) — aka dysthymia.
Note: Neither smiling depression or high-functioning depression are official diagnoses in the DSM-5.
If you think you’re experiencing smiling depression, the easiest first step is to contrast how you feel versus how you appear to the outside world.
When you’re alone, do you feel persistent symptoms — yet you never express any of these feelings to others? This is a typical pattern of smiling depression.
Depression is a common mental health condition that impacts the way someone thinks, feels, and acts. It can cause symptoms like:
- lack of energy, fatigue, or exhaustion
- irritability, outbursts, or changes in mood
- changes in appetite or weight fluctuations
- loss of interest or pleasure in activities you once enjoyed
- feeling worthless or guilty
- difficulty thinking, concentrating, or making decisions
- thoughts of death or suicide
If you or someone you know is considering suicide, you’re not alone. Help is available right now:
- Call the National Suicide Prevention Lifeline 24 hours a day at 800-273-8255.
- Text “HOME” to the Crisis Text Line at 741741.
Not in the United States? Find a helpline in your country with Befrienders Worldwide.
Please don’t feel that your promotion at work or vibrant social life negates “down” feelings. Your life doesn’t need to be falling apart for you to live with depression.
If you’re experiencing smiling depression, others may not be able to tell you’re in distress. But just because your symptoms aren’t visible through your behaviors, you can still feel them deeply.
If you believe someone you love is experiencing smiling depression, the mask they wear can make it hard for you to know what’s really going on.
You may want to look out for these subtle signs:
- talking more philosophically than normal
- making excuses to not hang out with friends
- being vulnerable, then taking it back
- seeming detached or “aloof”
- difficulty making decisions
Your loved one may try to conceal their inner feelings, but this isn’t always bulletproof — a happy facade can sometimes wear thin enough that little signs come to light.
Hiding your depression may feel safer — and that’s understandable. Yet if we’re aware about why we’re concealing it in the first place, it can help us change and open up to the people we love and trust.
Not sure why someone would hide their depression behind a smile? Here’s a few reasons:
Stigma surrounding mental health conditions like depression hasn’t made it any easier to open up. Perhaps you’re afraid of how you’ll be perceived by others, or fear they’ll judge you.
Thankfully, public perceptions have started to change. For instance, the misconceptions that people with depression are responsible for their condition, that they’re undesirable to be around, and that they’re a threat are all fading away.
Getting support for a mental health condition isn’t a sign of weakness — in fact, it’s a sign of strength.
See how it feels to share what you’re going through with your friends and family. If you need to, open up a little at a time.
Have faith that they’ll understand (or at least try to). Let them know that it would mean a lot to you if they support you in finding the appropriate treatment approaches and coping tools to feel better.
Many people hide their depression because they think they can “fix” it on their own.
To help manage symptoms, some people self-medicate. In fact, people with depression can also have substance use disorder.
Depression symptoms can be incredibly hard, but they can get even worse when mixed with alcohol and drug use.
Social expectations can make it difficult for you to share how you’re feeling.
If you’re a man, you may feel societal pressure to “man up,” which can prevent you from wanting to be vulnerable about your thoughts and feelings.
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Remember: Managing depression isn’t as simple as “toughening up.”
Smiling depression isn’t an official diagnosis, but you may be diagnosed with a mental health condition such as atypical depression.
To receive a diagnosis, a medical professional will likely start by asking you questions to gauge your symptoms. They may also ask about any recent events that could have caused the depression.
Depending on your symptoms, you could be diagnosed with any of the following conditions:
- major depressive disorder (MDD)
- bipolar disorder
- substance or medication-induced depression disorder
- depression caused by an underlying health condition
- seasonal depression
- persistent depressive disorder (PDD)
Smiling depression can be complicated to recognize, given that you may not be outwardly showing symptoms of depression.
Many treatment options are available for managing depression, and you may want to try a combo of options rather than just one.
Some therapeutic methods that can help include:
Depending on what your doctor suggests, you may also want to consider medication. For some people, this is an option worth pursuing.
Outside of therapy and medication, self-care tools can make a big difference in treating depression. There’s no better time to start incorporating healthy strategies.
Some self-care options are:
- daily movement
- a balanced diet
- mental breaks
- 7 to 9 hours of sleep
- stress management
- mindfulness practices, like yoga or meditation
These are all healthy things you can incorporate into your everyday life to help you manage depression symptoms. Sometimes, even the seemingly “small” steps can make a big difference in how you feel.
Some people feel the need to hide their depression behind a smile, or may not look outwardly depressed.
No matter what your depression looks like, help is available.
In order to open up and seek help, you can think of your depression as any other health condition that requires support and treatment. There’s no shame in a person with diabetes needing insulin, right? There’s no shame in seeking help for depression, either.
For more support and resources, you can check out these links:
- NAMI Helpline
- SAMHSA’s National Helpline
- Depression and Bipolar Support Alliance’s support groups
- Psych Central’s depression hotline list
Need help finding a therapist? You can check out our detailed resource list.