When you think of a person with Depressionyou are likely to think of someone who is too short to get out of bed; someone who cries all the time for no particular reason; someone who is lethargic or irritable. What you probably don’t think about is a person who is smiley, confident, high achieveror high energy. But then you may not have heard of the lesser known but very real issue of ‘smiling depression’.

“Smiling depression is also known as ‘high-functioning depression,'” says Dr. Lynda Foulder-Hughesa psychotherapist, Counseling Directory member and author of REMEMBER the recipe for happiness, success and fulfillment in life. “If a person has smiling depression, they may appear confident, capable and ‘happy’ on the surface and will not outwardly display the typical signs that people normally associate with those who are depressed.”

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This is why the term “smiling depression” is used. “A key feature is that they can ‘mask’ their symptoms well and often smile or laugh even when they are experiencing excruciating inner pain and sorrow” she says. “So they often don’t seem ‘sad’ in any way.”

Unlike other forms of depression, high-functioning depression is not a formal medical diagnosis. “However, people with it will experience many of the same emotional and behavioral responses as those who are formally diagnosed with a depressive disorder” she says.

Often, those around a person with this condition will not notice that anything is wrong. “In fact, even those who experience smiling depression may believe there is nothing ‘wrong’ because they are still functioning with their everyday commitments,” she continues. “Sometimes living with depressive symptoms becomes normalized, so that the person experiencing it cannot recognize themselves in crisis. On the surface things look pretty even, but underneath it’s often hectic paddling just to stay afloat.”

As such, it is important that we are all more aware of it. “We need to check in with those around us, especially those who seem to be able to ‘do it all,’ and ask them how they’re really doing,” says Hannah Abrahams, a psychologist at The Soke Clinic.

“In my experience, these individuals have become so adept at looking successful to the world around them and to their community, that the idea of ​​letting the mask slip a bit can be really scary. Therefore, the need to create a supportive space becomes increasingly important.”

Signs of “smiling depression”

It can be very difficult to spot when someone has smiling depression, but there are often small signs.

“For example, one person with smiling depression can spend the whole week as high performers, but at the weekend they are so exhausted they can’t get out of bed and enjoy their days off, says Dr Foulder-Hughes. “Alternatively, they may continue to take on huge amounts of commitment and will never say no to the extra demands of caring for others, while neglecting themselves in the process.”

Other symptoms may include the typical signs of depression, even if you don’t show them outwardly.

“Feeling hopeless, sad, unable to feel pleasure or joy in previously enjoyable activities, helplessness, and isolation are all indicative of depression.” she says. “There can also be changes in sleep patterns such as inability to fall asleep or stay asleepsleeps too much and wakes up often at night or early in the morning. Or you may have difficulty concentrating.

“Eating habits are often affected, with the person either comforting themselves, filling an empty feeling, or having little or no appetite.”

You might notice perfectionistic tendencies. “People with smiling depression tend to need to keep everything presentable and in order on the outside for fear that if it cracks or changes, the person’s vulnerability will become apparent,” says Abrahams. “There may also be evidence of emotional dysregulation: when a person is quick to get angry or frustrated. This is often because a person’s emotional needs are not being met. Erratic and sometimes more manic behaviors are part of a strategy for avoidance and thus survival.”

Finally, pay attention to your self-talk. “Typically, a person experiencing smiling depression will have a constant stream of internal negative self-thoughts about themselves, contradicting the outwardly confident and competent persona they are trying to portray,” says Dr. Foulder-Hughes.

Eight ways to cope with smiling depression

It takes a lot of effort and effort energy to pretend everything is finewhen it isn’t.

“At some point, most people living with smiling depression will hit a tipping point, where things start to get overwhelming and they feel like they can’t take it anymore,” warns Dr Foulder-Hughes. “But there are things that help before the crisis happens.”

Here she gives eight important tips:

Keep a routine

“Establishing a good daily routine where healthy sleep patterns are followed is important. Sleep supports overall health and is often one of the first things to change in people with smiling depression.

Go to bed and get up at the same time every day, so that you don’t spend too much time in bed, and the sleep you have is restful. Get up as soon as you wake up, make your bed (to avoid the temptation to go back in), open your bedroom window (which provides a connection to the outside world), shower or wash (the change in body temperature helps improve mood).”

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Exercise

“Exercise should be built into your daily routine. No matter how small, exercise improves mood and increases energy levels. If possible, try to exercise in the morning. The most important is it should be fun and accessible. For example, put on your favorite music and dance – exercise doesn’t have to be hard to do and lift your mood.”

Practice some form of mindfulness

“Mindfulness is focused attention in the present moment and is a proven way to help people who are depressed to enjoy life as it happens and to appreciate the little things. For example, noticing the things that make you laugh and focusing completely on the laughter when you experience it.”

Put yourself first

“Invest in yourself by first learning how to meet your needs. Treat yourself with compassion. Make sure you schedule enjoyable activities every day, just for you. Even the smallest things that bring you joy, like sipping your favorite coffee can have a big impact on how you feel. Also invest in your learning and try new experiences. Say no to things you don’t want to do, and don’t feel guilty by putting yourself first.”

Spend time with the right people

“Invest your time in the people who matter to you and who you enjoy spending time with. Pay close attention to how people make you feel. Spend less time with those who make you feel exhausted or unappreciated, and more time with those who create fun, laughter and joy.”

Get into nature

“Nature has a big impact on how you feel. Try to spend as much time as you can outdoors, in all weathers and throughout the year and experience the different seasons. For example, even a short go outside in a local park in nature can really lift your spirits.”

Eat well

“Diet and how you consume your food and drink is extremely important when dealing with smiling depression. Make sure you eat regular meals every day, sitting at a table and using your best crockery and glassware. How you present your food and drink matters for how you like it. Consciously eat your food and drink so that you pay attention to the taste, the smell, the texture and so on to enjoy every mouthful.”

Seek help

“Recognize when you are struggling and contact your doctor or a mental health professional before you reach a crisis.”