Understanding the silent struggles of smiling depression



Published Jun 7, 2024


It is heart-wrenching when someone who always seemed happy takes their own life. This can be incredibly confusing for friends and family.

Some people hide their true feelings behind a smile. They might seem cheerful and successful on the outside but are deeply hurting on the inside. This secret struggle is often called "smiling depression."

People with smiling depression do not show their pain. They continue with their daily lives, excelling at work or school, maintaining friendships, and never letting anyone know they are struggling. This makes it very hard for anyone to see their true feelings.

Because their suffering is hidden, these individuals might feel isolated and believe no one understands them. They might think they have to deal with everything alone. This can increase their risk of suicide.

Smiling depression might not be an official medical term but, for many, it's a very real problem. This type of depression occurs when people hide their true feelings behind a smile, making others think they are happy.

Smiling depression is particularly dangerous because it’s harder to detect, making it difficult for people to get the help they need. It also places individuals at a higher risk of suicide.

Because they are used to pushing through their pain, they might have the determination and energy to plan and carry out a suicide attempt.

What is smiling depression?

Also known as walking depression or high-functioning depression, smiling depression has become a popular term in recent years.

However, it isn’t officially recognised and doesn’t appear in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

While there's no exact number for how many people have smiling depression, researchers think that 15 to 40% of people with depression show unusual signs.

Smiling depression can sometimes look like the high-energy phase of bipolar disorder, known as “bipolar disorder with mixed features.”

The biggest threat of smiling depression is that it often goes unnoticed. Because it doesn’t fit the typical image of depression, family and friends might not see the warning signs.

Teens especially may appear happy, upbeat, and successful while secretly battling deep depression.

Current studies show that even teens might not realise they're depressed. For instance, one study discovered that people from cultures less focused on individual emotions often experience depression through physical symptoms like tiredness, headaches, stomach aches, and loss of appetite instead of feeling sad.

As a result, they might not understand what’s happening to them.

Someone with smiling depression is overly cheerful behaviour that seems exaggerated or unnatural.Picture: KoolShooters/Pexels

Smiling depression can be tricky to identify because individuals with this condition often appear happy and well-adjusted on the surface.

Here are some signs to watch for:

  • Persistently sad or down.
  • While they might not show it outwardly, privately they may feel deep sadness and hopelessness.
  • They often feel exhausted despite seemingly having high energy levels in social settings.
  • Increased irritability, anger, or frustration that seems out of character.
  • Overly cheerful behaviour that seems exaggerated or unnatural.
  • Downplaying or
  • Suicidal thoughts.

Why people hide behind a smile

Many people with smiling depression have strong support networks and plenty of resources, yet they find it hard to open up about their struggles.

This is especially common in cultures where mental health issues are stigmatized or in families that value willpower and self-reliance over discussing problems or seeking help.

This is particularly true for male adolescents, who often learn to keep their feelings to themselves.

Helping someone with smiling depression requires sensitivity and understanding. Here are some practical steps you can take to support them:

Recognise the signs: Be aware of signs like persistent sadness, mood swings, anxiety, and loss of interest in activities.

Pay attention to changes in their behaviour, such as pretending to enjoy things or being overly sensitive to criticism.

Choose the right moment: Find a quiet, private time to talk.

Express your concern: Share what you've observed in a caring way. For example, "I've noticed that you don't seem as happy as you used to be, and I'm worried about you."

Listen actively: Allow them to talk about their feelings without interrupting or offering immediate solutions.

Suggest therapy: Encourage them to seek help from a mental health professional, such as a psychologist or counsellor.

Offer to help them find a therapist or accompany them to their first appointment.

Let them know you're there for them and that they don't have to face their struggles alone.