What is “Smiling Depression” and Why is it Dangerous?

What is “Smiling Depression” and Why is it Dangerous?

At first glance, the term “smiling depression” seems like another self-indulgent concept or buzzword reminiscent of a sad clown. Of course, depressed people can smile! Many people might think with exasperation, they keep coming up with new mental illnesses - what’s next, “calm anxiety”?

However, this is a real pathology that is actually more dangerous than typical depression. People presenting with “atypical depression,” aka, “smiling depression,” are at far greater risk of suicide because they feel they have no options for help.

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Plus, they have the wherewithal and energy to go through with such a plan, unlike someone who is too empty and sad to even get up and take a shower.

What is Smiling Depression?

Smiling depression is the term used to describe someone who has all the outward signs of “happiness,” i.e. a job, a family, a stable career, a seemingly good life, but internally is plagued by deep sadness and feelings of worthlessness.

People with smiling depression present normal lives. They laugh, they joke, and they act as if everything is great – like an Instagram photo. They are often very high-functioning and successful. They brush their teeth and go to work every day. They have their lives together everywhere but on the inside.

What they don’t do is tell people they are struggling with anxiety, despair, or paranoia, in fear of being perceived as “weak” or “crazy.” Besides, with all the good in their life, wouldn’t that just be whining and complaining? So, they keep it all inside, and therein lies the problem.

How is it Different Than Typical Depression?

With typical depression, the person affected is often overcome with emptiness and a lack of energy. They usually withdraw from social activity, and then physical activity. The fatigue can get so bad, they stop caring for themselves at all.

Many depressed people stop eating. They stop grooming and brushing their hair. A common symptom of depression is being too tired to even maintain one’s appearance. They seem to drop off the face of the earth. It’s often obvious what is happening. When you see them, they are visibly sad and exhausted. When you talk to them, they are distant and morose.

Depression itself is fairly easy to spot, diagnose, and start treating. Smiling depression, unfortunately, is not. The person with smiling depression may not even realize they are in fact, depressed, because their lives are a facsimile of the American Dream. To admit something is wrong could put all of that in jeopardy.

The possibility of judgment, especially when you are “#blessed,” is unbearable.

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What Are the Warning Signs?

The warning signs that someone may be in danger is a sudden shift in behavior. Perhaps a person gets unusually philosophical or fatalistic during an otherwise unremarkable conversation. Their attitude may go from shallow small talk and positive vibes to a darker place.

Another sign is sudden withdrawal from friends and loved ones. A person who is usually involved that suddenly disappears should be checked on.

Also, if someone you know starts giving away their possessions, or making the rounds to tell people how much they’ve meant to them – almost saying “goodbye” – that is a common warning sign of suicide and should be addressed.

Often people have a recurring thought. That thought turns into rhetorical questioning. Then, the rhetorical questioning turns into logistics and “what-ifs.” Finally, it becomes a real plan. This plan can be sitting in the back of their head for years until one day, they decide to do it.

This act is almost always preceded by one of the above signs. The person in question may suddenly get a life insurance policy or be preoccupied with getting their financial affairs in order. It’s often planned quite naturally, under everyone’s noses. Especially when their life looks great on paper.

What Can We Do About It?

One of the primary things we must do in regards to mental illness is to end the stigma which surrounds it. We have to have open dialogues that do not paint the person afflicted as crazy or unstable or dangerous. This causes many people to hide their problems to a point it becomes completely overwhelming.

We must not see mental illness as being weak or a heavy burden on society. This causes people who suffer to self-loathe, self-harm and wish they were dead. Instead, we have to talk about it for what it is and the symptoms it produces, so we can be solution-based instead of problem-based.

Another big misconception is there being no difference between poor mental health and having mental illness. Poor mental health happens when otherwise normal people have episodes of depression or anxiety associated with stress or grief. It does not mean there is a mental illness inherent within the individual.

Sometimes the misconception that all mental health issues are also mental illness issues leads people to medications and perceived disorders they don’t need or have. It may prevent some mentally ill people from taking their symptoms seriously and getting help, because they chalk it up to regular stress.

People with mental illness can be hard to deal with – I know because I have mental illness. My moods can be difficult at times. My thought processes must be stopped on occasion from an outside source, often my husband or a close friend who will tell me I need to check myself. And I do. Sometimes just a quick, real connection is all it takes to set me on the right path.

If we can foster real relationships with people and normalize both mental illness and occurrences of poor mental health, so we are not afraid to reach out to others, it will help more than we can imagine. Folks who suffer will have options and support. Those who love people with mental illness will be able to easily recognize the signs of trouble.

Most importantly, the depressed can reach out as well. They will no longer feel the need to hide their pain behind a smile.

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