Smiling depression is a thing worth knowing about—even if it’s not officially recognized

Recently I learned that an old friend—a lingerie-loving sprite with a harlequin grin—took her life. We were estranged for years, but a mutual friend had recently spent time with her and sobbed to me on the phone about how “she seemed so happy.” There’s a lot more to the story, but when I think about that sad phone chat, smiling depression comes to mind because how she seemed is clearly not indicative of how she actually felt. As the public conversation about mental health expands, so is how living with a mental disorder looks. (Depression, for example, isn’t limited to an image of crying in bed for days on end).

For many, it looks like nothing because so many people have learned to expertly mask their symptoms. This basically sums up smiling depression, which is characterized by maintaining the facade of happiness while battling depression. Sufferers often appear outwardly joyous and successful in all the typical parts of life “success” conjures—like having an S.O, a great job, and being wildly accomplished.

It isn’t formally recognized as a psychiatric term, but comparisons have been drawn between it and atypical depression, a common form of the condition where mood reactivity is the key element (the mood can improve temporarily with positive events). Alas, atypical depression has its own diagnosis criteria separate from smiling depression, so to conceptually understand the latter—an idea that’s oh-so prominent right now—I called upon an expert to break it down.

Psychologist Selena Snow, PhD says it’s common to not notice your own symptoms of depression, which can lead to not taking a first step and reaching out for help. Instead, a person may “just think that they are lazy or unmotivated, which tends to increase feelings of worthlessness and guilt and create a vicious cycle of more negative thoughts, feelings, and behaviors.” For many, all of this comes under the guise of everything being “fine” and presenting oneself with a—you guessed it—smile. Because when everything seems okay externally, a person may not even recognize what’s going on within. After all, it’s easy to know why you’re sad when your life is a mess, but when everything’s fine? That’s very confusing.

“There are many reasons someone may intentionally mask their depression, such as fearing the shame of the stigma of depression and the possible negative reactions of others, not wanting to burden others, or feeling guilty that they are depressed when they have so many objectively good things in their life for which they believe they should be grateful or happy.” —psychologist Selena Snow, PhD

Furthermore, other people in the person’s life won’t necessarily interpret symptoms the same way. For instance, during my personal worst depressive episode, I shrunk down to 96 pounds. While my mom was concerned, my friends thought I look ah-mazing! My friends aren’t bad people who were enabling me—they just had no idea what was going on beneath the surface. Mental-health conditions reflect inner states and aren’t as easily spotted as, say a broken leg.

All of this confusion and mixed messaging can very easily lead to masking. “We’re socialized to put our best foot forward and make a good impression on others,” says Dr. Snow. “There are many reasons someone may intentionally mask their depression, such as fearing the shame of the stigma of depression and the possible negative reactions of others, not wanting to burden others, or feeling guilty that they are depressed when they have so many objectively good things in their life for which they believe they should be grateful or happy.”

And fact remains that no matter how many celebrities champion speaking openly about mental illness, it is really, really hard to megaphone that you’re not okay. That’s why, though not a formal psychiatric term, smiling depression feels like a phenomenon. We’re getting better at hiding that we’re unhappy on our perfectly curated (and calculated) social profiles, at our having-it-all-together business meetings, and with our loved ones we’d rather not burden. Still, if you’re feeling depressed and ashamed or confused but not willing to share that with people in your life, it’s important to find a safe haven, like group therapy or some other form of formal help.

“People are able to drop the mask of smiling depression and freely talk about their difficulties in a safe space without fear of negative judgment,” Dr. Snow says of finding a community. And I love that, because it seems that many inadvertently use their smiles to isolate themselves. Community and everything it stands paves the way for a new image of depression—one of a nodding head that says “I’m not alone.”

Dating someone struggling with depression? Here are tips to help. Plus, certain lifestyle shifts can help ease symptoms.