Hidden Depression: What Is It and How to Overcome

Written By

Helen Kaminski, MSc

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Hidden depression is a condition that affects millions of people worldwide. While it can be a debilitating and challenging experience, depression is treatable with proper care and management.

Unfortunately, not all individuals with depression receive the help they need, and some may hide their symptoms, leading to hidden depression. This type of depression can be especially dangerous as it often goes unnoticed and untreated.

In this article, we’ll discuss the dangers of hidden depression and ways to identify and manage this condition.

graph representing number of people with depressive disorders

A visual displaying worldwide number of people with depression 1990-2019

What is hidden depression?

Hidden depression, or smiling depression, is a condition where individuals conceal their symptoms and struggle with depression privately. According to National Alliance on Mental Illness, these individuals may present as happy, successful, and accomplished, masking the pain and despair that they experience behind closed doors.

Many people with hidden depression are high-functioning and able to maintain their responsibilities at work, school, and in social situations. However, they often suffer in silence, fearing judgment or stigma associated with mental illness or with seeking help.

A study published in the Journal of Affective Disorders found that approximately one-third of individuals with depression do not seek help for their symptoms.

The study surveyed over 2,000 adults in the United States and found that individuals who were less likely to seek help for depression were more likely to be male, older, less educated, and have lower incomes.

The study also found that individuals who reported higher levels of stigma surrounding depression were less likely to seek help for their symptoms (source: Mojtabai, R., & Olfson, M. (2009). Treatment seeking for depression in Canada and the United States. Psychiatric Services, 60(8), 1054-1061).

In certain cases, individuals may choose not to openly discuss their symptoms of depression due to potential negative consequences. This can be seen in a recent study conducted in 2020, which revealed that mothers refrained from disclosing their depression for fear of child protective services removing their children.

Such concerns about losing custody of their children can act as a barrier to seeking help and being transparent about their mental health struggles.

This underscores the need for creating safe and supportive environments that encourage open communication and destigmatize mental health issues so that individuals feel empowered to seek help without fear of repercussions.

What are the dangers of hidden depression?

woman working at night like workaholic

While smiling depression may seem like a coping mechanism for some, it can be incredibly dangerous.

Hiding depression can lead to a delay in seeking treatment, which can worsen the condition and increasing the risk of suicidal or self-harm thoughts and behaviors.

Individuals with hidden depression may also engage in high-risk behaviors such as substance abuse, self-harm, and other destructive behaviors to cope with their symptoms. These behaviors can be hazardous and lead to severe consequences, including overdose or accidental harm.

In addition to the risk of harm, hidden depression can also take a toll on an individual’s relationships. The person may feel isolated, and their loved ones may not understand why they are struggling, leading to strained relationships and further feelings of loneliness and hopelessness.

According to research, emotional distress, constrained by traditional notions of masculinity, may explain why depression in men can often be hidden, overlooked, not discussed, or ‘acted out.’

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Additionally, these findings suggest that some men who are depressed can experience a trajectory of emotional distress manifest in avoidant, numbing, and escape behaviors which can lead to aggression, violence, and suicide.

Gender differences appear not in the experience of depression per se but in the expression of depression.

Take our Free Mental Health Quiz for Depression

Signs of hidden depression

It can be challenging to identify hidden depression, as the person may not display the typical signs and symptoms of depression. However, there are some subtle signs that you can look out for:

  • Difficulty Sleeping – Individuals with hidden depression may have trouble falling asleep, staying asleep, or experiencing early morning awakenings.
  • Loss of Interest – Individuals may lose interest in activities they once enjoyed or lose motivation to complete tasks.
  • Fatigue and Low Energy – Depression can lead to physical fatigue and low energy, making it challenging to maintain daily responsibilities.
  • Irritability – Individuals with hidden depression may become easily irritable, short-tempered, or frustrated.
  • Appetite Changes – Changes in appetite, such as overeating or undereating, can indicate depression.
  • Self-Criticism – Individuals with hidden depression may have negative thoughts about themselves, their abilities, or their accomplishments.
  • Increased Substance Use – Those struggling with hidden depression may turn to alcohol or drugs to cope with their emotions.
  • Social Media Addiction – People with hidden depression may spend a lot more time on social media versus the average.

If anyone is experiencing any of these symptoms, seeking help and support is essential.

A study published in the Journal of Counseling Psychology found that individuals who experienced hidden depression were more likely to report feelings of shame, guilt, and fear of being judged by others.

The study found that individuals who experienced hidden depression were less likely to seek help for their symptoms, which can lead to adverse outcomes such as decreased social support and increased risk of suicide (source: Rasmussen, K. A., & Linehan, M. M. (2004). Suicidal behavior in outpatient psychotherapy clients with depression. Journal of Consulting and Clinical Psychology, 72(1), 62-67).

Managing depression

two people hugging in a group setting

The first step in managing hidden depression is acknowledging that you may be struggling and that it’s okay to seek help.

Here are some strategies that may help individuals manage hidden depression:

Seek Professional Help – Working with a therapist or counselor, or looking at online options can be beneficial in identifying and managing depression symptoms.

Engage in Self-Care Activities – Activities such as exercise, meditation, and spending time outdoors can improve mood and reduce symptoms of depression.

Connect with Support – Seeking support from family, friends, or a support group can help individuals feel less isolated and provide a safe space to express their emotions.

Practice Mindfulness – Mindfulness techniques such as breathing exercises and meditation can help individuals manage their emotions and stay present in the moment.

Set Realistic Goals – Setting small, achievable goals can help individuals build confidence and a sense of accomplishment, improving self-esteem and mood.

Focus on self-care: Self-care is an essential part of managing hidden depression. This can include things like getting sufficient sleep, eating a healthy and balanced diet, and engaging in activities that bring you joy.

Develop healthy coping strategies: Developing healthy coping strategies can help you to manage the symptoms of hidden depression. This may include things like journaling, practicing deep breathing exercises, or engaging in creative pursuits.

Challenge negative thoughts: Negative thoughts can be a significant contributor to hidden depression. Learning to challenge and reframe negative thoughts can help you to develop a more positive outlook and reduce symptoms of depression.

Stay engaged in treatment: Managing hidden depression is an ongoing process, and it’s essential to stay involved in treatment even after you start to feel better. This may include continuing therapy or taking medication as prescribed by your healthcare provider.

It’s important to remember that the more frequently and consistently you stay at this, the better results you will get.

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Is there a cure for hidden depression?

Remember that managing hidden depression is a process, and it may take time to find the strategies that work best for you. With the proper support, tools, and resources, however, it is possible to manage hidden depression and lead a fulfilling life.

Hidden “smiling” depression is a severe issue that requires attention and support. It’s not always easy to recognize the signs of someone struggling with depression, especially if they are good at hiding it. Therefore, it’s crucial to approach the topic with sensitivity and compassion.

Dr Azhar Qureshi

What about taking medication? There are individuals who express concerns regarding the use of antidepressants and other medications due to potential side effects.

However, it is important to note that while antidepressant medications are commonly prescribed in the United States, not everyone with depression includes them in their treatment plan, and that’s perfectly acceptable.

According to a trusted source, approximately 19 percent of people in the United States sought treatment for a mental health condition in 2019. Among them, just under 16 percent were prescribed medication as part of their treatment, while just under 10 percent opted for psychotherapy or counseling, either alone or in combination with medication.

Many individuals find that psychotherapy and changing their diet, exercise routine, thought patterns and sleep habits can be effective treatments, particularly if their symptoms are mild or moderate.

These non-pharmacological interventions can positively impact mental health and can be viable options for managing depression.

Encouraging those who are struggling to seek help and providing them with resources and support can make a significant difference in their well-being.

It’s also essential to recognize that depression is not a personal weakness but a mental health issue requiring treatment.

As a society, we need to reduce mental health stigma and create a safe and supportive environment for those struggling with depression to seek the help they need.


References

  1. Number of People With Depression 2019 https://ourworldindata.org/grapher/number-with-depression-by-country
  2. ‘Big Build’: Hidden Depression in Men https://journals.sagepub.com/doi/abs/10.1080/j.1440-1614.2005.01665.x?journalCode=anpa
  3. Barriers to Implementing a Group Treatment for Maternal Depression in Head Start https://dworakpeck.usc.edu/sites/default/files/2020-10/Palmer-Molina%20Palinkas%20Monro%20Mennen.pdf
  4. Treatment Seeking for Depression in Canada and the United States https://ps.psychiatryonline.org/doi/10.1176/ps.2006.57.5.631
  5. Antidepressant Use Among Adults: United States, 2015-2018 https://www.cdc.gov/nchs/products/databriefs/db377.htm#section_4

YouTube video
“I’m Fine” – Learning To Live With Depression | Jake Tyler | TEDxBrighton

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About the author

Helen Kaminski, MSc

Helen Kaminski, MSc

Mindful living for a happier, healthier you. I’m a medical writer, Licensed Mental Health Counselor, and a mental health advocate in Warsaw, Poland, with nine years working as a therapist. I hold a Master's in Clinical Psychology degree from the University of Warsaw. I specialize in writing about mental health, using my experiences and academic background to educate and inspire others. In my free time, I volunteer at a Disability Learning Center and go for nature walks. My writing aims to break down mental health stigma and help others feel understood. Social connections are vital to mental well-being, and I am dedicated to fostering communities of support and empathy. By sharing knowledge and personal insights, I strive to create a more compassionate world. Social

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