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Smiling depression: Hiding behind a smile

People with smiling depression often hide their concerns and pain behind a happy face, while leading seemingly normal lives. The good news is that this common mental health issue is treatable.


By Paula Kehoe

Depression affects millions of Canadians each year. When many people think of depression, they might imagine someone who is exhausted and unable to function. But for some people with the condition, there are none of these familiar signs.

Instead, they appear cheerful to the outside world, successfully managing their day-to-day lives. It may appear that they’re okay, when in reality they’re not. This is known as “smiling depression”.


What is smiling depression?

“Smiling depression isn’t a formal clinical diagnosis. It’s a term that mental health professionals use when describing people who have a kind of depression that’s carefully hid from others,” says Dr. Deanndra Pimentel. Dr. Pimentel is a registered psychologist and the manager of psychological treatment services at Back in Motion. “It’s difficult to detect because a person can appear to be happy, without cares. But behind the smiling facade, that person may be really struggling with a wide range of depression symptoms.”


How to spot smiling depression symptoms

It’s difficult to determine exactly what causes smiling depression. But it can stem from a number of things such as past trauma, work troubles, a chronic illness or other health diagnoses, or relationship failure.

Dr. Pimentel says people with smiling depression generally experience typical features of depression. Some of these may include:

  • Negative mood and prolonged sadness

  • Feelings of guilt, worthlessness, helplessness or hopelessness

  • Loss of interest or pleasure in activities you used to enjoy

  • Change in weight or appetite

  • Difficulty sleeping or sleeping too much

  • Decreased energy or fatigue

  • Thoughts of death or suicide

  • Poor concentration of difficulty making decisions

  • Irritability or excessive crying


Who is at risk?

It can be hard to spot people suffering from smiling depression, Dr. Pimentel warns. And anyone can be at risk. In most cases, a patient of smiling depression is someone who:

  • has high hopes and ambitions

  • holds a stable job, with a family, good relationships and has an active social life

  • is a high-functioning individual

  • smiles when you greet them and appears optimistic

  • carries on with their daily tasks and routines


“Outwardly, everything looks completely normal. Even though they may be laughing with friends, family or colleagues, they may actually feel disconnected and empty inside.”

The reasons why people hide their depression and keep it private are different depending on the person, she adds.

We asked her what the most common reason is that she hears from patients.  

“Worrying what others might think of them, and those people’s perception of someone with depression, she says. Other reasons, according to Dr. Pimentel, are:

  • feeling guilty and justifying that they don’t have a reason to be sad

  • avoiding being a burden on friends and family, particularly those who may be going through their own problems

  • thinking mental illness is a personal weakness

  • feeling ashamed of their feelings

  • fearing discrimination in the workplace or losing their job

  • avoiding being labeled a complainer

  • feeling afraid or embarrassed to seek treatment

  • treatment is expensive and waitlists can be long


“Often, people haven’t recognized their symptoms as depression or may believe it’s not a problem in the first place. They may think that the way they’re feeling is temporary and it will go away on its own.”


Getting help

When you’re experiencing stress that’s impacting you on a regular basis or feel unable to function or cope, it’s important to seek professional advice or information, Dr. Pimentel says. “If you’re experiencing symptoms of depression but hiding it from everyone, there is hope. Treatment depends on the individual as well as the nature and severity of their symptoms.”

Dr. Pimentel recommends these steps to guide you on your path to healing:

  1. Acknowledge that what you’re feeling exists and it’s important. Only when you accept that your problems are serious enough can you start making an actual difference.

  2. Visit your family doctor or make an appointment with a psychologist or a registered clinical counsellor who understands depression. A practitioner can create a customized treatment plan to help you improve your symptoms. This can include a number of psychological treatment options including: cognitive behavioural therapy, interpersonal therapy and more.

  3. Share your feelings with someone you can trust. This can be a friend, a relative, or a professional. Opening up and sharing your feelings is critical in coping with depressive thoughts.

  4. Engage in simple actions that can work towards improving your mood, even temporarily. Things like a healthy lifestyle, positive affirmations, journaling, pursuing a passion or exploring your creativity.

You deserve to feel as happy on the inside as you appear on the outside. If you or someone you know is struggling with smiling depression, don’t hesitate to seek out treatment. Use Lumino Health to find a psychologist.


Written in consultation with Dr. Deanndra Pimentel from Back in Motion, manager of psychological treatment services.

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