Causes And Symptoms Of Smiling Depression

By Sarah Fader

Updated December 13, 2018

Reviewer Wendy Boring-Bray, DBH, LPC


"Don't judge the book by its cover" is a phrase that can often apply to those who are suffering from depression. While on the outside they may look happy and functioning, the reality is that these individuals could be struggling with depressive and negative thoughts. According to the National Institute of Mental Health, approximately 10% of the U.S. population suffers from depression.

The reality is that depression is not experienced by everyone in quite the same way. In fact, some people might not even realize that they are depressed, especially if they are getting through their daily lives smiling and not isolating themselves. This effect is often referred to as smiling depression.

Definition Of Smiling Depression

According to the Urban Dictionary, smiling depression is when you are depressed inside, yet able to hide these feelings and appear happy and chipper to others. For those suffering from smiling depression, it can be difficult to get help because it is hard for them to break from the facade of a happiness to reveal what is really going on inside their head. As a sufferer, it can be easy to discount your feelings, or fear acknowledging them might make them appear "weak" to others.

Essentially, the façade of happiness is a defense mechanism to hide their true thoughts and feelings. A person who suffers from smiling depression could be feeling sadness for many reasons such as from a break-up, a job loss, or even the loss of a loved one. They might also be struggling due to feeling of a lack of purpose in their lives. Sadness can also manifest in a feeling that things in life are just off or that something isn't right, even though the individual can't articulate what exactly it is.


The best way to explain smiling depression is to think of a theater where the actors are all wearing masks. Those masks hide problems from the outside world, but the reality behind the mask might be very different. Smiling depression sufferers can have a family, hold a full-time job, and even have an active social life, but behind the mask, they may be suffering from sadness, panic attacks, and even suicidal thoughts.

Causes Of Smiling Depression

A common symptom among those who struggle with smiling depression is a belief that they are simply not good enough as they are. There is a poor self-image, which feeds into a feeling of emptiness, emotional numbness, self-critical behavior, and high expectations that continue to be unmet.

As a result, the individual may find themselves trying to do everything perfectly, creating a need to control others and their surroundings. There is a link between perfectionism and depression, which is often mediated by the individual's self-esteem or lack of self-esteem.

Perfectionists are often at high risk of developing depression because they set unrealistic expectations for themselves and others. When those expectations are not met, they struggle to recover from disappointment and are not able to keep those disappointments in perspective. Over time, it contributes to greater feelings of worthlessness and potentially, without the right help, suicide.

Additionally, when you don't take the time to examine and share your feelings, they can bottle up. Over time, negative feelings and thoughts can feed into each other, creating a loop in your head that pushes you further into sadness and low self-worth.

Steps For Smiling Depression Sufferers

It can be difficult for those suffering from smiling depressionto realize that they are dealing with depression. Carrie Krawiec, a licensed marriage, and family therapist indicated that individuals with smiling depression can exemplify happy, put-together outward appearances, yet keep their inner turmoil hidden from the world.

"These people would likely hide symptoms and true feelings from others, feeling more and more isolated, which would contribute to more worthlessness and hopelessness, and without adequate help could lead to suicide," said Krawiec.

By learning to recognize the signs of depression, you can recognize when you need to seek out a licensed therapist or other assistance to address feelings of sadness and worthlessness.

The first step is to acknowledge that your feelings are valid and that your symptoms are not a sign of weakness, but a sign of emotional distress that must be addressed. Secondly, find a provider to talk to that you can trust. It can be difficult to confide in someone, for fear that they will ridicule you or not understand what you are going through. However, talking it out can be a way to start helping yourself. It might not make you feel better right away, and you shouldn't expect this individual to be able to make things go away. Opening up can help you to acknowledge your feelings and lay the groundwork for addressing them.


As part of this process, it is important to value yourself. That can be difficult if you are struggling with self-esteem issues. Plus, when we feel bad, it is easy to fall into a self-critical pattern, one that can negatively impact your self-esteem. You need to take time to nurture your self-esteem. Treat yourself as you would a friend. Write a letter or email of encouragement to yourself, and be sure to draw attention to the positives aspects of your personality, as well as being compassionate with yourself. Practicing self-compassion is a great way to help adjust your views about what you are worth as an individual.

Helping Those With Smiling Depression

If you have a friend who suffers from smiling depression, understand that you aren't going to be able to talk them out of it. You won't be able to tell them they are wrong feeling the way they do and that they will snap out of it. Instead, remind them of your love and then let them express how they are feeling without judgment.

Listen actively, acknowledging what they are sharing and even offer to be there as a listening ear in the future. If you feel that the situation has gotten more serious and requires an intervention, don't just jump in without talking to them about your concerns first. Help them to see that you are motivated by love, then work together to outline a plan of action you feel is necessary. Support them as they take those steps.

Those who have progressed to suicidal thoughts need the intervention of a licensed and trained therapist, who can help them to address those feelings in a way that does not involve physical harm to themselves.

Be a source of support as they decide to see a therapist. For someone wearing this mask, visiting a therapist for the first time may not be easy. Your support could be critical for getting them in the door to take the first steps in addressing their feelings in a way that will benefit them for a long time to come.

Having Compassion For Yourself

If you suffer from smiling depression, it is important to recognize that no one is perfect, and that you will make mistakes. When others make mistakes or deal with difficult situations, it's important to have compassion for them. The point is that you need to have self-compassion, as you would for others.


That might not be easy because depression often comes with unrealistic expectations of what we can do and what we are capable of accomplishing. Part of your humanity is a mix of good and bad, strengths and weaknesses, and a few flaws. Recognizing that can give you the courage needed to do what is best for you, including having an honest viewpoint.

Start by taking care of yourself, including eating right, exercising, and keeping to your normal routine. These actions can help you to create a pattern of self-care, which is critical as you address the feelings of low self-worth and sadness. It will also help you process the feelings and thoughts behind the symptoms.

Additionally, working with a licensed therapist can help you to identify unhealthy patterns, which can contribute to your feelings of low self-worth. Remember, smiling depression is a mask that often covers much deeper issues. By addressing those issues, you can acquire different coping skills to deal with circumstances that don't meet your expectations, and for those moments when you feel as if you missed the mark. If you believe you suffer from smiling depression or know someone that may be struggling in this regard, it is important to find help to address your feelings.

One of the biggest concerns for those with smiling depression is that they do not believe they are depressed, so they don't seek the help they need.

Working with BetterHelp, you can find a licensed therapist available online, who can work with you to address your depression and the steps you can take to process those feelings instead of hiding it behind a mask of happiness.

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