Causes And Symptoms Of Smiling Depression

By: William Drake

Updated March 24, 2020

Medically Reviewed By: Wendy Boring-Bray, DBH, LPC

"Don't judge a book by its cover" is a phrase that might apply to someone who is suffering from depression. On the outside, they may look like they're happy and functioning, but the reality is that these individuals are struggling with depressive and negative thoughts. According to the National Institute of Mental Health, approximately 10 percent of the U.S. population suffers from depression. If you think you may be one of those people, know that you're not alone.

You may think depression makes people hide under the covers and cry a lot, but in reality everyone experiences depression in a different way. Some people might not even realize that they're depressed, especially if they're getting through their daily lives with a smile. This effect is often referred to as "smiling depression."

To The Rest Of The World, You're Smiling. But On The Inside, You're Suffering.
Depression is Treatable Using An Online Therapist.


Definition Of Smiling Depression

Smiling depression describes a state when you're depressed inside, but you're able to hide these feelings. For people who are suffering from smiling depression, it can be difficult to get help because it's hard to break the facade of happiness and reveal what's really going on inside. As such, they may discount their feelings. They may also fear that acknowledging their feelings makes 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, including a breakup, a job loss, or even the loss of a loved one. They might also be struggling due to a lack of purpose in their lives or a feeling that something just isn't right, even though they can't articulate what that is.

The best way to explain smiling depression is to think of a theater where the actors are all wearing masks. Those masks hide their problems from the outside world, but the reality behind the mask might be very different. People suffering from smiling depression 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. They have a poor self-image, which feeds into feelings of emptiness, emotional numbness, self-critical behavior, and high expectations that are regularly unmet.

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

Perfectionists often have a 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 tend to lose perspective. Over time, this pattern contributes to greater feelings of worthlessness and can even lead to suicide.

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


What to Do if You Have Smiling Depression

It can be difficult for those suffering from smiling depression to realize that they're dealing with depression. Carrie Krawiec, a licensed marriage and family therapist, suggests that individuals with smiling depression can exemplify happy, put-together outward appearances while keeping 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," says 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.

First, acknowledge that your feelings are valid. Your symptoms are not a sign of weakness, but instead they're a sign of emotional distress that must be addressed.

As part of this process, it's important to value yourself. That can be difficult if you're struggling with self-esteem issues. Plus, when we feel bad, it's easy to fall into a self-critical pattern that can negatively impact our 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 positive aspects of your personality while showing yourself compassion.

Helping Those With Smiling Depression

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

Listen actively, acknowledge what they're sharing, and offer to be there as a listening ear in the future. If you feel that the situation is serious and requires an intervention, don't take action without talking to them about your concerns first. Help them to see that you're motivated by love, and then work together to come up with a plan. Support them as they take those steps.

To The Rest Of The World, You're Smiling. But On The Inside, You're Suffering.
Depression is Treatable Using An Online Therapist.


If, however, they've progressed to suicidal thoughts, they need the intervention of a licensed and trained therapist, and it's important that they seek help immediately. A therapist can help them to address those feelings in a way that does not involve physical harm to themselves.

If they decide to see a therapist, be a source of support. For someone wearing this mask, visiting a therapist for the first time may not be easy. Your support could be critical as they take the first steps toward addressing their feelings.

Having Compassion For Yourself

If you suffer from smiling depression, it's important to recognize that you're not less than others. You are not weak, but you do have a medical condition that likely requires help. If a friend was ill, you would have compassion for them, and you'd encourage them to seek treatment. Try to do the same for yourself.

That might not be easy because depression often comes with unrealistic expectations about what we can do. With honesty, you may be able to admit that everything is not okay. The next step is to take action. Depression of any kind can be overcome. Hundreds of millions of people with depression have worked to move past it, and you can, too.

As part of overcoming depression, you might need to make lifestyle changes related to diet, exercise, sleep, etc. Some changes will help, and some won't. As you start your journey to self improvement, it's important to know that there will be setbacks; there will be ups and downs, and you will fail as often as you succeed. However, if you trust the process, there's a light at the end of the tunnel.


Think of it as a stock market. On Wall Street, there are good days, crashes, runs, and everything in between. However, over the course of many years, the stock market rises, and investors profit. Invest in yourself through the good and the bad, and you'll come out on top, too.

Therapy Can Help

For someone with smiling depression, it can be scary, but therapy and medication can be important factors in getting better. Consider online therapy with BetterHelp. A therapist can help you understand how you're feeling and can give you the tools to make big changes, so you can feel better. Below you'll find counselor reviews from people experiencing similar issues.

Counselor Reviews

"Heidi has been a great help. I'm so very thankful. I was having a hard time getting my thoughts in order, and was at an all time low with my depression because I didn't know where to go or what to do. Heidi's guidance helped me tremendously and I am ever so grateful."

"Tamera is straightforward and supportive. She's not afraid of pointing out what to work on and give you the right tools immediately. It is highly personalized just for your unique symptoms and situation! Tamera helped me manage my depression and anxiety and I became more empowered to have more control in my life. I feel a lot happier."


If you're suffering from smiling depression, please be compassionate with yourself. You're not alone, and things can get better With a few simple steps, you can be on your way to a new life, and your smile will finally be real. Take the first step today.

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