Entrepreneur, Senior Leader & Ecosystem Builder with a degrees in Music, Psychology, Digital Mgmt & Transformation. Co-founder of the Music Factory and Earkick. Life-long learner with a deep passion for people, mental health and outdoor sports.
Content Warning: This article discusses topics related to suicidal thoughts and mental health struggles.
Have you ever met someone who seemed to have it all together? They’re successful, have a loving family, and are always the life of the party. But beneath this perfect facade, they might be battling something much darker—something they might not even fully understand themselves. This phenomenon is known as smiling depression or perfectly hidden depression (PHD), and it’s more common than you might think.
#1 Understand The Hidden Truth of Smiling Depression
Imagine your close friend, always the rock in your circle. They seem to have been born under a lucky star: getting into their favorite college, accepting the dream job, marrying their Highschool sweetheart, and leading an active social life.
They’re the ones everyone goes to for advice and support. Yet, recently, you’ve noticed subtle changes. They seem a bit more withdrawn, a bit more anxious. They laugh it off, saying they just need to relax, “busy life, you know”.
Then, one day, you receive a strange message from them, asking you to check on their home. You’re immediately concerned. When you arrive, everything seems in order—the dishes are washed, the house is clean. But the eerie silence makes your heart race. You call out their name, but there’s no answer.
You find them in their bedroom, surrounded by empty pill bottles. They’ve attempted to harm themselves. You’re stunned. There had been no indication they were suicidal. You realize they had secrets—deep feelings of terror, shame, and self-loathing they never revealed. These secret feelings nearly cost them their life.
Can you imagine a world where talking about these secrets is not shameful? Is it possible to create a culture where expressing those feelings is seen as healthy self-acceptance and even personal strength? To explore that, let’s first look into the science behind smiling depression.
#2 Understand The Science Behind Smiling Depression
People with smiling depression often present a perfect facade to the world, making it hard to see their inner turmoil. This condition can be difficult to diagnose using traditional methods. When someone seeks help, mental health professionals typically use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to assess mental illness. This manual focuses on symptoms such as sleep disturbance, loss of pleasure, and suicidal thinking.
However, the lens through which professionals view depression can be limiting. If a person doesn’t fit the standard criteria, their depression might be overlooked. This is particularly true for those who mask their pain with perfectionism. They might deny any issues with sleep or appetite, report a full life of gratifying activities, ambitious efforts and deny suicidal thoughts outright.
But suicidal often does not look suicidal.
Research has shown that the core of suicidal feelings is often intense psychological pain, not necessarily a clinical diagnosis of depression., a prominent suicide researcher, introduced the concept of “psychache”—intolerable emotional and psychological pain. His work emphasized that understanding and addressing this pain is crucial in preventing suicide.
Similarly, Sidney Blatt’s research highlighted that when perfectionism coexists with depression, it can drastically alter the depression’s presentation. He argued that it should be assessed not just through diagnostic measures, but by understanding the person’s self-perception and worldview.
#3 Why Normalizing Suicidal Thoughts Can Help Break the Silence
It’s crucial to understand that experiencing suicidal thoughts is more common than we often realize. These feelings, while deeply distressing, are a normal part of human experience for many people. This doesn’t mean that acting on these thoughts is normal, but rather that having them is a sign of significant emotional pain that needs to be addressed.
Over the years, countless individuals have confided in Dr. Margareth Rutherford about their suicidal thoughts. Some do so hesitantly, fearing drastic reactions or the loss of their autonomy. Others express a profound relief, as sharing these thoughts allows them to shed a heavy burden of shame that has permeated their entire being. And then there are those who speak with deep sadness, recognizing how close they’ve come to a tragic decision.
#4 The Secrets We Keep and Why We Keep Them
The secrets people keep are varied and often deeply personal. They can include feelings of inadequacy, fear of failure, past traumas, and unexpressed grief. For instance, someone might hide a history of childhood abuse, a traumatic event, or feelings of intense shame about their perceived shortcomings.
Why do people keep these secrets? Often, it’s because of societal pressures and expectations. There’s a pervasive belief that expressing vulnerability is a sign of weakness. Admitting to struggles, especially mental health struggles, can be seen as failing to cope, which clashes with the ideal of being resilient and capable.
Expressing these hidden feelings is seen as risky for several reasons:
1. Fear of Judgment: People worry about being judged or perceived differently. They fear that revealing their struggles will lead to others thinking less of them.
2. Stigma: There’s still a significant stigma around mental health issues. People might fear that admitting to depression or anxiety will lead to discrimination or exclusion.
3. Burdening Others: Many people don’t want to burden their friends or family with their problems. They might feel that sharing their struggles would impose on others or make them seem needy.
4. Self-Perception: Admitting to hidden struggles can conflict with how people see themselves. If they pride themselves on being strong and independent, acknowledging their vulnerability can be incredibly challenging.
#5 Create a Culture of Acceptance and Strength
Can you imagine a world where talking about these secrets is not shameful? Imagine a culture where expressing feelings of fear, shame, or self-loathing is seen not as a weakness but as a step towards healthy self-acceptance and personal strength.
In such a culture you would encounter:
• Open Conversations: People would feel safe to talk about their struggles without fear of judgment. Conversations about mental health would be as normal as talking about physical health.
• Support Systems: There would be strong support systems in place. Friends, family, and colleagues would know how to listen and provide support without making the person feel judged or inadequate.
• Education and Awareness: There would be widespread education about mental health, reducing stigma and encouraging people to seek help when they notice a change in mood.
• Emphasis on Strength: Expressing vulnerability would be seen as a strength. People would recognize that it takes courage to admit to struggles and seek help.
#6 Actionable Suggestions for Addressing Smiling Depression
If you suspect someone might be struggling with smiling depression, here are some actionable steps:
1. Encourage Open Conversations:
Create a safe space where people feel comfortable sharing their feelings without fear of judgment. Some people may rather open up to a personal AI chatbot for mental health than a fellow human, or you can encourage them to start a journal like countless celebrities and stars.
• Example: Consider a friend who always seems upbeat but recently mentioned feeling overwhelmed. Respond with, “I’m here for you, no matter what you’re going through. It’s okay to talk about what’s really on your mind.”
“It’s okay to not be okay. Talking about it is the first step to feeling better.”
2. Ask the Right Questions:
Instead of sticking strictly to symptom criteria, ask questions that explore their emotional and psychological pain. Questions like, “When do you feel most at peace?” or “What thoughts keep you up at night?” can provide deeper insights.
• Example: If a colleague seems unusually quiet, you might ask, “Is there a particular time or situation that makes you feel at ease?” This can open a dialogue about their emotional state.
“The right questions can reveal hidden struggles. It’s about understanding, not diagnosing.”
3. Listen Without Judgment:
If someone confides in you about their struggles, listen empathetically. Avoid dismissive responses like, “You have so much to be grateful for,” or “Other people have it worse than you.” which can shut down the conversation.
• Example: A family member confides in you about feeling empty and hopeless despite their successful career. Respond with, “I’m here to listen, and I want to understand what you’re going through.”
“Listening without judgment creates a space where healing can begin.”
4. Promote Strength-Based Assessments:
Focus on the individual’s strengths and resilience. This approach can help them see their own worth and potential for overcoming challenges.
• Example: Highlight a friend’s resilience by saying, “I admire how you’ve managed to keep going despite everything. Your strength is inspiring.”
“Acknowledging strengths helps us see our own potential.”
5. Educate About Mental Health:
Share information about smiling depression and the importance of addressing psychological pain.
• Example: Share articles or resources about smiling depression with a friend who might be struggling, saying, “I found this really insightful. It helped me understand better what you’re feeling. Can you look through it and share what you think of it?”
“Education is key to understanding and overcoming mental health challenges.”
6. Encourage Accepting Help:
Encourage seeking help from mental health professionals who understand the nuances of smiling depression. Therapy can be a powerful tool in uncovering and addressing hidden struggles. If your suggestions are met with resistance, encourage starting with self-reflection and a safe place to vent.
• Example: Suggest to a friend, “Talking to a therapist or mental health companion could really help you navigate these feelings. There’s no shame in seeking support.”
“Accepting help can provide the guidance needed to uncover and address hidden struggles.”
If you have become reliant on alcohol or drugs to help you cope with your emotions then it might be time to cut this back. Of course, you may need a helping hand with this and that’s okay. If you have health insurance then you can get access to a BCBS drug rehab center.
#7 People Don’t Need Fixing, They Need Companionship
Walking through the hidden corridors of smiling depression, you’ll realize it’s not about fixing someone; it’s about walking alongside them, offering a hand when they need it most. This journey requires patience, empathy, and an open heart. It’s about being present and creating a space where they feel safe to express their true feelings without fear of judgment.
By being there consistently, showing genuine concern, and validating their experiences, you help them navigate their struggles and gradually uncover their hidden pain. It’s all about supporting their journey toward healing and self-acceptance, one step at a time.
Now stop scrolling and check in on a friend!
