This Is What Depression Looks Like: How To Confront A Struggle Invisible To Others

Despite how common they might be, depressive disorders can be frequently misunderstood and stigmatized by many. When you’re experiencing emotional distress, fear of judgement might make it challenging to reach out for help. However, while some may be tempted to hide their symptoms, it is not generally a sustainable solution. There doesn’t have to be shame in experiencing depression, and there are effective ways to address it for many. A combination of therapy, medications, and lifestyle adjustments can help most people improve symptoms of depression. Read on to learn more.

Symptoms of depression

Many experts agree that there can be several types of depression, including major depressive disorder, postpartum depression, and persistent depressive disorder. Depression symptoms can vary in duration and intensity, but might include some of the following: 

• Feeling sad, hopeless, helpless or empty 

• Crying frequently and/or easily 

• Unexplained body aches and/or headaches 

• Feelings of irritability, anger or agitation

• Experiencing a loss of interest in things you used to enjoy

• Experiencing sleep disturbances (such as sleeping too much or not enough)

• Experiencing a lack of energy

• Weight or appetite changes 

• Feelings of restlessness 

• Experiencing difficulty concentrating or making decisions 

• Guilt, self-blame or feelings of worthlessness 

• Experiencing thoughts of suicide

Major depressive disorder is generally regarded as a common (but very serious) mood disorder. Most people might require professional help to get better. Symptoms can often be effectively addressed with a combination of therapy and medications. It’s recommended that you seek medical advice before starting or stopping medications. A doctor may recommend a treatment plan based on your medical history and any medical conditions you’re currently experiencing.

What is smiling depression?

Smiling depression is generally regarded as a colloquial term that can sometimes be used to describe  major depressive disorder. Individuals living with smiling depression might mask symptoms, possibly in an attempt to avoid judgement or emotional distress. 

Other reasons some people may mask their symptoms can include not trusting doctors, being a perfectionist, fearing repercussions, not wanting to worry family or friends, guilt or shame, worry about being perceived as weak, difficulty paying for physical or mental healthcare and fear of being prescribed antidepressants that can cause side effects.  

Atypical depression can develop most commonly in young people, possibly lasting for an extended period of time. It can co-occur frequently with anxiety disorders, and it can pose a higher risk of suicidal ideation than other types of depression. 

While many people with atypical smiling depression might mask some of the classic symptoms of depression, the following symptoms may be frequently present: 

• Mood reactivity

• Increased appetite and/or weight gain

• Lethargy or excessive exhaustion

• Heaviness of auxiliary limbs 

• Body aches and pains 

• Increased feelings of irritability and sensitivity

Confronting your symptoms

The following strategies are considered by many to be healthy lifestyle choices and coping mechanisms that can improve your symptoms: 

• Trying mindfulness, meditation, or yoga

Practices like mindfulness can help you become more aware of your thoughts and feelings while abstaining from judgement. Some studies have found details that suggest that it can be as effective as medications at reducing symptom intensity and preventing relapses. 

• Practicing R.A.I.N

When you are experiencing depressive emotions, you can try using the RAIN acronym to help you move through them. This generally stands for the process of recognizing emotions, accepting them without judgement, investigating the feeling, and non-identifying with the emotion.

• Letting go of perfectionism

Perfectionism can put people at a heightened risk of experiencing depression and self-criticism. You can challenge perfectionistic thoughts by identifying them, replacing them with more realistic statements, examining the bigger picture and compromising.  

• Starting a habit of positive self-talk

Negative self-talk can be a common feature of depression. If you frequently talk down to yourself, it may be helpful to consider whether you’d make that statement to a friend. If not, you can consciously reframe your thought. For example: You can change your automatic thought of “I’m a failure,” to “I’m proud I tried this even if it didn’t work out”.

• Joining a support group

If you’re finding it difficult to discuss your depression with a friend or family member, you can consider joining a support group. Studies have found details that suggest that both online and in-person support groups can be effective at reducing depressive symptoms. 

• Getting some exercise every day

Exercise can release endorphins and can provide a healthy distraction from negative thought processes, which can improve your mood and reduce symptoms of depression and anxiety disorder. Exercise can also boost self-confidence, provide increased opportunities for social interactions and can act as a healthy stress reliever. 

• Making other lifestyle adjustments

Healthy practices, such as getting enough sleep, gratitude journaling, eating a balanced diet, spending time with people you care about, trying new activities, listening to music you enjoy and spending time outdoors can all improve your mood. 

Getting professional help: How and where to start 

It can be helpful for many to remember that getting professional support can be a sign of strength—not weakness. Here are some ways you can begin your journey to healing: 

• Getting a diagnosis

If you think you might have depression, you might consider reaching out to a health care provider. They may perform tests to rule out other mental and physical health conditions, provide a diagnosis, and discuss whether medications like antidepressants may be helpful for you. 

• Psychotherapy 

There are several types of psychotherapy (talk therapy) that can be frequently used for major depressive disorder. These can include cognitive behavioral therapy (CBT), interpersonal therapy and supportive therapy. 

How can online therapy help those who are experiencing depression or anxiety disorders? 

CBT is generally considered to be one of the best types of therapy that can address depression and anxiety disorders. During sessions, therapists can help clients to identify and restructure negative automatic thoughts that can cause distress and sadness. Exploring the causes of these thought patterns can help clients process past life experiences and effectively reduce depressive symptoms. 

If you have atypical depression, you may find it easier to discuss your internal thoughts when you are physically distant from your therapist. Online CBT can be offered on platforms like BetterHelp, and it can enable you to seek help from the comfort of your own home.

Is online therapy effective? 

Studies have found details that suggest that online CBT can be effective for many people living with major depressive disorder. Many have found that this method of therapeutic intervention can be more effective, affordable and available, possibly implying that more people are receiving the health support that they need as a result. 

In the same study, measurable positive mental and physical health impacts were observed specifically in patients who were living with depression and related conditions. 

What can loved ones do for those living with smiling depression?

Smiling depression can be difficult to identify, but you can look out for the following signs in yourself or those you love: 

• Sleeping changes 

• Significant weight changes 

• Changes in substance use 

• Increased irritability

• Complaining about unexplained physical pain

• Personality changes (such as becoming more quiet or pessimistic) 

• Increased risk-taking

• Canceling plans frequently or becoming more distant 

Many might find that, one of the best things that they or their loved ones can do is to build more genuine social relationships that provide space for vulnerability, acceptance and validation. 

Additionally, de-stigmatizing mental health challenges can make it easier for friends to discuss their feelings and seek help proactively.

Research suggests that stigma against mental illnesses is one of the largest factors that can deter young people from reaching out to a professional. Taking proactive steps to mitigate this experience at a family and friend level can generate positive, society-wide effects. 

Here are some suggested steps you can take to reduce stigma: 

• Educate yourself about common psychiatric disorders and mental health conditions.

• Evaluate your thoughts, attitudes, and judgments. 

• Consider how the words you use may be stigmatizing and educate others who may not be aware.

• Try using person-first language. A person is not generally defined by their mental health challenges. 

• This could look like saying “someone who lives with smiling depression” compared to “someone with smiling depression”. 

• Treat everyone with respect.