Often you see people who appear to be all set in their personal and professional lives, always having a smile on their face, not giving any impression about their inner world where nothing feels good. Such people are happy outside but in their inner life, nothing is close to their idea of what it means to be happy. They are fully functional, not at all perturbed by the challenges outside but inside, putting in humongous efforts to keep their pieces together. They are constantly fighting battles inside that no one knows about, sometimes even they fail to recognize that there is any such conflict inside.

Such is their outward appearance that their close family members and friends never feel the need to take them to a mental health professional. Our existence has so become synonymous with challenges, dissatisfaction and unhappiness that if one is able to put together a pleasing front to the world around, it is believed that all is good.

Human personality, given all its complexities and idiosyncratic tendencies, is a complex phenomenon where it takes time and sincere efforts before one can understand what is wrong with it. Generally, it is suggested that when it does not feel right inside, see a professional who can help you get in touch with your deepest feelings and concerns and also can help you disentangle your thoughts.

When one is masking one’s real feelings and appearing all good outside, it is termed as “smiling depression”. The term “smiling depression” is not an official term in diagnostic manual of psychological disorders but it is a more common an occurrence than the clinical depression. Smiling depression is more likely to be diagnosed as “major depressive disorder with atypical features” by DSM (Diagnostic and Statistical Manual of Mental Disorders).

Usually, the primary symptom of depression is deep, prolonged sadness. But for smiling depression, there are some other symptoms such as fatigue, changes in diet and sleep patterns, loss of disinterest in activities that were earlier of interest, irritability and aloofness. In a person with smiling depression, all these symptoms are masked. The individual appears happy and it seems that he does not have any problem of any nature. But in his own mind, the individual is full of doubts about himself, his choices, his decisions and actions. One is not sure about which next step will be more appropriate to the situation. One is more likely to be agreeing to what others propose or suggest and rarely initiating something on his own. A person with smiling depression generally lacks enthusiasm for any new activity and prefers to stick to his routine. He smiles and laughs but the smile does not reach to his inner core and is generally a defense to avoid facing any questions from others around. Such individuals ensure that they are not confronted by others so they observe extreme caution in everything that they do. They are over-sensitive and, therefore, avoid getting into situations where they can be triggered.

Smiling depression is more common than one can think of and also is one of the leading causes of suicides given the high-functioning nature of the individuals with “smiling depression”. It can be a great move if we start to normalize mental health issues so that people do not have to mask their concerns and they feel accepted in coming out with their issues.

Purnima Gupta

Psychotherapist- Anahata Mental Health Clinic