Smile, though your heart is breaking…

Smiling depression: appearing happy on the outside while feeling depressed inside.
This is a dangerous condition to have and why we need to pay attention.

By Olivia Remes, Researcher at University of Cambridge

Smiling depression is a difficult condition to deal with. It refers to looking happy on the outside while inside feeling depressed. Internet searches for this term have shot up and for good reason too. It affects so many of us: about 1 in 10 people are depressed and a significant number of these individuals have smiling depression (or “atypical depression” – this is the scientific term that most closely resembles smiling depression).

What is even more disconcerting is that people with this smiling (or “atypical”) depression are at particularly high risk for suicide. But many times, you would never guess it. Because those affected put on a mask or façade to the outside world while hiding the pain or hopelessness they are feeling inside. They smile when you meet them and are engaging and pleasant when you talk to them. But only they know the low mood and loss of pleasure they are experiencing, the emptiness that is pervading their body, the hopelessness that is weighing them down. The energy that they have to push through and fulfil their obligations makes it seem as if everything is fine. They might have a stable income, family and friends, and seem to be leading normal lives. But the way they look on the outside does not match what they are feeling on the inside.

This is why this condition is hard to spot. Unlike individuals with other forms of depression in which they have very little energy, people with smiling depression have the energy to act on their suicidal plans. This is why smiling depression can be very dangerous.

Symptoms of smiling depression
People with smiling depression might also experience symptoms like heaviness in the arms or legs, overeating, oversleeping, and they can be easily hurt by criticism or rejection. They also tend to feel worse in the evening. Although people with smiling depression feel empty and down, their moods can lift in response to positive events. If they are praised in relation to their work or receive a compliment, they can experience momentary happiness or a mood lift. But usually only for a brief moment before going back to feeling down. Although many things can trigger this condition, low mood stems from occurrences such as financial problems, a relationship ending or marriage breaking down.

What can be done about it?
There are ways to deal with smiling depression. If you think you’re affected, an important first step is to acknowledge what you are feeling and not brush your symptoms under the rug. Just because you can fulfil your duties and take care of your family in spite of feeling low doesn’t mean that you are ok. Depression left untreated can become worse in severity over time and lead to serious consequences, such as chronic diseases and suicide. Some people might feel ashamed or embarrassed to seek help, thinking that they have nothing to complain about. But it’s important to be kind with ourselves and do what it takes to help ourselves. Only then can we turn our mental health around. And if we improve on an emotional and psychological level, then we become better partners, we become better neighbours, we become at leading our own lives. So we need to pay attention to what we are feeling inside and start taking care of our needs.

There are several things we can do to achieve this. One of these things is going for cognitive behavioural therapy, which is aimed at changing our thinking patterns and equipping us with a mental toolkit for dealing with challenges. Something else we can do is engage in physical activity and meditation. A study done a few years ago by Rutgers University showed that physical activity and meditation done twice a week led to a decrease of almost 40% in people’s depression levels. Study participants showed these tremendous results after only two months.

Finding meaning and purpose in life
Finally, one of the most important things we can do for our mental health and overall wellbeing is achieving meaning and purpose in life. People without this are at risk for depression. When we find our meaning and purpose, only then do we realize that our lives are important. And this can start by taking the focus off of ourselves and placing it onto another individual. Turning our attention from inwards to outwards. Seeing how we can impact someone else’s life and help them out. This can be done by volunteering or taking care of another human being. Or even an animal.

The famous neurologist Dr. Viktor Frankl said that finding meaning and purpose in life is essential if we want to have good mental health. He worked with prisoners of war and noted that there was one key difference between those who survived and those who didn’t. This key difference lay in whether they had meaning and purpose in life. He wrote in his book that, for one man it was knowing that his daughter was waiting for him and he needed to keep living for her. For another, it was knowing that he still had work that he needed to finish, and he was very passionate about this work.

Making a difference in someone else’s life and thinking about their needs and wants ultimately makes us realize that our actions matter. It makes us realize that what we do is important, that we are important. And this can ultimately give us meaning and purpose and has a positive influence on our mental health.

stephanie_berkeley_zl4u2oa9Smile, though your heart is breaking…