"Smiling Depression" Explained

By Kelly Burch 02/21/19

Low mood is not the only feature of depression. 

a woman with smiling depression

Depression is associated with sadness, crying and an inability to get out of bed. However, up to 40% of people who have depression may have “smiling depression” and not exhibit these symptoms.

“It can be very hard to spot people suffering from smiling depression. They may seem like they don't have a reason to be sad—they have a job, an apartment and maybe even children or a partner. They smile when you greet them and can carry pleasant conversations. In short, they put on a mask to the outside world while leading seemingly normal and active lives,” Olivia Remes, a doctoral candidate at the University of Cambridge, wrote for Science Alert.

Many people are able to “keep up appearances” even while they’re feeling down. Marissa, a 22-year-old from New Jersey, posted a picture of her smiling at an adorable puppy, with the caption, "Sometimes it's the little things that bring the most joy."

However, Marissa told Women’s Health how she really felt that day: “I wish I had half of this puppy's joy. Earlier today I was driving, and looking for objects to crash into. My life feels so overwhelming that I just can't deal.”

Smiling depression isn’t a medical term, but depression with atypical features is. People who suffer from depression with atypical features might have primary symptoms including weight gain or appetite increase, sleepiness, or social isolation.

However, they can still experience positive reactions to good events, whereas many people with typical depression might not be able to tap into the joy brought by good news or positive occurrence. 

This can make it hard for some people to recognize that they are depressed, Dr. Michelle B. Riba, of the University of Michigan Comprehensive Depression Center, told Health.

“Many people will come to their doctor complaining about sleep problems, or headaches, not realizing that it’s a mood disorder because they don’t have low mood. Not all symptoms of depression always occur at once.”

Another woman who spoke with Women’s Health posted a picture of herself in a shirt that said “Be kind always.” However, that didn’t actually fit her mood, she explained. 

"I feel so down I almost broke into tears at the grocery store today. I wish I could have extended this kindness to myself,” the 33-year-old said. 

The feelings of smiling depression can sneak up and be surprising, said Rebecca, 36, who posted a photo of herself smiling at a friend’s wedding. 

"After this, I snuck out of the reception to cry in my hotel because I suddenly felt depressed without knowing why,” she said. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.