Back to Top A white circle with a black border surrounding a chevron pointing up. It indicates 'click here to go back to the top of the page.'

If you fake a cheerful or happy mood to hide inner despair, you could have 'smiling depression'

This article was medically reviewed by Aaron Sternlicht, LMHC, MS, CASAC, a therapist and addiction specialist, and a founding partner of Family Addiction Specialist in New York, NY.
A sad woman looking at the camera with a paintbrush in her hand painting a smile overlayed her face.
CBT and interpersonal therapy may help you overcome smiling depression. Alpgiray Kelem/Getty Images

  • With smiling depression, you might hide your true emotions and your mood may briefly lift at times.
  • You may mask depression if you learned to hide feelings in childhood or think people will judge you.
  • It's important to get help for your symptoms, especially if you have thoughts of suicide.
Advertisement

Smokey Robinson once sang, "People say I'm the life of the party 'cause I tell a joke or two … Although I might be laughing loud and hearty, deep inside I'm blue." 

Lines like these perfectly illustrate the concept of smiling depression: This term describes someone who puts on a happy face to mask their emotional pain. 

Smiling depression isn't a medical diagnosis, but if you tend to mask your emotions with smiles and jokes it could mean you have a specific type of depression called major depressive disorder (MDD) with atypical features, says Sam Nabil, a licensed professional counselor and CEO and Lead Therapist of Naya Clinics

A diagnosis of MDD with atypical features means your symptoms don't match what experts consider "typical" for depression. So, your mood might temporarily improve when good things happen, and you may not seem sad or down to other people — which can make it harder to get a diagnosis. 

Here's what to know about the signs and causes of smiling depression, as well as how to get support for this condition.

Advertisement

Signs of smiling depression

Like other types of depression, smiling depression can involve a range of symptoms, according to Dr. WIlliam Anixter, a psychiatrist and director of the Asheville Community Program at Cooper Riis Healing Community. Examples include:

Yet, despite these symptoms, people with smiling depression may appear cheerful and optimistic to not just strangers but also friends, family members, and coworkers.

Of course, keeping up the facade of happiness while despair bubbles under the surface can feel exhausting. It can also keep you from sharing your feelings with loved ones, which may worsen loneliness and isolation, according to Anixter.

The more successfully a person can convince the world around them they're OK, the less likely they'll get the support they need, says Dr. Edward Ratush, a board-certified psychiatrist, medical director at The Center for Great Expectations, and co-founder of SohoMD.

Smiling depression may also involve a higher risk of suicide. While all types of depression can lead to thoughts of suicide, Ratush says people with smiling depression are often more likely to have the energy to form a plan and act on it.

Advertisement

Examples of smiling depression

Experts say smiling depression is no less severe than other forms of depression. A few examples of how smiling depression might play out in real life:

Example 1: John consistently achieves high grades in all of his grad school classes, and his classmates describe him as having a sunny disposition. 

When a friend invites him to have dinner after class, he makes an excuse about needing to study — in reality, he's exhausted from putting on a happy face all day and doesn't have much of an appetite. 

Usually, he'd be excited to get home in time for his favorite hobby — cooking — but lately, he doesn't have the energy or interest to plan and prepare meals, so he picks up fast food for dinner instead.

Example 2: Sally's social media followers scroll through posts showing her awe-inspiring travels, loving relationship with her partner, and impressive career successes. Most of them think she really does "have it all." 

Followers know Sally for her infectious smile. But they don't know she cries herself to sleep at night, though she has no idea why, or that she's been avoiding sex with her boyfriend because she no longer feels any pleasure or connection from intimacy.

Advertisement

Causes

A number of things can contribute to smiling depression.

For example, Anixter says that your caregivers may have taught you to hide your emotions by saying "men don't cry," or ridiculing you when you told them you were sad.

Knowing what causes your depression can help you identify it and seek support. Some common triggers of smiling depression include:

In particular, "your identity — how you see yourself — strongly determines whether you will mask your depression or not," Ratush says.

Moreover, social media doesn't help. Many people only share their most positive moments on social networks, and that pressure to show happiness and success in your own life, whether you feel it or not, can contribute to smiling depression.

Finally, when you have high expectations for yourself, Nabil says any perceived "failures" may lead to crushing shame, self-doubt, or insecurity. And when you don't meet those expectations, your fear of disappointing yourself, or others, may fuel your depression by making you feel like you're "not enough."

Advertisement

Risk factors

The cultural stigma around depression can play a part in smiling depression, too — if you consider your depression unacceptable or a sign of weakness, you might attempt to hide it however you can. 

"People with smiling depression think, 'I have too many responsibilities right now to be depressed,' or 'I can't acknowledge these feelings when others have it worse,'" Ratush says.

You may also worry about what your partner or coworkers will think of you if you talk about your hopelessness, low mood, or any other symptoms of depression. 

Other risk factors for smiling depression include:

Advertisement

How to get support

Since loved ones are less likely to notice the signs and symptoms of smiling depression, it's especially important to actively seek help when you need it.

Anixter and Ratush advise working with a professional if smiling depression begins to:

  • Damage your relationships
  • Make it impossible for you to keep up with work, school, or other obligations
  • Lead to thoughts of suicide
  • Negatively affect your sleeping or eating habits

Smiling depression can make it harder to reach out for support, due to fear of what people will think, Ratush says.

"Forming a trusting connection with a therapist to whom you can reveal your true feelings is a big first step to breaking free from the prison of social disconnection and isolation," Anixter says.

Types of therapy that might prove particularly helpful for smiling depression include:

You can search for a therapist near you using online databases like GoodTherapy, Psychology Today, Inclusive Therapists, and TherapyTribe. These databases also offer the option to filter results by specialty — like depression.

Depending on your symptoms and their severity, Anixter says your doctor or psychiatrist may also recommend antidepressant medication, which can help improve your mood, sleep, and appetite.

Advertisement

Insider's takeaway

Loved ones may not always recognize the signs of smiling depression, and people with this condition may find it difficult to reach out for help. That's why it's important to know the warning signs.

You may have a greater chance of experiencing smiling depression if you have perfectionistic tendencies, recently went through a significant life-changing event, have a family history of depression, or tend to compare yourself to others. 

No matter the cause, it's important to seek support for smiling depression if it has negative effects on your health, work, or relationships. A therapist can provide a safe space where you don't have to put on a smile and can candidly share your experiences without fear of judgment or other negative consequences.

Advertisement

Jump to

  1. Main content
  2. Search
  3. Account