If your teen is smiling and seems happy, surely they aren’t depressed, right? That may not be the case.
15% of Californian youth reported having a major depressive episode in 2022, and not all of those cases are obvious. Instances of adolescents hiding their depression behind a happy mask are called smiling depression. Teens have many reasons for trying to keep their mental health a secret. There are smiling depression symptoms to look out for, despite teens’ attempts to cover up the reality of their mental health. Knowing them will help us keep our teens safe and healthy.
Smiling Depression: What You Need to Know
Smiling depression isn’t an official diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it is a real concern. Smiling depression is sometimes called walking depression or hidden depression.
Those with smiling depression can attend to their daily responsibilities with nothing appearing out of the ordinary. They could go to school and interact with their friends like everything is fine. They could come home and talk to their family, showing no signs of depression. When they’re by themselves, they usually feel exhausted from keeping up their happy facade on top of the draining nature of depression. They still experience the typical symptoms of depression, like sleep disruptions, fatigue, loss of interest in activities and relationships they once enjoyed, difficulty concentrating, and hopelessness. Teens with smiling depression usually face these challenges alone.
Some teens with smiling depression can even “trick” themselves into thinking they don’t have depression. They can perform all the tasks necessary in their lives, and their relationships and performance in school haven’t suffered. This can be confusing for the adolescent, too, and leave them unaware of their own depression.
Smiling Depression Vs High-Functioning Depression
Some may call smiling depression “high-functioning depression.” While those with smiling depression may be high-functioning, not everyone high-functioning has smiling depression. Some individuals with high-functioning depression will still exhibit symptoms of depression outwardly. It’s important to remember that neither of these terms is an official diagnosis.
People at Risk for Smiling Depression
The risk factors for general depression apply to smiling depression too. These include a family history of depression, stress, trauma, life changes, substance use, and more.
Smiling depression includes additional risk factors. Perfectionists are more prone to smiling depression because they want to appear put together and high-functioning to others around them. Often, these individuals don’t want to show weakness to themselves, either. They may internalize their depression even more.
Certain cultures and family beliefs can also increase the risk of smiling depression. In some areas of the world, depression is seen as uncommon, or even nonexistent. The United States, California included, is a diverse nation made up of people from all cultures. Some teens inevitably face the challenges and pressures of American society while facing contradicting attitudes at home due to different beliefs and cultures.
The largest risk factor for smiling depression is a lack of support. If a teen feels like they can’t open up about their negative feelings to their friends and family, they’ll internalize and conceal those feelings. This is especially true if the people close to them look down on people with mental health conditions, or stigmatize them.
Why Teens Hide Behind a Smile
Teens have various reasons for trying to conceal their true feelings. The teenage years consist of worrying about reputation, wanting to please their parents, and wanting to look cool. All of these factors and more contribute to smiling depression.
Fear of Burdening Others
Teens don’t want to worry their friends and family or cause them stress. They don’t want anyone to feel obligated to comfort them or take care of them, especially when they have their own responsibilities. This can make teens bury their feelings and depression.
Fear of Backlash
There is still a stigma against mental health conditions in our society. People with smiling depression may fear someone judging them if they share their true feelings. They might worry the person will diminish their feelings, tell them to get over it, or think they’re “weird” for being depressed.
Familial pressure may also play a role. Some parents may not be supportive of their teens seeking mental healthcare or being open about their feelings. They may foster an environment where talking about feelings is frowned upon. Teens with depression may cover it up to avoid disappointing their families.
Concern About Appearing Weak
Perfectionists in particular may find this challenging. Some people want to appear perfect and put together. This is especially true if they’re someone expected to support others or be a role model. They want to appear strong and reliable to other people, and they think their depression contradicts that. Instead, they’ll pretend nothing is wrong.
Unrealistic Expectations of Happiness
Teens with depression can scroll through social media and see countless photos and videos of happy people. People only showing their good sides on social media can lead adolescents to believe they’re the only person feeling depressed. They conform to their unrealistic expectations of happiness and what they think the world expects from them even though they’re depressed.
Guilt
Guilt and shame come with depression, and some teens may feel like they don’t have a justified reason for being depressed. Whether they experienced trauma to trigger the depression or everything seems right in their life, it doesn’t matter. Depression can impact everyone. Sometimes teens feel bad about their feelings no matter what. This can cause them to cover their depression with a smile.
Denial
Adolescents may also try to trick themselves into believing they don’t have depression. Some succeed. They think if they continue to smile, function well, and seem happy, they aren’t depressed.
Symptoms of Smiling Depression: Unmasking the Facade
Smiling depression symptoms are the same as regular depression symptoms, they’re just more difficult to spot. Individuals with smiling depression actively try to hide their symptoms. Symptoms of smiling depression to watch out for are:
- Fatigue
- Weight and appetite changes
- Sleep disturbances
- Difficulty concentrating
- Loss of interest in activities
- Substance use
- Low self-esteem
- Hopelessness
- Suicidal thoughts
Smiling Depression and Increased Suicide Risk
Some may think those with smiling depression don’t experience depression as deeply as those who don’t hide it. That isn’t true. In some cases, teens with smiling depression feel even more lonely and isolated than those who are open about depression. They don’t have anyone to talk to, so they keep their thoughts and feelings to themselves. That can cause a deep feeling of loneliness.
Individuals with smiling depression tend to have more energy than those who don’t hide their depression, too. They may see this as a benefit, but it comes with dangers. One of those dangers is an increased risk of suicide. While anyone with depression is at risk of suicide, those with smiling depression tend to have more motivation to successfully carry out the act. They also are more likely to go without treatment than those outwardly expressing depression symptoms.
Recognizing and Treating Smiling Depression
Smiling depression can be difficult to recognize. Keep an eye out for the previously mentioned symptoms, and check in with your teen frequently. Ask them how they’re feeling, and make sure they know they can talk to you whenever they’re feeling down. Let them know it’s okay to feel sad and depressed. Stay patient, and remember that depression takes time to heal from, even when enlisting the help of a professional.
How to Get Help For Smiling Depression in Los Angeles
If your teen has smiling depression, it’s negatively impacting the quality of their life. Any kind of depression is difficult to recover from without depression treatment. Seeking help for your teen’s depression is one of the best things you can do for them as a parent.
BNI Treatment Centers, located in the Los Angeles area, offers mental health and substance use disorder treatment to teens ages 13-17. Falling behind in school isn’t an issue while seeking treatment at BNI. We work with teens’ schools to keep them on track with their education during their time with us, all while working toward recovery. For more on what we do, call us at (888) 522-1504.
BNI Treatment Centers: Science-based, evidence-backed, compassion-led.
