Major depressive disorder (MDD) affects almost seven percent of the American population. Unfortunately, not all the symptoms of depression are obvious.
Of these, the vast majority (eighty percent) won’t seek treatment, although it is a very treatable condition.
The number of people with clinical depression increases by about twenty percent each year. (1)
The Dangers of Depression
Depression has become prevalent even in school-aged children. (2) Yet MDD remains an almost invisible pall on the mental health of society.
For the eighty percent who are either undiagnosed or not receiving treatment, their depression is concealed but no less real.
They go about their daily lives, aware that they are beyond sad, and donning a face of “normality” so others don’t suspect the pain they feel. We’ve itemized below some tell-tale signs of concealed depression so you can recognize it in a loved one (or yourself!).
Only with recognition and compassion can those who agonize with this hidden burden be supported and helped to work through its pitfalls and rise again to a state of good mental health.
Sadness isn’t the same as depression; watch the video below to learn the differences.
13 Symptoms of Depression
There can be a multitude of reasons why people battling depression may wish to keep it hidden, most prominently:
- Fear of ridicule or stigmatization
- Fear of sharing their innermost thoughts and feelings/trust
- Feeling that no one else can understand (or wants to try)
- Thinking they are beyond help.
Depression is a mental state in which someone feels unmotivated, irritable, sad, disinterested, discouraged, and/or hopeless for an extended period, to the point that these feelings interfere with routine daily function.
Some may have thoughts of suicide. (3) If we know what to look for, we may be able to see behind the façade to help someone in need.
1. Loss of Interest in Favorite Activities
Depressed people can distance themselves from the things they most love. They may suddenly discontinue activities that used to bring them joy.
2. Change of Eating Habits
Some people overeat when they’re under a great amount of stress while the opposite is true for others. A noticeable change in eating habits is an obvious sign that something is wrong. Further, someone who used to enjoy a social meal with others and now prefers to eat alone is showing signs of isolation—a red flag for depression. (4)
3. Abnormal Sleeping Habits
Like eating habits, sudden and persistent change in sleep habits can be a sign of depression. Whether it’s an escape of excessive sleeping at one extreme or the inability to sleep at the other, sleep is an activity that a depressed person can control when s/he may feel out of control. (5)
4. Knowledge of Mind-Altering Substances
Someone who is trying to hide something is acutely aware of anything taken into the body that can cause loss of control. Caffeine, sugar, alcohol, recreational and pharmaceutical drugs and their interactions can all affect mood and behavior, causing ups and downs. The depressed person knows this and will be very careful with these and similar substances.
5. Being Affable and Expressive
While some people become quiet and withdrawn if depressed, some who hides it can be especially outgoing and boisterous. They may express themselves outwardly through music, writing, comedy, and other forms of art. Self-deprecating humor is often a sign of depression. (6) Depressed people understand more fully the dark and light sides of their inner selves and let out only what they want others to see.
6. Being a Perfectionist Who Seeks Love and Attention
Fear of being discovered or losing love and respect can lead people hiding depression to become almost obsessed with appearing perfect.
They know very well their own talents and faults but want others only to see successes while hiding failings. They may fear that if others see their imperfections, the care they so need will be withheld or withdrawn.
7. Having Abandonment Issues
“People who conceal their depression often take extra care to appear all right or even over-the-top upbeat. They stick to the positive parts of their public persona and hide what’s going on inside.
This secrecy can be caused in part by extreme fears of abandonment. People experiencing depression may be afraid of rejection if they confess their true feelings. This can lead to ‘cover-ups’ so that friends will not notice signs of pain.” (7)
8. Cover-ups and Alibis
Hiding true emotion means you have to lie. Plausible excuses and alibis are ever at-the-ready for someone who wants to avoid particular situations.
If someone is constantly coming up with reasons why s/he can’t do or participate in something s/he used to, avoids certain people or social circumstances, or becomes overly secretive, it can be a sign of inner struggle.
9. Obsessive Habits
Everyone develops her/his own ways of coping with stress and anxiety. We all have habits, both good and bad. A depressed person tends to rely on them. Whether it’s something seemingly healthy such as exercise or other routines like long drives, walks, cleaning, or smoking, if the routine is disrupted, a depressed person may become unreasonably upset. Habits offer a feeling of comfort and control; the loss of control—even if a minor thing—can be devastating for a depressed person. (8)
10. Outward Positivity and Denial
Posts on social media that reflect fun and going out of one’s way to say how great everything is can reflect denial of sad truth.
“So, why would anyone deny depression? There may be several reasons, the most obvious of which relate to work, self-esteem and self-image. Denying that your emotional state isn’t all it might be is a good way of pressing ahead. You may not be firing on all cylinders, but you’re hoping it’s just a virus or a bit of pressure that will pass. This is extremely common. It’s the psychological equivalent of running a car on reserve fuel and hoping it won’t shudder to a halt. Denying depression is caught up with all sorts of things. Men stand as a good example because depression doesn’t fit with their sense of self. They may view depression as something that affects women, or they may struggle with admitting their symptoms to themselves…On the one hand people with symptoms of depression are less objective about their own situation than they may be in assessing others. Equally, denial of depression is a major hurdle in seeking treatment. Denial is a powerful mechanism and one that, if confronted, can lead to angry and upsetting scenes,” explains Health Central. (9)
11. Deepened Awareness of Life and Death
Having gone through extensive consideration of life and perhaps ideation of death, a depressed person is keenly aware of both. (10) It may come in a purely personal form or in the larger view of society or the universe. (11) The meanings of mortality, life, and death can be subjects for which the depressed person has strong opinions and perceptions.
12. Experiencing an Existential Crisis
The search for life’s meaning for a depressed person can cause frequent changes: switching jobs, homes, cars, areas of study, relationships, and other major life decisions can indicate the constant quest to find what’s “right” with a constant feeling that something(s) is wrong. (12)
13. Small, Subtle Cries for Help
The depressed person isn’t enjoying it. The feelings may be familiar but they are not comfortable. Even if they try to hide it, if you look closely, depressed people will put out little hints that they need help.
Concealing depression is a way for some people to avoid feeling they are a burden to their loved ones. It can also be tied to a fear that they’ll be negatively labeled.
People battling depression may not reach out but need their loved ones to take the first step. Talking about your own life experiences, including failures and difficulties, can help others openly talk about theirs.
Trust is critical because it’s fear that keeps the depression hidden. Social isolation breeds depression and depression can lead to isolationism. It’s becoming epidemic in the Western world. (13)
The reasons why there is such an epidemic of MDD is an issue not properly faced by the medical community and society as a whole.
Poor diet; sedentary lifestyle; chemicals all around us; loss of social interaction; and the unstable, violent state of the world all lend themselves to negative feelings, both physical and emotional. (15, 16)
If you are struggling with depression, seek help—you are not alone. Family and friends can help. Someone objective may feel more comfortable to talk to, like a mental health professional, community helpline, or member of the clergy.
If you suspect someone you know is trying to hide her/his depression, reach out because s/he may not be able to. Find out more about depression by checking out the infographic below.