Hidden Depression Among Us
August 14th, 2012
By Cynthia W. Lubow, MS, MFT, Depression Topic Expert Contributor
You may know someone who is depressed and not know they’re depressed. People expect someone who is depressed to cry a lot, stay in bed all day, mope, or sound like Eeyore from Winnie the Pooh. But depression isn’t always this obvious.
Some people can totally fake it. They can smile and laugh; they can act like everyone else, even while they are in excruciating emotional pain inside. Occasionally people who can do this end up killing themselves, and no one can believe it. People who can act like they’re not depressed may not confide in anyone. Usually they find a way to spend time alone crying or letting down the facade and then go back to acting when they have to be with people. I’ve had clients who lived with their families and only found time to cry after everyone went to sleep, and only in the bathroom. The rest of the time they were acting like someone who wasn’t in pain. On top of the pain they already feel, acting happy is emotionally exhausting, and having this secret is isolating. So, faking it can even increase the depression.
Others funnel their pain into anger and people see them rage, abuse, shame, or react with annoyance or irritation to whatever happens around them. They may or may not themselves know they’re depressed, but others often don’t guess how much devastating emotional pain they are in. People may fear them, despise them, or dismiss them as mean. It is very difficult to feel sympathy for someone who is hurting people, and it is difficult to see their vulnerability, so their depression goes unnoticed.
Still others are addicted to something, and the depression is obscured by the addiction. People with addictions spend most of their time and energy relating to the addiction. They plan to do it, anticipate doing it—these phases excite them and elevate their mood temporarily. Then they use whatever they are addicted to and it boosts their mood. But then the thrill wears off, and they are depleted by the effects of the addiction and may also feel remorse or shame, so the depression descends on them, pulling them down like a cement jacket. They begin the cycle again to try to feel better—plan and anticipate…. Their whole life is about running from depression, but it becomes centered around the more dramatic force of addiction, and the depression can be unrecognized. I am not saying that all addicts are driven by depression—depression can also be caused by addiction. But addiction can be a form depression takes that is not easy to identify as depression. I include eating disorders in this category. I also include people who work most of their waking hours.
Depression isolates people. Whether they are hiding from the world in bed, preoccupied with an addiction, pushing people away with anger, or keeping their real thoughts and feelings inside while pretending to be okay, people with depression usually feel very alone. Depression also has a built-in isolating fog quality that makes it very difficult to feel connected to people. Even when people feel safe to express exactly how they feel, it is very difficult for people who haven’t experienced a deep depression to understand how that feels. How can anyone who hasn’t experienced it understand a pain that is as intense as any open-heart surgery without anesthesia, with no cuts or bruises to show? How can anyone who hasn’t experienced it understand the complexity of pain that is not only unbearably intense itself but also complicated by many painful factors like the stigma of mental illness and the confusion of the fact that unlike other illnesses, depression causes behavior changes. People attribute behavior to the moral character of the person, rather than to the illness.
The pain is also complicated by the fact that depression attacks a person’s thoughts and feelings, rather than liver or lungs. Depression can cause a person to think she hates herself or is unhappy in her relationships. It can cause someone to believe everyone would be better off without him, or even that others would be better off dead. It can cause people to feel sad, angry, guilty, numb, or rageful, even when none of this is how they feel when they aren’t depressed.
So what can you do to help people you love who are depressed, if you can’t tell they’re depressed? Ask questions very kindly and listen to the answers very carefully. Empathize with their emotional pain—even if you have to guess at what it might be. Let them know you are there to listen and understand for as long as it takes, and you aren’t taking no for an answer. Of course if you aren’t trustworthy—if you judge them, or talk to others about what they tell you, or interrupt, get impatient, or misunderstand them, then it is better for them to talk to someone who can really listen without any of this. Being a reliable, trustworthy, patient, nonjudgmental listener is the best thing you can do in most cases with someone who is depressed.
A couple of caveats: I am talking about adults—children and teens require some variations. Also, addictions cloud the picture of depression and require their own, very different intervention. Nonjudgmental listening is still essential but may need to be combined with some firm boundary-setting and professional treatment for the addiction.
Related articles:
The Irritable or Angry Experience of Depression
When Someone Really Listens, We Heal
Feelings 101
© Copyright 2012 by Cynthia W. Lubow, MS, MFT, therapist in El Cerrito, CA. All Rights Reserved.
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Comments
I think that I have been at that place in my life when I was depressed but never really let on to others what I was feeling on the inside. They always just saw me for the funny guy that they were used to seeing, and had no idea the pain that I had chosen to hide within. I think that it took a few really close friends top finally get me to own up that something wasn’t quite right, and quietly i sounght and received help for it. It just wasn’t something that I wanted to advertise or felt like anyone had to know anything about. I have never been someone who has to let everyone and their brother know what’s going on in my private life because the way I see it, that’s my business.
it must be horrible to have to pretend to be happy when there is something hurting you inside..i cannot do such a thing at any cost..i just cant.
while that is a harmful thing to do no doubt,i believe people who are capable of doing this in the first place are more vulnerable..if something bothers someone and he acts like everything is fine he is only going to turn out worse off than me because i would definitely share it with someone and feel better!
This article was so refreshing to read. So many people think of the stereotypical depressed person, and don’t realize how good at acting people really are. I know that I’ll do just about anything to mask my depression while I’m at work or out and about, but when I am home, sometimes it’s an effort just to brush my teeth. When I muster up the guts to honestly answer someone’s “how are you today?” question, they are ALWAYS shocked if I answer that I’m crabby, or depressed, because it NEVER shows on my face or in how I carry myself. It is exhausting, like you said, but in sharing articles like this, educating others, hopefully the world will have a few more sensitively tuned people that can look past the facade and step into a helping, caring role, even for a few minutes.
Thank you for this article!
Kind of scary when you think about just how many people could be dealing with depression all alone because they are really good at hiding their feelings and their emotions. It is often hard to tell when that person who is perpetually up is hurting, and that’s why I think that sometimes it is so hard to believe when they do something that shows just how much they have been in pain. We have to look beyond the outward appearance and really listen to what our friends and loved ones are saying- you might not be able to see that pain, but if you pay close attention then you may be able to hear it in the things that they say.
I have never seen anyone who very convincingly hid the fact that they were depressed.
Most of the time people who are depressed do show us the signs, but we totally miss them because as a whole we are more focused on ourselves than we are on others.
Purple Dreamer: You are causing harm and hurt to yourself by doing that. Speak with a friend, go out for a walk and just observe nature, there are so many things that can help. And if you still don’t feel better you don’t have to pretend like everything is fine. it will only be disadvantageous to you in the long run.
Sometimes you keep shoving those emotions and feelings so deep down inside that all of a sudden you realize that you need some help, but have no idea where to go for it.
You find it hard to go to your friends to admit to this because you have kept it to yourself for so long that you are scared they may not believe you.
Live the truth, ask for help
Do you think that since these people can so easily hide what they are experiencing that maybe they would have an easier time recovering? I mean, if they can hide it, then maybe the illness doesn’t run so deep?
Thank you all so much for your moving, compassionate responses! The better we can all be at watching and listening compassionately, the more people will feel safe to talk about their pain and get help.
Conner, what you’re saying makes sense, but I actually don’t think they have an easier time recovering–in fact I suspect that this version of depression probably lasts much longer than many more obvious versions. I do think they function better than other versions, though.
Depression is horrible! Because it hurts mentally to just think, a person tends to just sit around and watch TV etc. Veg out! I am that kind of person. I at first thought I could hide the pain but then realized that you need to talk to someone! I do go to a physiologist who is very good for me. She listens and lets me get all the bad stuff off my chest. Then she will talk to me and let me know that when you are Depressed, life isn’t fun or happy! But you have to do things to stop this from completely taking over your life! I tell her I am so exhausted by the weight of this depression and I just want to be normal again. I love talking to her and I also know that by going to see her I’m out and about and doing something different.
I often refer to Depression as like the movie “Ground Hog Day.” No matter how much you want to do this or that it’s kind of like every day is the same. If I accomplish something one day I feel great but as soon as I’m done I Veg out again. I know that my depression will not be there forever, going through a divorce is hard and when my divorce is final, I know I’ll be okay. I’ve been going through this divorce for 3 very long and painful years! I just can’t see the good right now because I need closure. The closure won’t come until this is over! So for now I deal with it the best way I know and that is to take each day at a time. Some days are good while others are simply the worst. I know I will come out of this because I like the person I am. I am very strong and I know that I am a good and caring person. Please, if anyone is going through depression, talk to someone, that’s a start! You need to get rid of your pain!
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