One of the many unfortunate legacies of the coronavirus pandemic has been an increase in mental health issues. At the top of the list is depression. It’s not an uncommon mental health issue; approximately 10% of the U. S. population suffers from some form of depression. And it’s one of the most treatable mental health conditions, usually managed with counseling or psychotherapy.
Depression can be caused by several factors associated with different types of diagnoses. For example, seasonal affective disorder is a form of depression that comes with the changing seasons and lack of sunlight. It affects one to two percent of the population. Medical problems and medication cause about 10 – 15% of depression in people. And postpartum depression affects one out of every seven new mothers.
Your view of the world and assumptions about how the world works can also cause depression. Relying on the judgments of others can subject you to unrealistic expectations that then cause depression and anxiety. Social media plays a part in your view of the world and seeing the predominantly cheerful, successful posts of others tends to make you think everyone else is doing much better than you. In reality, most people will never share their emotional, painful life stories with the outside world. Not seeing the authentic life of others causes you to question your own self-worth and lowers your own self-esteem.
Stress, which is an automatic response to stimulus that requires you to change or adapt, is also a major cause of depression. This can be brought on by loss, childhood trauma, or big life changes like hardships brought on by the current pandemic, for example. Some people are able to just roll with the changes, while others find themselves falling into despair. “There are a lot of people suffering right now, some invisible and some visible,” said Jeff Hubbell, Director of Behavioral Health at GraceMed.
More than sadness
Sadness is typically the most common reported characteristic of depression. In addition, people suffering from depression report a lack of interest or pleasure in almost all activities, especially those that were previously enjoyed. But not everyone experiences depression in the same way, nor does depression look the same in every person who is experiencing symptoms.
A person suffering from depression may have trouble sleeping or may seem to sleep all the time with little or no energy to get out of bed. In fact, they often have little energy for anything. Because of this, they have feelings of worthlessness and guilt which then add to the lack of energy or motivation.
There is also an inability to focus or concentrate. They may not have the same appetite they once did, either eating more than usual or very little at all. It may seem to someone suffering with depression that life is moving in slow motion. The endless cycle of dealing with the symptoms drains what little self-esteem and self-worth they may have, leading to suicidal thoughts.
Not as typically, some people manage their lives with no apparent outward symptoms while fighting depression. They may be effectively hiding the signs of depression by working hard to look “normal,” or they may not realize that they are depressed. These are the people suffering from hidden depression. Also known as smiling depression or high functioning depression.
Behind the mask
Often described as wearing a mask, the happy face form of depression disguises the pain, anxiety and anguish of trying to get through another day without falling apart. To the outside world, these people appear to be cheerful, optimistic and generally happy. They hold down jobs and seem to have healthy family and social lives. At times they can become compulsive showing signs of being a workaholic. They can also be prone to substance abuse and compulsive gambling in an attempt to generate the feeling of happiness.
The smile is a defense mechanism, part of the external façade of wellness. Under the mask, they are concealing sadness, panic attacks, low self-esteem and insomnia. There are also suicidal thoughts which are of particular concern because with high functioning depression, the initiative to follow through is very real. More overt forms of depression drain energy out of a person, making it difficult to just get out of bed let alone have the energy to commit suicide. With hidden depression, the mask is hiding so much that even close family and friends may not see the signs before it’s too late.
While some people don’t recognize their own feelings of depression, others are working hard to hide their condition on purpose. They don’t want to upset anyone like family or friends by admitting how they really feel, fearing others will be let down. This is due in part to the high standards they set for themselves.
Others are trying to practice “faking it until you’re making it” in the belief that they can will themselves to be happy. But that doesn’t work when you’re really faking the smile for others not yourself.
And some don’t trust their own feelings. They question whether they really have depression because they are able to carry on with their active life. With friends and family commenting on how motivated, successful and cheerful they are, it’s hard to imagine and acknowledge that they are actually under the cloud of depression. Further, they may think of their thoughts of wanting to rest as being lazy. They may feel guilty about the nagging desire they have to withdraw from social activities.
Why hide it
For those who knowingly wear the mask, their attempt to hide the depression often stems from the outward opinions of others. For example, men are often told that “real men don’t cry.” It’s not okay to show weakness. So they work at keeping those feelings inside and try their best to go about life as usual.
Some people hide their feelings because they believe that sharing the way they really feel will be a burden to others. Depression and guilt are connected. If someone shares how they really feel, they will then feel guilty about putting you in a position to lend a hand. In a way, they lack the ability to ask for help without feeling bad about themselves. They downplay the way they feel because, in their minds, other people are worse off.
And there is also the fear of how they might be perceived if others knew they were depressed. Professionally, will they be looked at differently or passed over for promotions or more challenging projects? The stigma that goes with mental health is real, and there is still that chance that a diagnosis of depression will be misunderstood.
It’s okay to feel like you’re not okay
Everyone goes through life with their own challenges. One in five Americans is affected by a mental health condition, and the average time until they get treatment is eight to ten years. That’s a long time to not feel like yourself. With the advances in treatments and the push to acknowledge that your mental health is important, more people feel safe seeking relief. As Jeff puts it, “You don’t need to suffer in silence, reach out to a medical or mental health professional. You won’t regret it.”