It was a lovely opportunity to speak with Victoria Health on the topic of Smiling Depression, raising awareness of what it really is - symptom rather than a diagnosis.
VH: Is smiling depression common?
AT: “Smiling depression” is a relatively common strategy that people with depression (often undiagnosed formally at this stage) employ as a means of “trying to get on with it”. I say “often undiagnosed formally” because once someone has a formal diagnosis, they have already made a step onto the pathway of healing, and although how quickly they are able to manage will vary, one of the key things is acknowledging that what they are feeling is normal, it is not their fault, yes they have to manage it, but part of that is accepting it…as such there is less of a need at that point to “cover up”.
It is essential that we see “smiling depression” as a strategy rather than a diagnosis in itself – the diagnosis is “depression”, and a method of coping can be to “smile” or say “I’m fine” in order to remain strong.
Looked at in this way, it will be more commonly seen in people who believe they have to – for whatever reason – “keep going”. Perhaps they have a family they feel they have to be strong for, perhaps they are in a position of responsibility at an organisation which is less sympathetic, perhaps they just aren’t in a situation where they feel they can allow themselves to fully accept their vulnerability. Or simply, perhaps they just want to be left alone.
The strategy of smiling (the “brave face”) is sometimes not enough to mask the other symptoms if you look closely – perhaps they are less well groomed, perhaps their body language is less confident, perhaps they are making more mistakes or they are red eyed from a lack of sleep, or maybe there is a change in their eating habits (ie. they are gaining weight or losing weight). But, because we are often in a culture which doesn’t like to probe or risk offence, we may not ask further, and in turn the smile often is the outward show of a belief of not wanting to burden others.
So, yes, in short, it is a very common coping strategy.
VH: Why is smiling depression receiving more attention at the moment?
AT: Like many things when something sounds “catchy” or other people are talking about it, it is natural that people jump on that bandwagon. However, this is why it is important that “smiling depression” is understood for what it is – the act of smiling to hide the other feelings and symptoms of depression, often seen in someone who has not yet sought help.
As such it is therefore important to possibly look for other signs and symptoms – some I’ve mentioned above, others can include “all or nothing” thinking eg “Oh everyone thinks I’m not good enough…” and that sort of phrasing sometimes slips into conversation unnoticed; and if you do notice such patterns – enquire further perhaps about their sleep pattern, if they perhaps are under stress – or if you are able to, if they are experiencing other thoughts and feelings which they’d like to discuss.
VH: What are the causes of smiling depression?
AT: The causes of depression are varied – we are unsure if it is psychological, social (eg. External events) or if people have a genetic predisposition to negative thinking – or if it is a mix of all three. What brings about the strategy of smiling as a coping mechanism may be because they have bene told to “pull yourself together” or that “it’s not that bad”, or because they are in a position where they feel they cannot fully appreciate their sadness.
Unfortunately, what actually happens is that this behaviour makes it harder and harder to get the help they need, and if they get to suicidal ideation (thoughts or behaviours) it could be too late.
VH: How can you ease the symptoms?
AT: Some tips
If you recognise that someone has other patterns of behaviour indicative of depression, it is helpful to open a dialogue if you can (ideally in a non threatening, private place). Then if possible urge them to seek professional help. As tempting as it may be it is not best for you to try and help counsel them because depression as an illness will cause people to behave in a way that sucks others in – especially if they are not professionals. What you can do is be there for them as they go through the process – which sadly can also be difficult depending on the quality of mental health support in your area.
If you are feeling depressed, try to avoid using smiling to cope – it is important to acknowledge your feelings and accept that you are not “strange” or “a burden” or “just being silly” depression is a very real and very horrible illness – and it is also not your fault if you have it.
At the very least, if you find it difficult to speak to anyone, a good start is to try and find an outlet to express your feelings – some people do it through journaling, others through poetry, dance, song, music, art and so on…anything that allows you a little release of emotion can help free your mind enough to think a little more clearly about seeking help because ultimately, the smiling is a coping strategy and will have a shelf life.
As always, it is best to seek help before the point of crisis, or before it gets to the point where it is taken out of your hands because you are no longer able to cope and your body breaks physically or emotionally.
Dr Audrey Tang is a chartered psychologist and author. Listen to her podcast Retrain Your Brain here; and catch her practical masterclasses Psych Back to Basics on DisruptiveTV & Energy Top Up for resilienceFor coaching tips and tools including positive psychology: click WORK WITH ME or SKILL PILL and here for Media appearances or Psych Q&A. Twitter/IG @draudreyt