Today, you’re going to learn all about concealed depression and how to overcome it.
Concealed depression, also called invisible depression, hidden depression, “smiling” depression, or high functioning depression, is not a mental disorder for which you can receive a diagnosis from a doctor or a therapist. It’s a syndrome, or a set of characteristics that suggest a certain disorder or problem. (*)
Two of the main symptoms of clinical depression are a noticeably depressed mood and lack of feelings of pleasure in normally pleasurable activities.
When you focus on counting your blessings and avoid expressing or even admitting painful feelings, then you might be using perfectionism to hide your depression.
This is why a highly functioning person can be invisibly suffering from depression.
- What Is Clinical Depression?
- What Is Concealed Depression?
- How To Tell If You Have Concealed Depression?
- Healthy Coping vs. Concealed Depression
- Allowing Yourself To Feel Your Emotions
- How To Overcome Concealed Depression? Effective 3-Step Guide
- Step 1. Increase Self-Awareness
- Step 2. Confront Your Old Coping Skills
- Step 3. Connect with Emotional Pain for Healing
What Is Clinical Depression?
Clinical depression is mainly characterized by a melancholy mood that usually lasts for several days, ranging from moderate to severe. (*)
According to the DSM-5 (American Psychiatric Association 2013), symptoms of clinical depression must include at least one of these primary criteria:
* A noticeably depressed mood for all or most of the day
* Anhedonia – inability to feel pleasure in normally pleasurable activities.
Along with four of these additional criteria:
* Foggy thinking or indecisiveness
* Fatigue, agitation or irritation
* Sleep and appetite disturbance
* Problems with goal setting
* A general slowing down of mental and physical activity
* Feelings of hopelessness or helplessness
* Feelings of low self-esteem and worthlessness
* Thoughts of self-harm
Moderate depression is when symptoms of depression are present for two years in adults, and for one year in children.
To be diagnosed with severe depression symptoms need only be present for two weeks but must cause major impairment.
What Is Concealed Depression?
Most people are not sad and are capable of functioning well and have no apparent reasons to be depressed and yet many feel down or hopeless.
This happens when the person experiences an emotional denial or detachment, in which shame, trauma, hurt, or anger are kept under wraps. (*)
How To Tell If You Have Concealed Depression?
The following are characteristic of concealed or high-functioning depression:
1. You are a perfectionist and have a constant, critical inner voice;
2. You constantly worry and need to control yourself and your environment;
3. You have a heightened or excessive sense of responsibility;
4. You focus on the well-being of others but you don’t allow them into your inner world and you struggle with emotional intimacy in relationships;
5. You detach from painful emotions and actively try to shut them off;
6. You constantly keep yourself busy and use accomplishments to feel valuable;
7. You believe strongly in counting your blessings, discount your pain and struggle with self-compassion;
Healthy Coping vs. Concealed Depression
One of the main reasons why depression can be hidden is because it can mask itself as “healthy coping.”
1. Healthy Coping
As we grow up, we start learning and gathering certain skills and strength that we use when we need them, such as anger management and self-soothing skills.
These coping skills, whether they were healthy or not, help you deal with life.
Healthy coping happens when you use healthy, constructive skills to deal with whatever comes your way
Healthy coping can involve compartmentalization of feelings, as you tend to the more pressing things. But when it’s safe and you have the energy and time, you connect with those feelings, good or bad.
How do we learn to compartmentalize?
Healthy parenting model and teach children soothing skills, that help them learn that feeling sad or hurt is tolerable, and that there’s a time and a place to express them.
2. Concealed Depression
If your coping skills are healthy, you learn that you can’t get over pain if you won’t connect with your strong thoughts, experiences, and emotions.
But if you struggle with concealed depression, your logic might be backward – you believe that you’ll break down if you admit vulnerability or hurt.
Allowing Yourself To Feel Your Emotions
Our emotions can be messy, inconvenient, and even confusing. They oftentimes make us do things we wish we hadn’t done. It’s no wonder our emotions scare us sometimes.
Although most of us believe that our feelings and deserve to be addressed respectfully and fully, we also think of emotions as being disruptive and unproductive—at home, at work, and everywhere else.
However, the more we ignore our feelings, or suppress them, the stronger they become. Difficult emotions don’t heal themselves. If we don’t express our emotions, they build up inside us, until they eventually become too heavy to carry any further.
How Did You Go Numb?
We go numb inside when we lose the ability to even identify what we’re feeling. When that happens, we become unable to understand why we’re experiencing an emotion, which creates even more confusion.
And when we’re unable to identify, understand, or put into words what we feel, we can’t do anything about it. It becomes impossible to master our feelings and learn to make them work for us, not against us.
One of the main reasons we go numb inside is growing up in homes where everyday emotional issues were ignored – no one had ever talked about them or taken actions to address them.
In a way, your life didn’t have to be tragic for you to struggle with your difficult emotions.
Emotions Serve A Purpose
Think of difficult emotions as the emotional equivalent of physical pain. It’s inconvenient, but it serves a purpose. Physical pain sends a powerful signal that something is wrong, nudging you to take action of some kind.
Without physical pain, you wouldn’t do consult your doctor or paid attention to whatever might have caused your pain. Your situation could have gotten worse, potentially leading to a premature death.
Emotions work the same way. They send a signal that something is wrong. Perhaps, you need to let go of some toxic relationships, change your job, or change your thinking pattern that creates suffering in your life.
Anxiety nudges us to improve things that a more positive mood might be willing to accept.
Even anger can be a great motivator, driving us to act and perhaps to fix what made us angry in the first place.
Pessimism makes it easier for us to anticipate things that could go wrong and make plans to prevent them.
Guilt acts as a moral compass, nudging us to apologize and fix our mistakes and prevent making that same mistake in the future.
How To Overcome Concealed Depression? Effective 3-Step Guide
Step 1. Increase Self-Awareness
1. Awareness and Gaining Knowledge
You have to identify a problem as a problem if you want to change it.
Your hiding behaviors may have been intentional for some time. You may know how and why they started.
After a while, your hiding might have became so entrenched that it became unconscious.
2. Overcoming Denial
Even when you recognize some hiding behaviors, you might not realize how that behavior is doing more harm than good.
For instance, if you identify with perfectionism which a constant, critical voice, you’re likely to argue that the voice is helping you function and keep the quality of my work where you need it to be and isn’t toxic. Why would you change that?
That’s denial talking.
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3. Practicing Mindfulness
Mindfulness helps you deepen your experience of the present.
It helps you turn off the autopilot mode in which you operate so much of the time—brooding about the past or worrying about the future—and instead turn in to things as they are in the present.
It’s only when you sit with emotions and give them space in the present that you can experience full emotional expression.
4. Making a Commitment
The experience of feeling your emotions might seem frightening and very intense. Your high-functioning depression might argue that if you felt pain, it might never go away.
You are going to feel worse before you can feel better – this is how change occurs.
It’s normal to feel discomfort, agitation, and confusion when you begin to get in touch with your emotions and challenge familiar belief systems, but remind yourself that this won’t last forever, and that eventually, you’ll feel so much better down the road.
Make a commitment to be willing to give the time and effort it takes to become deeply connected with your inner thoughts and emotions.
Step 2. Confront Your Old Coping Skills
Using the skill of mindfulness and awareness, you’re going to confront your old rules that may have previously been necessary for your emotional survival.
These rules include your “must do” and “never do” lists that have governed your life and created the disconnection you’re feeling now.
Begin to identify whether a rule or belief is helpful and helps you lead a fulfilling life, and so is to keep, or is helping and so needs to be challenged and replaced with a more helpful rule or belief.
How to Evaluate Your Beliefs?
Step 1. Identify the beliefs That Underlie Your Actions (or Lack of Action)
For instance, if you were abused, or neglected, you might have absorbed critical messages about what you should believe about yourself and about others.
You might think, I deserved what I got… It was my fault..I am unlovable.
Step 2: Decide Whether Each Belief Is helpful
This step can be hard as your thoughts could be so distorted that they seem fine to you.
So a good way to decide whether a belief is helpful or not is to ask yourself, Would I teach this belief to a dear friend? Or to my child?
If the answer is a resounding No! then that’s a clue that you shouldn’t be applying it to yourself either.
Step 3: Replace Old Destructive Beliefs with New Constructive Ones
Oftentimes, this takes risking a behavior change before you can challenge an old belief and replace it.
For instance, if you believe crying in front of people is a sign of weakness and a risk that you might get hurt, you might need to find the courage to cry in front of someone before you can realize that being vulnerable helps bond relationships and a good way to receive support.
Step 3. Connect with Emotional Pain for Healing
Connecting with your emotions can be an intense experience. This is why you’re going to need tools to help you with that:
1. Compassion—Being Empathetic Towards Yourself
For most of us, it’s easier to compassionate towards other people than it is towards ourselves.
Self-compassion means extending kindness and generosity toward yourself, without judgment.
2. Acknowledgment—Recognizing the Lessons You Learned
Acknowledging your past lessons isn’t about blame – it is recognizing that something existed or exists, whether intentional or unintentional, positive or painful.
For instance, if your father walked away when you were a child, the message you’d learn might be “People you love can disappear from my life,” or “If I love, I can get hurt.”
Ask yourself the following questions about each painful memory:
* What message did I receive from this experience about myself or about life?
* What did I come to believe about my capability of being loved, safe, and valued from this experience?
3. Mindfulness—Being Present with Your Emotions
Allowing yourself to feel any emotion deeply may be hard for you.
But to fully acknowledge the messages you received, you need to also allow your emotions to come to the surface and feel the message’s emotional impact, be it positive or negative.
If the emotions are painfully strong and it’s hard to be present with them, try the following:
* Visualize a place where you feel safe and go there in your mind.
* Use meditation to not fuel the pain but to simply notice it and let it go.
* Find safety through writing by giving your emotions shape and form, or a beginning and an end.
* Ask a safe person to be with you and to be there for you.
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When perfectionism is the way you’ve survived, it can be hard to believe that vulnerability and allowing yourself to feel your emotions, especially the painful ones, will lead to a greater sense of security and well-being.
But it’s only when you sit with your fears and risk allowing your emotions to come to the surface, that fear loses its power to control you.
What Can I Do If I Don’t Feel Very Much?
Not feeling is a defense mechanism people usually develop in childhood to avoid feelings of pain and helplessness.
If you have trouble getting in touch with your emotions, close your eyes and focus on your chest and belly area as you take a deep breath into your belly.
Pay attention to the flow of your breath. Is your belly relaxed? Is your heart calm? What other sensations can you feel?
If you still don’t feel anything, try to focus on what “nothing” feels like. Then try to feel out whether “something” might be hiding behind the “nothing” sensation.
Paying better attention to your physical sensations can help you practice feeling.
Throughout the day, try to pause for a few minutes and direct your attention to the question: How do I feel right now?
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- Portions of this article were adapted from the book Perfectly Hidden Depression, © 2019 by Margaret Robinson Rutherford. All rights reserved.
- Portions of this article were adapted from the book Permission to Feel, © 2019 by Marc Brackett. All rights reserved.