Behind the smile

I have a friend, a wonderful, kind and caring friend. She’s the kind of woman who can handle anything, the kind of woman who has always something going on, the kind of woman who talks to everyone, the kind of woman you can laugh with. She’s the kind of woman people would never believe to be suffering from depression. She’s social, she’s active, she’s smiling… How could she possibly be depressed?

Depression doesn’t have just one face. There are different types of depression and they can manifest in various degrees. People suffering from dysthymia (popularly known as high functioning depression) can often function in a way most people won’t notice anything is off. They can do the things they need to do, socialize, and smile. Even when they don’t feel like it.

Because the symptoms of high functioning depression aren’t as obvious as those of Major Depressive Disorder (MDD) it may not be easy to recognize them, neither by the person itself, nor by the people around them. There is also the danger that people are so used to the feeling that they think it’s normal. But high functioning depression is an illness and needs treatment. Left untreated this could eventually even result in MDD.

My pitfall is that I compare everything to when I suffered from MDD. Everything was so black and hopeless that everything looks pretty good now. But that I’m feeling better now doesn’t necessarily mean I’m doing good. I guess for me it’s a combination of being used to feeling like this and really wanting everything to be good and thus fooling myself into believing everything is ok.

Symptoms someone with high functioning depression may experience are:

  1. Difficulty experiencing joy
  2. Very critical of self and others
  3. Constant self-doubt
  4. Fatigue
  5. Irritability or anger
  6. Small things feel insurmountable
  7. Worrying and feeling guilty
  8. Need to zone out
  9. Sadness you can’t seem to pinpoint the cause of
  10. Perfectionism
  11. Inability to rest and slow down

These symptoms are pretty generic and are easy to overlook when someone is hiding it for the world or even themselves. And it doesn’t help that there is still a stigma surrounding mental illness and we live in a world that emphasizes positivity and happiness. But when you think you recognize these symptoms in someone you care about, see if you can get a look behind the smile.