Concealed Depression: Signs and Treatment


Concealed depression is the depression that you are experiencing inside but hiding the symptoms and signs from others by putting up a brave front. It is also called hidden depression or smiling depression because on the outside you will be smiling though on the inside you might be feeling sad and hopeless. They bottle up their thoughts and emotions, putting up a happy front for everyone else when in reality, they are struggling with sadness, loss of meaning and purpose in life, low self-esteem etc., on the inside. At the extreme, they may even experience suicidal thoughts.

A person with a fake smile and thumbs-up
A person with a fake smile and thumbs-up

Why People Conceal Depression?

There are several reasons why one would attempt to conceal one’s depression. For instance (1) There is social stigma associated with mental illness, (2) One does not like to admit even to oneself that one is mentally ill and has depression, (3) One thinks it is a temporary phase that one can get over, and so does not want to reveal his innermost feelings to others lest they be biased or prejudices towards them, (4) One may think it is unmanly to confess feelings of helplessness, or (5) One may not realize that the symptoms one is experiencing are symptomatic of depression and may think they are merely part of the normal ups-and-downs of life, etc. Thus, depression can go unseen, unrecognized, and undiagnosed.

Signs of Concealed Depression

How can you tell if you have concealed depression? Here are a few symptoms and signs to look out for:

  • You often feel low, but go to great lengths to make others believe that you are perfectly hale and hearty
  • Changes in your eating habits – eating too much or too little than previously
  • Dramatic weight gain or weight loss in a short period of time
  • Changes in your sleeping habits – sleeping too much or too little compared to previously
  • Not finding things pleasurable that once were pleasurable, such as watching TV, having sex
  • Severe and persistent tiredness and fatigue, especially when accompanied by other symptoms. This symptom is present in over 90% of people with depression.
  • Going to any extent to avoid the company of family and friends
  • Feeling that “that is how life is” or “I am a loser”
  • Feeling that you have to accept your situation and there is no one out there who can help you change
  • Indulging in lifestyle habits like listening to music, doing exercise, going on long drives, going for long walks in an attempt to cheer yourself up and ward off the low moods
  • Feeling a keen sense of abandonment whenever people leave you for extended periods of time
  • Finding that your memory is not as good as before and you are finding it difficult to concentrate
  • You lose your train of thought when speaking
  • Increased abuse of alcohol and drugs. Nearly 20% of people with anxiety or mood disorder, such as depression, also have an alcohol or substance abuse disorder.
  • You may feel excessively aware of and tend to dwell on certain harsh truths of life, such as your mortality
  • Feeling that life is meaningless
  • To compensate for your feelings of sadness, hopelessness, and low self-worth, you may search for larger-than-life kind of goals and purposes to pursue so as to feel significant and good about yourself
  • You may suddenly breakdown and give vent to your feelings in front of someone you feel close to, such as a family member or friend, and quickly try to downplay the outburst
  • Feeling needy for love and acceptance by others
  • Being angry and irritable more than usual
  • You may have unexplained, chronic physical ailments, such as backache, chronic pain, digestive problems, or headache
  • The above signs get more significant if you are very talented or have some special abilities like drawing or writing poetry because depression is common among the most inspired and life-changing artists, musicians, writers, and charismatic leaders

What to do if you suspect you have concealed depression?

If you have good reason to believe you have concealed depression, then:

  • First and foremost seek professional help, such as seeking an appointment with your physician or psychiatrist to undergo questioning and examination to rule out other causes for your low moods.
  • Exercise regularly.
  • Practice stress-reduction techniques, such as yoga, deep breathing exercises, and meditation (mindfulness)
  • Eat a balanced and nutritious diet
  • Improve your self-esteem through practicing positive self-affirmations – look up online resources on how to do it
  • Do not isolate yourself. Try to socialize as much as you can, especially with family and close friends
  • Join a local support group or enlist for group therapy

What if you suspect a loved one has concealed depression?

If you strongly suspect a loved one, say, a family member or a close friend, has concealed depression, then take the following steps:

  • Try to spend more time with them
  • Offer a sympathetic ear
  • Ask probing questions gently to see if they are willing to open up and share their innermost feelings with you
  • Listen to them and offer opinions and advice non-judgmentally
  • Encourage them to keep in touch with you
  • Contact them regularly on your own
  • Ask them to seek professional help and assure them that that is not something to be ashamed of
  • Offer to accompany them to the physician or psychiatrist

Treatment of Concealed Depression

If your physician or psychiatrist sees you and confirms that you have concealed depression, then he may treat you along the following lines:

  • Prescribe medication, mostly in the form of an antidepressant
  • Suggest you undergo psychotherapy in the form of cognitive-behavioral therapy, psychodynamic therapy, or interpersonal psychotherapy
  • Or, ask you to undergo both of the above, simultaneously, for maximum benefit
  • If you are not helped by these modalities of treatment, he may suggest brain stimulation therapies that are known to work in treatment-resistant cases of depression, such as, electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation, deep brain stimulation, etc.


Concealed Depression: Signs and Treatment
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Concealed Depression: Signs and Treatment
Concealed depression is the depression that you are experiencing inside but hiding the symptoms and signs from others by putting up a brave front.
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