What Is Smiling Depression?
Medically reviewed by Melissa Bronstein, LICSW
"Smiling depression" is a term used to describe people who have depression yet smile and look happy. It isn't a true diagnosis, but one way that people with major depressive disorder present themselves to others.
For some people, smiling is their way of improving their mood, while for others, it's a way to hide their true feelings.
This article will discuss smiling depression symptoms and treatment. It will also cover the factors that lead to smiling depression.
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Smiling Depression: How It Feels
On the inside, people with smiling depression can feel sad, empty, or irritable. They may lose interest in hobbies or activities they typically enjoy. However, on the outside, they may smile, laugh, and seem satisfied at work, school, and home.
It's this difference between how someone feels on the inside and their seemingly happy appearance on the outside that characterizes smiling depression.
Other symptoms people with depression may have include:
Hopelessness
Low energy
Poor concentration
Feelings of guilt
Help Is Available
If you or someone you know is having suicidal thoughts, dial 988 to contact the 988 Suicide & Crisis Lifeline and connect with a trained counselor. For more mental health resources, see the Verywell Health National Helpline Database.
Masking Depression by Smiling
In smiling depression, people mask their depression by keeping a happy outward appearance. Despite feeling symptoms of depression on the inside, they keep a smile on their face.
To others, they may appear to be someone who is living life fully and is content, such as having a good job and many friends. The happy disposition can make it difficult for those around them to know they have depression.
A person might mask their depression as a way to avoid seeking treatment. It might be a way of convincing themselves and those around them that they don't need help for their low mood.
Functional Depression
Functional depression is similar to smiling depression. It is not a medical diagnosis or medically recognized term. However, people may use it to describe someone who has depression but looks fine on the outside and can maintain functions such as going to work, socializing with others, and pursuing hobbies.
Does Smiling Help Depression?
A commonly held thought is that smiling can help improve a person's mood and may help depression. Smiling doesn't seem to hurt a person's mood. But there isn't strong research to show smiling dramatically improves mood.
A 2019 meta-analysis of studies found that smiling does help improve mood, but only by a little bit. Smiling had a positive impact on a small number of the study participants, but the number was very low.
Using Botox (onabotulinumtoxinA) injections to reduce frowning is being explored as a treatment for depression. The theory is that frowning reinforces negative emotions in a feedback loop.
Several trials have compared this treatment to placebo or treatment with antidepressants and found that it can result in improvement of mild to moderate depression. However, a phase 2 clinical trial by the manufacturer did not produce significant clinical results in moderate to severe depression.
As an individual, you may find smiling or reducing frowning helps improve your mood. While there is no harm in trying, the research is not strong enough to recommend it.
Factors That Can Lead to Smiling Depression
Depression can affect people of any gender, age, or period of life. Research shows that several risk factors can lead to depression. A person's genetics, environment, and psychology all play a part in depression.
Someone may smile when they are depressed so others around them do not suspect anything is wrong. Smiling can be a way for some people to mask their depression.
Diagnosing Smiling Depression
Smiling depression is not its own disorder but is one presentation of major depressive disorder. If you are experiencing depression symptoms, contact a healthcare provider for an evaluation. They can screen for depression and other mood disorders and may refer you to a mental health specialist.
Symptoms and symptom duration are used to diagnose major depressive disorder. If you have depression symptoms for most of the day, almost every day for two weeks, you may be diagnosed with depression.
When the healthcare provider asks questions, it's crucial to provide honest answers. This will allow the provider to properly determine if someone has depression and the best treatment plan.
How to Turn Smiling Depression Around
Since smiling depression is merely an outward presentation of depression and not a clinical diagnosis in and of itself, it's no surprise that the treatments for smiling depression and typical depression are the same. The primary treatments are medication and psychotherapy.
Below are more details about treatment options.
Medication
Medications called antidepressants are commonly used to treat depression. There are several types of antidepressants, and it may take some trial and error to find the right one.
Antidepressants work by helping the brain produce certain molecules or by changing how the brain uses certain molecules.
No one should stop taking an antidepressant before talking to their healthcare provider. Sometimes, people will start to feel better with an antidepressant and think they can stop. This can cause withdrawal side effects or symptoms to return if not tapered correctly (dosages reduced stepwise).
Psychotherapy
Psychotherapy, also known as therapy, talk therapy, or counseling, can help treat smiling depression by teaching the person ways to change their habits and behaviors, or to develop new ways to think.
Psychotherapy is generally used in conjunction with medication for people with moderate to severe depression.
Self-Care
Self-care is an important piece to managing smiling depression symptoms. Depression can cause people to avoid social situations and stop participating in their favorite activities.
Ways to incorporate self-care into smiling depression treatment are:
Exercise regularly.
Avoid alcohol and drugs.
Develop a regular sleep schedule.
Restart activities or hobbies that used to be enjoyable for you, or find new ones.
Engage in social activities.
Summary
Smiling depression is not a medical diagnosis but a term used to describe people who have depression and have a happy, smiley outward appearance. They may use smiling as a way to boost their mood or as a way to mask their true feelings from those around them.
Diagnosis and treatment for smiling depression are the same as major depressive disorder. Do not hesitate to reach out to a healthcare provider when experiencing depression symptoms.
Read the original article on Verywell Health.
