You see smiling faces, but are those people really happy? Or maybe you’re the one who’s smiling, but inside you’re down in the dumps.
Do you walk into a party looking excited and energized, but go into the bathroom for a break and find yourself rolling your eyes or muttering under your breath? Or maybe you’re a rock star at work, but the second your feet hit the door, you’re ready to veg out on the couch — and it’s happening more days than not? Just a bad day, or is it smiling depression?
Unlike traditional depression, the condition known as smiling depression may be easily masked and sometimes the depressed person doesn’t realize what they're experiencing.
Tanya Komblevitz, a Chicago therapist, advised monitoring your feelings and noting if you're experiencing at least five of the nine symptoms of depression on most days:
- Depressed mood or irritable most of the day, nearly every day
- Decreased interest or pleasure in most activities that you once enjoyed
- Significant weight change or change in appetite
- Insomnia or hypersomnia (excessive sleepiness)
- Purposeless motions like pacing or wringing your hands
- Fatigue or loss of energy
- Guilt or worthlessness
- Difficulty concentrating
- Suicidal thoughts
Why is smiling depression more common now?
While seasonal affective disorder (SAD), a type of depression associated with changing seasons, can be partially to blame for some symptoms, depression and smiling depression can be more common during the winter, too.
"Lack of sunlight and a decrease in physical activity due to winter weather fuels depression," said Karen Cassiday, a clinical psychologist at The Anxiety Treatment Center in Chicago.
Depression is a complex mental disorder and may affect men and women differently. People with smiling depression may be able to put on a show in public, at work and even at home with their families. Often, someone suffering from smiling depression can hide it from others because they’re trying to keep up with a put-together and accomplished persona.
How can you treat it?
1. Therapy can help.
Within the first few months of the new year, people often make a point to finally address the things that have been bothering them, Komblevitz said.
“New Year’s resolutions are often about self-care in the form of diet and exercise, but clients recognize that emotional self-care is just as important. They make a point to take care of themselves through therapy, and commit to their overall well-being," she said.
And in her experience with her patients, therapy can help.
"Therapy can help you identify unhealthy patterns in your life and break the cycle," Komblevitz said. For example, many people fall victim to cognitive distortions (inaccurate, negative interpretations of events or situations), which can lead to feelings of low self-worth. Therapy can help identify distorted thoughts and change them into more positive, adaptive and accurate thoughts.
2. Try acting “normal.”
Cassiday suggested doing normal things a non-depressed person would do.
“Socializing, keeping track of three things to be grateful for each day, eating a healthy diet and avoiding junk food, are proven ways to fight depression,” she said.
4. Try a healthy diet.
Speaking of avoiding junk food, Jessica Hehmeyer, functional medicine expert at Aligned Modern Health in Chicago, considers the gut to be “the second brain” (which explains “gut feelings”) and suggested that what we put into our gut can help improve our mental health.
“Our mood is regulated by serotonin, 90 percent of which is produced in the gut,” Hehmeyer said. “If we’re feeling anxious or depressed, we may have a deficiency of serotonin, which travels directly from the gut to the brain.”
To improve serotonin production levels, Hehmeyer suggested a diet based on vegetables and healthier carbs like sweet potatoes, oats, barley and whole grains.
5. Light therapy
"Vitamin D levels can be much lower in winter months due to less sunlight," said Sarah Katula, an advanced practice nurse at Advocate Good Samaritan Hospital in Downers Grove, Illinois. She recommended getting at least 20 minutes of sunlight a day in the winter.
Light therapy has been shown to help some people with seasonal affective disorder.
6. Exercise can help, too.
If you don’t feel like dragging yourself to the gym, buy some workout DVDs to follow along to in your living room, or do lighter exercises such as yoga or Pilates.
7. Try acupuncture.
With little to no negative side effects, acupuncture is a great way for someone to feel like they’re taking a step towards feeling better without fully confronting the depression through therapy. Acupuncture can provide a non-invasive, medication-free alternative treatment.
"While each patient condition is unique, there are a number of studies showing the efficacy of acupuncture for mild to moderate depression and low mood," said Dr. Nada Milosavljevic, a physician and faculty member at the Harvard Medical School. "I have also used it for some patients with stress and anxiety issues and it has been of benefit."
If you’re concerned someone you love may be struggling with smiling depression, gently address it. Next time you ask a friend or family member how they’re doing, let them respond. Then, look them in the eyes and compassionately ask, “But how are you REALLY doing?”