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Behind the smile: The silent struggle of Smiling Depression

Simranjeet Kaur

I met a 23-year-old who, despite attempting the same competitive examination twice, couldn’t qualify. We all understand the difficulty such a situation can pose for anyone.

While he spent time with others, sharing meals and sitting together, he began withdrawing from social life, concealing his inner turmoil behind a facade of happiness.

The fear of being perceived as weak prevented him from opening up about his struggles. In isolation, he grappled with feelings of guilt and the pressure of unmet expectations. Eventually, he was diagnosed with severe chronic dysthymia.

Hidden Battles Behind a Smile:

If we can’t see something, does it mean it doesn’t exist? Many times, we force ourselves to wear a mask of a smile, concealing the internal war we face. We may appear happy, engaging with people, and smiling outwardly, but internally, we battle feelings of helplessness and self-doubt.

Depression hides behind the smile, unspoken and unnoticed. Individuals with smiling depression maintain day-to-day functionality, attending social events, working, or going to school. However, they persistently struggle with low self-esteem, restlessness, low mood, hopelessness, helplessness, and hidden bouts of crying and despair. They mask their difficult feelings behind a cheerful demeanor, portraying themselves as fine and happy-go-lucky. In smiling depression, mental health remains concealed and undetectable, with unexplained spells of crying. Many times, it seems difficult to identify this because the symptoms may not fit our common image of distress. Research indicates that untreated depression can increase the likelihood of suicide and pose various other risks.

There is a universal risk of depression regardless of age or gender, from students managing educational and peer stress to adults navigating professional and personal demands. The incongruity between what they feel internally and their outer outlook can create feelings of isolation and guilt for those affected. Misunderstandings or unsympathetic responses from others who perceive them as “fine” can exacerbate feelings of loneliness and invalidate their emotions.

Prevalence and recognition research on smiling depression is still a relatively growing area within the mental health field, but several studies exist. One study, published in the *Journal of Affective Disorders*, found that a substantial proportion of participants with depression presented with atypical symptoms, including outward positivity despite internal distress.

The Reasons Behind Concealing Depression:

Why do people hide their depression? There can be a myriad of reasons, including:

1. Fear of Judgment: A common reason is the fear of being judged. People often judge those who suffer from mental health issues, compelling sufferers to hide their struggles and suffer alone.

2. Lack of Support from Family and Friends: The absence of emotional support can exacerbate feelings of isolation.

3. Lack of Realization: Some may not recognize that they have depression, worsened by an invalidating family and social environment.

4. Protection of Feelings: People might conceal their depression to shield their emotions.

5. Fear of Burdening Others: There’s a fear of burdening family and concerns about being perceived as weak or a failure.

6. Upbringing in a Toxic Environment: Individuals may have been raised in a critical and toxic environment, where expressing emotions is stigmatized.

The Denial and Consequences:

People with smiling depression are often in denial, unable to acknowledge their need for help. This denial can lead to the adoption of unhealthy coping mechanisms, such as substance abuse. They may keep themselves excessively busy, using work as a means to escape.

We need to create environments where individuals feel safe to express their feelings without being hesitant. They should not feel they’re being judged. Medical and therapeutic interventions are needed, and an empathetic space must be provided. Through a combination of pharmaceutical interventions, psychotherapy, lifestyle adjustments, and social support, we can effectively manage symptoms and improve the quality of life.

Encouraging open dialogue, reducing stigma, and promoting awareness are essential steps toward providing meaningful support for those going through smiling depression. We need to create a supportive culture by educating communities about the subtle signs and symptoms of mental health issues, facilitating timely support, and dismantling stigma.

Addressing smiling depression requires remembering that we all have unique journeys. With the right treatment and psychosocial support, relief and emotional balance can be restored in life.

Dear readers, sometimes when everything seems fine, it might not be what it appears. We need to normalize discussions about mental health in our families, schools, colleges, and universities.

Monthly mental health awareness programs should not just be a formality but a sincere objective. Providing non-judgmental spaces is crucial, and outreach is essential. We must educate the masses to eliminate the stigma surrounding depression.

Remember, bottling up emotions is never helpful. If professional help is inaccessible, start opening up about difficult emotions with trusted individuals. This can pave the way for seeking professional help in the future. Teletherapy is now available, challenging the stigma associated with mental health issues.

In our Valley, government institutions like Tele MANAS (IMHANS) provide free psychosocial support and psychological interventions through a team of professional counselors, clinical counseling psychologists, and psychiatrists. They are reachable through a toll-free number at 1-800-891-4416.

Simranjeet Kaur is a Counseling Psychologist and can be reached at simranjeet04445@gmail.com

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