Smiling Depression: How Happy Faces Can Mask Depression

Smiling depression is not always easy for parents to identify. The typical signs of depression, such as changes in appetite, sleep patterns, and energy levels, may not be obvious, resulting in what’s essentially a secret depression that’s difficult to spot. 

If you’re the parent of a teenager, it’s important to understand this condition so you can recognize the symptoms and help your child. 

What Is Smiling Depression? 

Smiling depression is a mental health condition characterized by a person’s ability to hide how depressed they are behind a facade of happiness and contentment. It’s called smiling depression, or sometimes walking depression, because individuals who are struggling with this issue may often smile and appear happy despite being sad or hopeless. 

Although it isn’t designated as a technical diagnosis under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Embark Behavioral Health Treatment Director Jake Sparks, a licensed marriage and family therapist, said this hidden sadness is still a very real condition. 

When asked to explain just what is smiling depression, Sparks said, “With smiling depression, teens internally feel symptoms of depression, including persistent sadness, hopelessness, anxiety, irritability, difficulty concentrating, and low energy — all of the things we associate with normal depression. However, they’re able to present themselves to the world as someone who doesn’t have those symptoms.” 

Smiling Depression Symptoms 

While the outward symptoms of smiling depression can vary from teen to teen, some common indicators include: 

  • Loss of interest in pleasurable activities: According to Sparks, many people with smiling depression feel like “Nothing is a ‘want to.’ Everything becomes a ‘have to’ instead.” 
  • Fatigue: They may seem tired often. 
  • Hopelessness: They may feel they’ll never get out of their rut or stop feeling their negative emotions. This sense of hopelessness from depression leads them to avoid getting treatment or asking for help because they feel there’s no point. 
  • Changes in appetite, weight, or sleep: Sparks said, “People with smiling depression tend to overindulge. They’ll overeat and oversleep as a way to moderate their depression.”
  • Low self-esteem or low self-worth: It’s common for people with depression to struggle with their self-confidence. 
  • Difficulty concentrating: Smiling depression can make it difficult for people to focus because they’re constantly placing so much effort on appearing happy and like they have their life in order. 
  • Substance abuse: Someone who’s feeling sad or hopeless could turn to drugs and/or alcohol as a way of coping with their feelings, leading to substance abuse
  • Thoughts of death or suicide: In extreme cases, a teen may consider taking their life. 

Some of these symptoms of smiling depression are clear and easy to recognize, but others aren’t as easy to spot. 

Sparks shared an example, saying, “Someone with smiling depression may be able to genuinely enjoy their birthday party. They may temporarily feel happy being there. But then, when the party’s over, their mood drops again. Their mood variability is a big part of what keeps their smiling depression hidden.” 

However, this isn’t a good coping approach for teens struggling with their emotions. Having a secret depression can even make the problem worse as time goes on. 

“For some people, the facade of ‘I’m doing great’ and ‘Everything is fine’ is actually part of the problem because their mental health needs go unmet,” Sparks said. 

Why Teens With Depression Can Appear Happy 

Talking about the reasons why teens who are depressed use a happy façade as a coping mechanism, Sparks said, “One of the first things we have to look at is the context of their emotional development, which is usually the family. Different families have different ideas of what’s healthy when it comes to sharing emotions. In some families, it may be normal to talk about distressing emotions, while other families may discourage, either intentionally or unintentionally, discussions about sadness, hurt, or shame. Some families may go even further and identify any discussion or even an experience of emotion as weakness. This puts a lot of pressure on the child to perform or to always be happy,’ which can be a setup for emotional failure.” 

Sparks continued by sharing how some cultures have varying expectations when it comes to mental health. Some talk about this topic, while others sweep their emotions under the rug. 

Familial and societal expectations can therefore be two major reasons why some teens who are depressed seem happy. They often feel like they must be OK simply because it’s what’s expected of them.  

There are a variety of other reasons teens with depression appear to be happy. 

A desire to fit in 

Many teens feel pressure to conform to societal expectations and may feel that admitting to being depressed makes them seem weak or different. As a result, they may put on a happy facade to fit in and avoid being ostracized. 

A fear of being a burden 

Teens may be afraid of burdening their friends and family. They may believe that expressing their true feelings will cause others to worry or feel responsible for their well-being. As a result, they hide how they’re really doing, resulting in a secret depression. 

A negative stigma around mental illness 

There’s still a significant stigma surrounding mental illness, so many teens may be afraid of being judged or discriminated against if they admit to being depressed. This fear may cause them to hide their true feelings and appear happy around others. 

A desire to protect their loved ones 

In some cases, teens with depression may want to shield their loved ones from their struggles because they’re worried their pain will hurt those close to them. As a result, they may use humor or positivity to hide their depression so they can protect those they care about.  

Risk of Suicide in Smiling Depression 

It’s important to know there’s a connection between smiling depression and suicide. Individuals with this type of depression can struggle with thoughts of death. They may experience passive suicidal ideation, which involves a desire to die, or active suicidal ideation, which involves planning how to die by suicide. Take any thoughts of suicide seriously, regardless of whether or not your teen appears happy on the outside.  

When asked about smiling depression and suicide, Sparks said, “There is research that shows because of the added emotional tolerance and wider variety of energy in people with smiling depression, they can be more at risk for acts of self-harm and suicide. Oftentimes, people with typical depression don’t have enough energy to take this step, while people with atypical smiling depression often have more energy and focus and conviction to carry out a suicide attempt.” 

How To Help With Smiling Depression 

According to Sparks, “All of the treatments for regular depression apply in the same way for smiling depression. It’s not a phenomenon in and of itself that’s so different from a major depressive disorder.” 

If you suspect your teen may be struggling with smiling depression, you can take steps to help them. 

1.  Love and accept your teen 

While your first instinct may be to talk to your teen about how they’re feeling, Sparks said the most important way to help your child is by simply loving and accepting them.  

“It would be great if your teen was immediately open and vulnerable with their struggles,” Sparks said. “The reality is, those struggling with depression, and particularly hidden depression, are likely to resist simple requests to ‘open up.’ Communicate your commitment and acceptance of them by providing love and empathy during their struggles, even if they don’t open up. Words are often not necessary for showing others how we feel about them.”  

This process, known as co-regulation, will set the stage for creating an open and safe space for your teen to talk about their feelings and struggles.  

2. Normalize conversations about depression and suicidal ideation

It’s also important that you normalize conversations about depression and suicidal ideation. Let your teen know through your actions that it’s OK to feel sad or overwhelmed, and that you’re there to support them.  

Sparks recommended making statements like “I noticed your mood being down more recently, and I’m wondering if you’re feeling depressed?” or “Let me listen.”  

He also noted that talking about being depressed may be overwhelming, so, “The more we can communicate that we as parents have no expectation of happiness, the more we allow our children to feel what they feel and, in turn, share it with us. Your child may still feel depressed after these conversations, but as a parent, wouldn’t you rather know what they’re feeling so you can get them the proper help?” 

3. Seek treatment for smiling depression 

If you’re concerned about your teen’s mental health, it may be helpful to contact a mental health professional. A therapist or counselor can provide smiling depression treatment, helping your teenager work through their feelings and providing them with the tools and strategies they need to address their condition. 

4. Encourage good health 

Encourage your teen to engage in healthy habits, such as getting enough sleep, exercising, and eating a healthy diet. In fact, look for opportunities to promote physical health among the entire family. Take family walks, eat a variety of nutritious food, drink plenty of water, and ensure everyone practices good sleep hygiene to best promote restorative sleep.  

“It won’t be enough to simply ask your teen to do these things,” Sparks said. “It will likely require the whole family shifting their awareness to reinforce health for everyone. This way, even if your teen can’t or won’t choose these options, at least you’ll be healthier and in a better place to support them.”  

5. Help them develop connections 

Assist your teen in connecting with others and building a strong support network, which can include friends, family members, and support groups. These people can help your teen feel less alone. They can also offer co-regulation and empathy, and contribute to your child’s sense of self-worth.  

To help your teen create, grow, and lean on a good support network, Sparks recommended asking them: 

  • How are your support systems? 
  • Can the people you have relationships with help you regulate your emotions?
  • Do you have relationships that provide a buffer against emotional hurt and pain? 

6. Be patient and understanding

It’s important to be patient and understanding with your teen as they work through their depression. Sparks said to create an environment where they feel comfortable sharing how they’re feeling and don’t hide their struggles. Remember, this is a process, and it may take time for them to improve. Offer your support and encouragement along the way. 

7. Teach self-care 

Teens with depression, including secret depression, need to prioritize self-care and make sure they’re taking care of their physical, emotional, and mental health. Teach them how to meditate and practice mindfulness. Support them as they engage in interests that help them connect with others and build healthy relationships.  

8. Educate yourself and find support for yourself 

It can be helpful to educate yourself about depression and how it can show up differently in different people. This can help you better understand your teen’s struggles and how to help them. 

As you support your teen, remember you may also be struggling. You may feel worried, helpless, and sad as you watch your teen deal with their depression. Find support for yourself as well. This can include talking to a therapist, joining a support group, or leaning on friends and family. 

Smiling Depression: Wrapup 

Smiling depression is essentially a secret depression, as it’s characterized by a person’s ability to hide how depressed they are behind a facade of happiness. It can be difficult for parents to recognize their teen is struggling with this condition, as they may not exhibit the typical signs and symptoms of depression. 

If you suspect your teen is struggling with this issue, talk to them about how they’re feeling. Approach them with patience and understanding. If, after talking to them, you’re worried about their emotional well-being, contact a mental health professional. Taking these steps will allow you to best support your child through their journey to heal from smiling depression. 

Embark is the most trusted name in teen and young adult mental health treatment. We’re driven to find the help your family needs. If you’re looking for support, contact us today!

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Embark Behavioral Health

Embark Behavioral Health

Embark Behavioral Health is a leading network of outpatient centers and residential programs offering premier mental health treatment for preteens, teens, and young adults. Dedicated to its big mission of reversing the trends of teen and young adult anxiety, depression, and suicide by 2028, Embark offers a robust continuum of care with different levels of service and programming; has a deep legacy of over 25 years serving youths; works with families to adjust treatment in real time to improve results; treats the entire family using an evidence-supported approach; and offers the highest levels of quality care and safety standards. For more information about Embark or its treatment programs, including virtual services, intensive outpatient programs (IOPs), therapeutic day treatment programs, also known as partial hospitalization programs (PHPs), residential treatment, and outdoor therapy, visit