
Smiling Depression: When You Seem Fine, But You’re Not

Depression is a mental health term and diagnosis that we read and hear about frequently, but have we lost sight of its true meaning? There are specific symptoms that a clinician looks for in order to make an accurate diagnosis, but depression can be complex — and some people who are living with it don’t appear outwardly depressed.
Instead, they may be highly functional and show few classic signs of depression. This is known as “smiling depression.” Despite the fact that it may be harder to spot compared to other types of depression, it’s still important for people who are coping with it to get the care they need.
At One Health Medical Care in Reston, Virginia, Dr. Mingliarti Tjahjana specializes in aiding patients with depression, including smiling depression. Her compassion and willingness to dig deep and listen carefully are hallmarks of the exceptional care she offers.
What is depression?
Depression is a mental health condition that causes lasting sadness along with a host of other possible symptoms, such as:
- Hopelessness; periods of crying
- Social isolation; easy irritability
- Loss of interest in things you once enjoyed
- Appetite changes; weight gain or loss
- Sleep problems; low energy levels
- Trouble staying focused; poor decision making
- Physical symptoms (i.e., headaches, sexual dysfunction)
- Thoughts of suicide or self harm (i.e., cutting)
Depression has varying levels of severity and affects many people — it’s estimated that one in six people cope with depression at some point in their lives.
What makes “smiling depression” different?
When someone doesn’t show signs of depression in an obvious way, it may be related to several core — but erroneous — beliefs, including the idea that:
- Depression reflects weakness
- Expressing feelings of sadness can burden others
- Others deal with much worse situations, so someone who is “better off” doesn’t have a right to feel sad, low, or empty
So, how does a practitioner like Dr. Tjahjana uncover when a patient is affected with smiling depression? She has an in-depth conversation with you about your feelings and whether you’ve developed strategies to hide your symptoms. She also asks you about your quality of life, and discusses that, even if you appear to be high-functioning, there may be depression lurking underneath.
Dr. Tjahjana looks for certain risk factors, including the fact that someone may be able to cope with everyday life and even function well, but they might come from a family whose culture has a strong stigma around mental illness.
She also investigates whether someone may have been experiencing persistent, long-term mild depression. Individuals living with smiling depression are also often perfectionists and strongly averse to looking or seeming vulnerable.
Dr. Tjahjana sees higher instances of depression within certain groups that are more prone to mood disorders, such as women, LGBTQ+ people, those with family histories of depression, and anyone who has experienced a major life transition like divorce, high stress, or trauma.
People living with ongoing health conditions, like chronic pain, cancer, or diabetes, are also at higher risk for depression, including smiling depression. Anyone experiencing hormonal ups and downs, like new mothers, are more prone to depression, too — and this is a time in your life when society expects you to be consistently elated.
The symptoms of smiling depression are the same as those we described earlier, but people affected may have a harder time recognizing their symptoms, or be in denial about them. This is why mental health is an important consideration for everyone.
Treatment options for smiling depression
Fortunately, even if you’ve been adept at hiding your depression — from others or just yourself — help is available. For any type of depression, including smiling depression, Dr. Tjahjana may:
- Refer you to a counselor for talk therapy
- Prescribe antidepressant medications
- Recommend lifestyle changes (i.e., healthy eating, exercise, better sleep)
Are you smiling through sadness? One Health Medical Care is here to help you feel better and get your life back. Call our Reston, Virginia, office at 571-572-9198 to schedule a visit today, or use our online booking feature at your convenience.
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