Thursday, December 5, 2019

Smiling depression – Grin and bear it

It is one of the most puzzling questions posed as grieving friends and relatives try to make sense of a senseless suicide: She loved life, always had a smile on her face and a bounce on her step, why would she take her own life?

The answer is Smiling depression. It is an oxymoron of sorts, and that is what makes it so intractable. A victim feels sadness inside but is able to function normally and present a façade of contentment and happiness to the outside world.

For many, it looks like nothing because so many people have learned to expertly mask their symptoms. This basically sums up smiling depression, which is characterized by maintaining the facade of happiness while battling depression. Sufferers often appear outwardly joyous and successful in all the typical parts of life “success” conjures—like having a great job, and being wildly accomplished.

There are still a lot of common misconceptions that need to be dispelled about depression. However, the latest term that has been making headlines has been ‘smiling depression’ which follows the age-old principle of don’t take everything at face value because in this case people are actually smiling through it. Typically, depression is associated with a deep sense of sadness, despair and lethargy a figurative and sometimes literal inability to get out of bed that depletes energy and impacts all aspects of life. What may or may not be suprising is that a lot of people in Botswana are suffering from depression. Some might not even realize that they are depressed especially if they seem like they are managing their day-to-day lives well. It doesn’t seem possible that someone can be smiling, chipper, functioning and at the same time depressed.

 Dr Sethunya Mosime, senior Sociology lecturer at the University Of Botswana says, “The reason smiling depression is so insidious is because people see mental illness/ depression/ anxiety as something so extreme you cannot hide it. They see the person who can’t even make it out of bed, or who doesn’t eat or overeats. Couple that with the depressive person’s desire not to feel any more worthless, anymore of a burden on those around them. Remember that there’s a very real sense of shame for feeling the way you do. While typical depression saps energy and its sufferers may lack the ability to act on suicidal thoughts those with smiling depression who have the strength to go about their daily lives despite inner feelings of hopelessness may also have the energy and motivation to follow through on such thoughts. Another way to think about smiling depression is to see it as wearing a mask. People suffering from smiling depression may offer no hint of their problem to the outside world. They often maintain a full-time job, run a family household, participate in sports, and have a fairly active social life. With their mask on, everything looks great, even at times perfect. However, underneath the mask they are suffering from sadness, panic attacks, low self-esteeminsomnia, and, in some cases, suicidal thoughts.”

Someone who feels sadness inside but is able to function normally and present a façade of contentment and happiness to the outside world – that is smiling depression. A lot of people experiencing a low mood and loss of interest in their day to day activities but manage to hide their condition by successfully masking the symptoms. A lot of them, in fact, may be particularly vulnerable to suicide. Suicide can be a particular threat to individuals suffering from smiling depression. Typically, people suffering from classic depression might have suicidal thoughts, but not the energy to fulfill them. However, those hurting from smiling depression can follow their plans through. This is why smiling depression can be more dangerous than a classic form of severe depression.  Family and friends may be unable to spot the signs of depression and sufferers often do not themselves admit to a problem. After all, if I have a well put together life – stable relationship, good friends, good satisfying job, no financial worries then what reason do I have to feel sad. The major characteristic of smiling depression is sadness. The smile and external façade is a defense mechanism, an attempt to hide their true feelings.

Dr Sophie Moagi, clinical psychologist at the University Of Botswana says, “Smiling depression is not a technical term. The closest technical term for this condition is “atypical depression. It can be very hard to spot people suffering from smiling depression. They may seem like they don’t have a reason to be sad – they have a job, an apartment and maybe even children or a partner. They smile when you greet them and can carry pleasant conversations. In short, they put on a mask to the outside world while leading seemingly normal and active lives. The fact that you are able to lead a seemingly normal life may seem to be an advantage over a person who has clinical depression and is completely unable to function, but having high functioning depression can actually be dangerous. You may be denying your symptoms even to yourself, which means there’s a good chance you are not reaching out to your doctor or to loved ones for help. Just because depressive symptoms are not completely incapacitating doesn’t mean that you shouldn’t get help. Working with a therapist can help you to identify the thought patterns and belief systems that are contributing to depressive feelings, as well as helping you to learn what tools you can use to improve your mood. These tools include meditation, physical exercise and learning mindfulness skills. Opening up to the people around you is an important step toward overcoming hidden depression. Instead of trying to hide your uncomfortable feelings, reach out to a trusted family member or friend and begin to get in the habit of discussing your feelings.” 

There is no specific cause of smiling depression. Sometimes it is triggered by an event – can either be the loss of a job or relationship, a sense of purpose and meaning in one’s life. People in a cultural or family environment that stigmatizes the expression of negative feelings as a weakness are more likely to put up a ‘happy face’ and keep their real feelings to themselves. This is often true for men who are less likely than women to seek help for their emotional problems in favour of their masculinity. Other common symptoms of smiling depression are feelings of anxiety, fear, anger, fatigue, irritability, hopelessness, and despair. Those suffering from this and other forms of depression may also experience problems sleeping, a lack of enjoyment in pleasurable activities, and a loss of libido. Everybody’s experience is different. It’s possible to feel just one or many of these symptoms. Smiling depression has been linked to those who tend to strive too high for perfectionism, those that have unrealistic expectations set by themselves or others for their own lives and who dwell on every small failure or embarrassment as an indication of worthlessness. There are many reasons someone may intentionally mask their depression, such as fearing the shame of the stigma of depression and the possible negative reactions of others, not wanting to burden others, or feeling guilty that they are depressed when they have so many good things in their life for which they believe they should be grateful or happy.

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