Smiling depression: symptoms, how to treat it?

Behind a smile can hide a deep malaise that can go as far as depressive states. This is called the smiling depression (Where “smiling depression” in English). facade happiness, this discomfort sometimes goes completely unnoticed because the person who suffers seems to be “well” and hides his suffering. This form of depression is very common. What is it concretely? How to recognize it? By what symptoms? How to heal and get out of this emotional pain? Insight from Aline Nativel Id Hammou, clinical psychologist.

Definition: what is a smiling depression?

Classically, when we think of depression, we imagine a sad person, who sulks, cries or never smiles. “In the case of smiling depression, sadness is masked by a smilelike a made of conditioning and of muzzling“, Aline Nativel Id Hammou immediately indicates. The person hide his discomfort with a smilejokes, joy of living as if everything was fine, which makes depression more difficult to detect. “Although it is not a term that we psychologists or psychiatrists use, smiling depression is something found in the behavioral attitude of many of our patients who suffer from depression. In my view, this concept makes it possible to breaking the taboo of depression and highlight common symptoms of depression such as denial and the repression, often in the early stages of the course of the depressive disorder“, she continues. The smile and the external facade are here a defense mechanism and an attempt to mask real feelings. Note that the term smiling depression not listed in DSM5but this form of depression would most closely resemble the atypical depressionterm present in the official classification.

“I have everything to be happy and yet I don’t know what’s wrong”

What is the cause of smiling depression?

“What emerges from studies conducted by professors of psychology (including a study published in the scientific journal Natureeditor’s note), is that the person who is suffering from a smiling depression has the feeling to have everything you need in life. I have moreover several patients who tell me “I have everything to be happy and yet I don’t know what is wrong”. This feeling that everything is going well is in fact distorted by the perception of happiness and success in the collective dimension which does not always correspond to ours”. she explains. These are behavioral attitudes that can be noticed at certain times in life, in particular in your thirties or forties. “When we pass ten, we tend to make life points or some sort of balance sheet. And that’s when thewe can become aware that the paths of life we ​​have taken are not in agreement with those we wanted take. There is also a feeling of shame to go wrong when objectively we have success and fulfillment factors, which are shared or at least wanted by many peopleexplains our interlocutor. In fact, the person does not allow themselves to show that they are not well. And if it starts to do so, there may be clumsiness of the surroundings who will not always understand or take seriously the malaise, which further reinforces the feeling of shame and guilt.”

What are the symptoms to recognize it?

“A smiling depression is characterized by typical signs of depression that the person tries to hide as much as possible. But at some point, these symptoms are no longer manageable and there is a kind of collapse that can manifest itself in several symptoms“:

• Lack of energy or loss of interest
• A decline in self-confidence
• eating disorders
• Concentration problems
• A retreat into oneself
• Tiredness,
• A permanent vulnerability
• A feeling of having no energy even upon waking up
• Irritability or susceptibility
• A tendency to sleep a lot
• Sentences of despair
• Rapid weight gain or loss…

Does smiling depression exist in adolescents?

Yes. Smiling depression can both adults and adolescents. The High Authority of Health estimates that nearly 8% of adolescents between 12 and 18 years old would suffer from depression. Among them, some would suffer from smiling depression. In effect, “at this age, depression often goes unnoticed: the adolescent has difficulty expressing his feelings, manifests his suffering differently from adults and his depression can be confused with feelings of depression, common in adolescence“, can we read on the site of the health authority. Depression can be confused, wrongly, with a “teenage crisis”period of normal and transitory depression marked by multiple transformations.

“Permanently pretending is extremely energy-intensive”

Is there a test to diagnose smiling depression?

There is no official test to diagnose smiling depression. Only a professional can officially diagnose depression. To establish the diagnosis of depression, the symptoms must last at least 15 days and be at least 5 in number, including one of the 2 cardinal symptoms: depressed mood (or irritable) or loss of interest (or pleasure), indicates the HAS.

“Constantly pretending and being in constant hypervigilance, is extremely energy-intensive and deleterious in the long run. To get out of a smiling depression, you have to be surrounded and heard. And especially not judged. You must also accept negative emotions that are a form of warning, allow yourself to question your criteria for fulfillment and then gradually modify your thought patterns. It is something necessary, otherwise we risk entering a spiral of depressive disorders or even anxiety-depressive disorders.“, wants to warn our interlocutor. We can for example see a mental health professional, a psychologist or a psychiatrist. “In consultation, we will start by tracing the life story of the person, we will question their desires, the questions of obligations, of duty, the expectations of those around them… Most of the time, we realize that the person has made certain life choices according to family or societal parameters and that now these choices no longer suit him. Above all, it is necessary accept being less standard and tell yourself that you have the right to want something else.“Finally, several studies, including one published in the journal Translational Psychiatryshowed that doing meditation or physical exercise alleviated depression and ruminations.

Thanks to Aline Nativel Id Hammou, clinical psychologist.