'Depression only lives behind wavering smiles and drawn curtains, shrugged shoulders and unanswered messages.' Not questioning the truth of this stereotype is to believe one of the biggest and sometimes catastrophic misconceptions around mental health: that depression looks a certain way.
As a psychotherapist, and someone who has journeyed through the depths of depression numerous times myself, I have sat with so many people for whom the caricature does not fit. I have been that person, who on sharing my diagnostic label would prompt responses of surprise. ‘But you look so happy, you seem so well.’
Recently, I tried to find a photo today to depict of one of the darkest times of my life for a piece I was writing. As I scrolled through the smiling faces, the family gatherings and the selfies taken with sleeping babies, it threw me how happy I looked in every little digital square; my wide smile enhanced by makeup and framed by colourful scenes.
How very different from the stark memories I have of how desperate and dark I felt behind closed doors and happy eyes. The crying on the kitchen floor moments before I donned my biggest glasses and stepped into the sunshine. The breathing down of waves of heart-racing panic, before I emerged with a fresh slick of mascara. The swallowing down of sobs that threatened to lurch forward in response to a sincere question posed with compassion, or a lingering hug.
How come when I scroll through those days, I remember darkness, but in the images captured, I see only light?
Depression doesn’t always look like crying and hiding away. It doesn’t always look like low energy or an aura of negativity. For me, and for many others, looking like you have it all together can be a coping mechanism, a defence against falling apart.
The reality is, depression doesn’t always look like crying and hiding away. It doesn’t always look like low energy or an aura of negativity. For me, and for many others, looking like you have it all together can be a coping mechanism, a defence against falling apart. Depression masks itself with many guises, meaning it often gets overlooked in ourselves and others, leaving sufferers sinking deeper into loneliness and shame.
To widen our understanding of the manifestations of depression, is to cast our support net that little bit wider. It’s to prompt compassionate enquiry instead of dismissal. To see beyond the coping mechanisms to what may lie behind them, could be the difference between someone feeling seen and someone being overlooked. Or, the difference between recognising our own need for support or dismissing our experience.
So, how can you spot a potential mental health issue when you only see happy? Or when the impulses to withdraw and socialise can sit - confusingly - side by side? Or when you know you don’t feel right, but the photos don’t look sad?
As a psychotherapist who has both walked through depression, and stood beside others in theirs, I’d like to share five unexpected signs:
1. Escaping into work, stress or chaos
Work is so often a source of focus and feedback - as well as stress and pressure - which makes it an ideal place to escape into. Whether a job is a therapeutic outlet for creativity, requires adopting a persona, or offers a distracting and endless list of to-dos, work can be an all-encompassing escape from the behind-the-scenes reality.
When someone throws themselves into a pool of water, the world is dulled out. In the same way, when you immerse yourself into the demands of work, the call of emotion can feel quieter.
2. Self-sabotage
Things can seem to be going well, opportunities arising and relationships appearing to thrive ... and then self-sabotage kicks in. Someone can experience a personal conflict between seeking the good, and not feeling worthy of it. This can lead to a conscious or unconscious desire to break, destroy or sidestep the good things, in order for the situation to 'fit' with a depression-tainted understanding of our worthiness. So, things might look to be moving in a good direction, and then seem to fall at the last hurdle or fall apart.
3. Overcompensation in terms of a 'positive mental attitude'
We do not fall for the painted-on smile of the sad-eyed circus clown, yet we can be far more skilled at presenting as ‘happy’ while feeling broken inside. We’ve learnt some good tricks along the way, and with the increasing promotion in our society of embracing a ‘positive mental attitude’, it is accepted, if not encouraged, to look on the bright side of life.
However, depression can hide behind the sturdy smile and an attitude of gratitude, but it does not fool the heart. Often what is happening is that the face might be turned towards the sunshine, but the feelings are still in the shadows.
4. Usual hobbies and self-expressions fall by the wayside
We all have our ‘things’ - the things that fuel, captivate, drive and delight us. Many of our pastimes or ways of expressing ourselves become a part of who we are. We all know the person who is always pursuing the next running challenge or creative feat; even the person who loves to wear huge earrings, or indulge in any other quirk or habit that brings joy.
One sign of depression is that those things stop bringing a sparkle to the eye or a spring to the step. When the energy required to keep oneself feeling able to face the world is in short supply, these joyful things can fall by the wayside. The running shoes gather dust, the bright clothes get shunted aside, and we don't prioritise these little self-expressions and delights.
5. Seeking fun to drown out the noise
If you turn the music up loud enough, you can’t hear yourself think. When your body is fizzing with adrenaline, it’s all you can feel. When you sink your body into freezing wild-swimming waters, your mind can be nowhere else. When you drink yourself into sleep, it shuts the world out.
And so, thrill- and sensation-seeking can be a way of seeking momentary respite or numbing from feelings of depression. But, while someone might be the life and soul of the party, when the light dims, the familiar depression rolls back in.
What to do if you are worried about someone or yourself
If you are concerned about someone you care for, ask open questions and let them know you’re there. It can feel tempting to push, but they may not feel able or ready to open up. However, when they are, they’ll know you’re waiting in the wings should they want to talk.
If any of the above is resonating for you, I want to share this. As someone who has smiled convincingly whilst walking through pain, and as a therapist who has sat with hundreds of people secretly walking through theirs, I want to tell you wholeheartedly that there is hope. Just because your depression doesn’t look like the black dog, it doesn’t mean your experience is any less valid, or any less deserving of support. Just because there are ways and things to silence, soften or nudge aside the feelings for a while, it doesn’t mean they aren’t there.
While depression can push us into secret solitude and shame, the key to finding that light at the end of the tunnel is to believe that you deserve compassion and support. Compassion is the antidote to shame, and support is the balm to the secrecy that shame so easily pushes us into.
For more help, the NHS has collected a list of mental health resources here
Bestselling author and psychotherapist Anna Mathur is the founder of__ The MotherMind Way - a new online platform full of life-changing advice, nurturing resources and community all supporting the emotional wellbeing of mums. You can also find more mental health advice and musing from Anna on her Instagram page @annamathur