It might sound like a contradiction, but smiling depression is very real and often very difficult to spot – especially in teens. 

Also referred to as high-functioning depression, this condition is characterized by depression that is masked by a smiley, happy exterior. Its symptoms are so atypical that teens may be able to effectively hide their symptoms from others or even themselves. This can be done subconsciously or as a direct response to societal pressure, fear of stigma, and lack of awareness surrounding teen depression and mental health. 

Below, we’re diving deeper into what parents and caregivers need to know about smiling depression, including common signs and what one can do about it. 

What is Smiling Depression?

What is smiling depression – and why is it so tricky to deal with?

Smiling, or high-functioning, depression is a form of depression where someone seems happy and well-adjusted on the outside but is struggling with depressive thoughts on the inside. You may also see it referred to as atypical depression or walking depression. 

Note that smiling depression is not a depression diagnosis in itself. Teenagers with symptoms that present in this way are instead usually diagnosed with persistent depressive disorder or major depressive disorder with atypical features. 

How Do You Know If You Have Smiling Depression?

By its very nature, atypical depression isn’t going to show up the same way as “typical” depression. But that doesn’t mean you can’t see the signs in your child. Things to look out for include:

• Subtle signs of distress despite appearing happy
• Fatigue and sleep issues
• Sudden changes in mood and behavior
• Slipping grades, procrastination, and difficulty focusing at school
• Physical complaints such as frequent headaches or stomach aches
• Perfectionism and trying overly hard to appear cheerful and in control

You can also look at it from a personal angle – i.e. how do you know if you have smiling depression? Would a teen or young adult even be aware of the issue if they’re otherwise acting fine? From this approach, the condition appears as a sort of balancing act between feeling sad and hopeless and putting on a good mood for show. It might not be obvious right away, but if the pattern persists it’s a pretty clear sign something is going on. 

Reasons Why Teenagers Hide Depression

Smiling while depressed isn’t always deliberate. However, there are some reasons why teenagers hide depression from themselves and others, including fear of judgment, social pressure, and a desire to put on a strong front for loved ones. 

No matter the reason, masking depressive symptoms can have far-reaching implications and prevent our adolescent youth from getting the help they need. If, as a parent or caregiver, you can watch out for the subtle signs above, you can be a first-line defense against this complicated condition. 

The Connection Between Smiling Depression and Other Disorders

Some mental health disorders go hand-in-hand with depression, regardless of whether the signs are obvious or not. 

The first is sleep disorders like insomnia or hypersomnia, which can be triggered or worsened by depression due to restless sleep, exhaustion, or imbalances in the body’s wake-sleep cycle. Poor sleep can exacerbate depression, too, increasing feelings of anxiety and emotional dysregulation in both the short- and long-term. 

There’s always an increased worry of substance use disorder since adolescents with atypical depression may turn to drugs or alcohol to cope. Anxiety disorders or suicidal ideation are also strongly linked to major depressive disorder, highlighting the need for early intervention and an effective treatment plan. 

How to Support a Teen with High-Functioning Depression

Smiling or not, teens need support from loved ones in order to address their depressive symptoms and learn how to cope. As a parent or caregiver, you can spearhead this process by:

• Encouraging open conversation: Let your child know they can speak openly with you about their feelings. 
• Monitoring sleep habits: Help teens establish a healthy bedtime routine and watch for sleep deprivation or other struggles. 
• Looking beyond the surface: Trust your gut and check in with your teen even when they seem fine. 
• Teach positive coping mechanisms: Work with your teen to figure out healthy coping skills like journaling, exercise, or mindfulness. 
• Seeking professional help: If necessary, a residential treatment program like The Ridge RTC can provide the specialized support your child needs. 

Smiling depression is real and easy to hide. It’s also often best treated with professional support. Take action right away if you’re worried about your child’s well-being, and don’t let an outward smile make you second guess your feeling that something is wrong. The Ridge RTC provides qualified mental health care for teens in home-like residential facilities in New Hampshire and Maine. Contact us today to learn more about our admissions process.