Do you have perfectly hidden depression? Answer these questions to find out

You may pretend everything is OK, but deep down, it is not.

Do you have perfectly hidden depression? Answer these questions to find out

You may pretend everything is OK, but deep down, it is not.
  • There is a kind of depression that we in psychology are missing.

  • It's not easy to detect, because people who have it, hide it.

  • They know what they are doing, in a way. But it's been their go-to way of coping for so long, it simply seems like who they are. Or who they have become.

  • They may not even realize it's depression.

  • I call it Perfectly Hidden Depression

  • If they enter therapy, they won't meet criteria for minor depression, called dysthymia, because they will look far too confident, too well-connected, too into what they are doing. They'll tell you that their lives are going great, and that they have so much to be grateful for.

  • They won't qualify as having major depression, because they are far from isolated, they don't cry or seem to have no energy. They won't admit any feelings of wanting to hurt themselves. They love a lot of what they're doing, they have high expectations that they have set and work very hard on reaching them.

  • So how could they be depressed? A little high-strung, or not getting enough rest. Perfectionistic. Maybe worry is something they do a lot.

  • It's depression all right. It's simply hidden beneath a lifetime of acting as if everything was and is fine. It's perfectly hidden depression.

  • It's not true contentment or authenticity ...

    • Because there are secrets. And where there are secrets, there is loneliness.

    • Because there is little self-care or compassion for self. And where there is lack of compassion, there is criticism.

    • Because this way of life, the perfectly hidden life, doesn't feel like a choice. And where there is lack of choice or freedom, there is enslavement - there are "shoulds," "musts," and "have to's" that govern their lives.

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  • Answer 'Yes' or 'No' to the following questions to help you see if you might have attributes of perfectly hidden depression.

    1. Do you struggle with confiding in others - especially about your real-life difficulties and problems?

    2. Do you obsess about things looking perfect, both for yourself and through others' eyes?

    3. Do you avoid talking to your partner (or your friends) about feeling hurt by them, or about a growing resentment you might have?

    4. Do you have trouble sleeping or turning your mind off at night?

    5. Do you have trouble admitting when you're feeling overwhelmed?

    6. Do you push yourself to get the job done, regardless of the cost to you?

    7. Do you respond to the needs of your friends even when it can short-change your own?

    8. Did you grow up in a family where feelings of sadness or pain were avoided, or where you were criticized or punished for expressing them?

    9. Have you ever been hurt emotionally, physically or sexually, and told no one? Or if you did tell someone, you weren't believed or supported?

    10. Did you grow up in a family (or are you still experiencing a family) where you felt like you had to meet defined expectations rather than being allowed to be yourself?

    11. Do you like to have control of a situation if you're going to be involved?

    12. Do you have a growing sense that it's becoming harder to maintain an organized structure in your life?

    13. If so, do you feel anxiety or even panic?

    14. Do you tend to not cry or rarely cry?

    15. Are you considered ultra-responsible, the one that can always be counted on by your co-workers or family and friends?

    16. Do you think that taking time for yourself is selfish?

    17. Do you dislike people considering themselves "victims"-that it's not their fault when something goes wrong?

    18. Did you grow up being taught that you were supposed to handle painful things on your own? That asking for help reflected weakness?

    19. Do you strongly believe in focusing on the positives in your life, or "counting your blessings"?

    20. Do you have a critical, nagging inner voice telling you you're not good enough, or that you could have tried harder, even though you accomplished your goal?

    21. Do you outwardly seem hopeful and energetic while, at times, you struggle with a sense of being trapped?

    22. Do you make lists of tasks to get done during the day, and if they are not completed, feel frustrated or like a failure?

    23. Were you an older child in a family where parents weren't available, and you took care of your younger siblings?

    24. Did you have to care for an alcoholic or otherwise dysfunctional parent as a child?

    25. Were you told that you were extremely special to one parent, and felt that you needed to please them in order to maintain their emotional stability?

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  • Count up your 'yes' and 'no' responses. If you had:

    • 5-8 'Yes': You're likely to be a very responsible person, though you may need to consider taking more time for yourself.
    • 9-11 'Yes': Your life is being governed by highly perfectionistic standards, which may be detrimental to your well-being.
    • 12+ 'Yes': May reflect the presence of PHD, or a depression that you deny (or are unaware of). You do this by intentionally creating a happy, perfect façade.
  • Lots of driven, accomplished people share these traits, or have these dynamics in their history. Often, they lead to success and happiness. When many of them are present, you are likely to experience perfectly hidden depression.

  • Check out Dr. Margaret on her new podcast, Self Work With Dr. Margaret. In each episode, Dr. Margaret takes a direct, solution-oriented approach to depression, anxiety, trauma or grief to guide you toward the changes you want.

  • Editor's note: This article was originally published on Dr. Margaret Rutherford's website. It has been republished here with permission.

Dr. Margaret Rutherford is a clinical psychologist in Fayetteville, Arkansas. In 2012, she began blogging, focusing on mental health topics. Her work can be seen on The Huffington Post, The Good Men Project, Better After 50 and Readers Digest. She also has published one eBook, “Seven Commandments of Good Therapy.” You can listen to Dr. Rutherford on her podcast, SelfWork!


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