Draft:Smiling Depression
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Introduction
[edit]Smiling Depression was first introduced by a German psychiatrist, Frieda Fromm-Reichmann, in 1959. The particular term is used to describe an atypical depression in which individuals’ true emotions are masked by their seemingly cheerful appearance. To be estimated, it affects about two percent of the patients suffering from depression. People with smiling depression do not have evident or noticeable symptoms, even when they are in a particularly low mood.
Smiling depression, also known as masked depression or cheerful depression, is not officially recognized as a formal clinic term or diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). Instead, it is frequently diagnosed as a major depressive disorder, with uncommon features, such as smiling and laughing even though feelings of happiness do not appear.
Symptoms
[edit]Atypical Features (Main Features)
Compared to classic depression, smiling depression usually shows atypical or unnoticeable features. Patients with smiling depression are constantly in a smile or use laughter to hide their true feelings.
Being troubled with smiling depression, patients may perform an overly positive demeanor. For instance, they will show positive emotions to others even when things do not go right. The tendency of being a control freak and the pursuit of perfection may be presented.
Typical Features (Minor Features)
Being one of the atypical depression, formal depression symptoms are also found in smiling depression. Patients with smiling depression will fall into a low mood and bad emotions, feeling numb, depressed, and hopeless. Difficulties are found in enjoying daily activities that used to be pleasurable.
Furthermore, physical impacts are brought by smiling depression. Patients may have a change in appetite and body weight. Either oversleeping or insomnia may be experienced. Moreover, inabilities in concentrating or making decisions are found in patients.
If worst comes to worst, patients may have thoughts of self-harm, or even commit suicide.
Contributing Factors
[edit]Life-changing Events
Smiling depression can be triggered by a sudden change in life, such as a break up, unemployment, or death of a loved one.
Judgements for expressing depressive symptoms
Smiling depression can occur when people get used to mask their feelings inside with laughter frequently, as they feel like expressing depressive symptoms will be judged. Under pursuit of perfection, expressing emotions may be seen as “attention seeking” or showing weakness, which will be easily judged by others.
Due to the pressure of needing to perform perfectly, people may tend to hide their feelings as they do not match with the perfection. Those who are afraid of judgments from expressing depressive symptoms are more likely to put on a facade and keep it within themselves.
Possible Threats
[edit]Smiling depression can be difficult to diagnose, as the traditional model of depression is not fitted. In addition, people living with smiling depression mostly do not realize the abnormal feelings, leading to refusal of seeking help. Without the illness being handled properly, patients with smiling depression have a comparatively higher possibility to treat their feelings with alcohol and drugs, leading to an addiction.
As patients with smiling depression hide their feelings most of the time , they may appear perfectly normal from the outside, which further increases the difficulty for diagnosis. For example, an active, high-functioning individual who has a good work life balance may also suffer from smiling depression. Take the actor Robin Williams as an example, his illness was only found after he committed the unexpected suicide.
Medical Treatments
[edit]Smiling depression can be treated medically by seeking professional advice, and taking medicine.
By seeking professional help, tools and support will be provided by the therapists or psychologists to manage the depression.
Medications for depression such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIss) may be provided, effecting on a change in hormones of the brain to fight with depression.
References
[edit]Bhattacharya, S., Laura Hoedebeck, K., Sharma, N., Gokdemir, O., & Singh, A. (2019). “Smiling depression” (an emerging threat): Let’s talk. Indian Journal of Community Health, 31(4), 433-436.
Elmer, J. (2018, November 14). Smiling depression: Symptoms, risk factors, test, treatments, and more. Healthline.
Lam, C. (2023, June 16). 【精神科】表面開心但原來是抑鬱症患者？了解微笑抑鬱症 | 林震 醫生. MEDcentra.
Reinfeld, J. (2024, February 6). Smiling depression: Types, symptoms, diagnosis, treatment. Mantra Care.