What Are the Signs of Hidden Depression?

Signs of hidden depression

Written by Dr. Paul Kelly, PhD, C.Psych.              February 19, 2024

This article is for people who want to learn about hidden depression.


If hidden depression is not recognized, it can cause greater problems. Are you concerned someone has hidden depression? Are you concerned you have it? Read this article. I tell you what to watch for – so you can identify and overcome hidden depression. You deserve to feel better.


What is Hidden Depression?

Why This Matters: If you understand hidden depression, you can deal with it.

Hidden depression is when someone feels very sad inside but doesn’t show it on the outside. They might keep doing everyday things like going to school or work and taking care of their family. They might even seem successful or happy to others. But inside, they don’t feel right. They feel sad and down. They might think they are not worth much or feel like they have no hope. Even though they are really having a hard time, they keep pushing themselves.

People call hidden depression “walking depression” too. Those with hidden depression keep going because they don’t want others to think they can’t manage. Sometimes, they might not even realize they are depressed until it gets really tough.


5 Signs of Hidden Depression

Why This Matters:  Knowing these signs can help you or someone you care about.

Hidden depression is when someone seems okay on the outside but is really struggling on the inside. It’s important to notice the signs because they’re not always obvious. Here’s what to watch for:

  1. Smiling but Sad: People might smile and laugh, yet feel sad deep down. Look for sadness in their eyes.
  2. Loss of Interest: They may stop enjoying their favorite activities, seeming less lively.
  3. Changes in Eating or Sleeping: They could eat or sleep too much or too little. These changes are often spotted by those close to them.
  4. Feeling Trapped: They might talk about feeling stuck, with a dull or forced tone in their voice.
  5. Self-Criticism: They often feel they’re not good enough and blame themselves for everything.

Warning signs also include feeling constantly tired, even with enough sleep, and feeling down without a clear reason. Focusing can become hard, even on simple things like reading or watching videos. People might get irritated easily. They withdraw from social activities. They feel numb. They might overcompensate by pushing themselves hard to stay busy.

Recognizing these signs is crucial because hidden depression can build up slowly. As it builds, it can significantly affect your life. Knowledge is power. If you know the signs of hidden depression, you can focus on overcoming it.


What are the Risks of Not Recognizing Hidden Depression?

Why This Matters: Understanding the risks helps you make better decisions about your mental health.

If you’re dealing with hidden depression, trying just to push through can make things worse. It might be tough to admit you’re struggling, but being open about your feelings is key to feeling better. If any of the points below sound familiar, talk to someone you trust. A friend or family member could be a good choice. Don’t keep your feelings hidden. You deserve to find relief and happiness.

  1. Getting Worse: If you ignore hidden depression, it can grow stronger over time. Not dealing with it can make your life more difficult later on.
  2. Physical Health Problems: The stress from hidden depression can cause real health issues like headaches, stomach aches, and even heart problems.
  3. Relationship Issues: You might argue more or feel misunderstood. Friends and family don’t see what you’re going through because your depression is hidden.
  4. Trouble at Work or School: It might become harder to focus or care about your work or studies. This can cause lower performance or grades.
  5. Turning to Substances: Some people might start using alcohol or drugs to cope. This can lead to addiction and other issues.
  6. Feeling Isolated: Pulling away from others can leave you feeling lonely. Then, your depression is even tougher to deal with.
  7. Self-Harm: Some people harm themselves to block out emotional pain.
  8. Thinking About Suicide: One of the most serious risks of ignoring hidden depression is having thoughts about ending your life. It’s crucial to seek help before these thoughts become actions.


How Can Friends and Family Help with Hidden Depression?

Why This Matters: Your loved ones want to support you. Let them know how they can help.

Friends and family are key to getting through hidden depression. Nobody beats depression alone; we all need a bit of help. Sometimes, people aren’t sure how to be there for you. Share the following tips with them. These tips will help you and them overcome your depression.


Advice for Friends and Family. What to Do:

  1. Listen Without Judging: Show you’re there to listen, not to pass judgment. Just being heard can mean a lot to someone.
  2. Encourage Talking: Gently invite them to share their feelings. You can also share yours to show it’s safe to talk about these things.
  3. Suggest Fun Activities: Ask them to join you in activities they might enjoy. Helping them get involved in something can boost their sense of achievement.
  4. Check Our Lifestyle Tips: Below, there’s a section with lifestyle advice. See if you can help your loved one adopt some healthy habits.
  5. Recommend Professional Support: Discuss how talking to a therapist could be beneficial. Offer to help find a good one. Perhaps accompany them on the first visit.


Advice for Friends and Family. What to Avoid:

  1. Don’t Ignore Their Feelings: If they open up, take their feelings seriously. You don’t need to fix things, just show you’re there for them.
  2. Don’t Pressure Them: If they’re not ready to talk or take action, respect their pace. Start with small steps if big ones seem too daunting.
  3. Skip the Platitudes: Phrases like “Just cheer up” or “Look on the bright side” aren’t helpful and can feel dismissive.
  4. Avoid Blame: Don’t make them feel worse about being depressed. Depression isn’t a choice. It’s not their fault.
  5. Look After Yourself: Avoid being a martyr. Make sure you’re also taking care of your own mental well-being.


Good Habits and Lifestyle to Manage Hidden Depression

Why This Matters: Small changes in your daily life can help you deal with hidden depression.

These good habits and lifestyle adjustments can really help if you’re dealing with hidden depression. Check out the list below. See what feels doable. Pick something easy as a first step. Maybe ask a friend or a family member to help you start a change. Remember, it’s okay to go slow. Trying one new thing at a time. That is the best approach when you’re feeling depressed. I have dealt with depression myself. These lifestyle changes helped me.

  1. Regular Exercise: Moving your body by walking, running, or doing yoga can lift your spirits. Exercise makes your body release feel-good chemicals called endorphins.
  2. Healthy Eating: Eating foods like fruits, veggies, whole grains, and lean proteins can help. Omega-3 fatty acids found in fish, and folic acid found in leafy greens, are particularly helpful for depression.
  3. Limit Screen Time: Spending too much passive time on your phone or other screens can make you feel worse. Try to cut down. Spend more time doing real-world activities.
  4. Connect with Others: Hang out with your positive friends or family members. Share your thoughts with people who care. This can help you feel less isolated and more understood. Being with others is an important antidote to depression.
  5. Do Things You Love: Make time for hobbies or activities that make you happy and give you a sense of purpose. Reconnect with something you used to do. Tune your guitar. Get out your box of paints or knitting needles. Bake some cookies.

Would you like more advice? Have a look at this article.


Psychotherapy Treatment for Hidden Depression

Why This Matters: Hidden depression can leave you feeling stuck and hopeless. Learn about therapy to get unstuck.

Here’s the Good News: Talking to a therapist is a really helpful way to deal with hidden depression. Check out the types of therapy listed below. Which one feels right for you? They are all safe choices. All of them can help you overcome depression. Most therapists are eclectic. They know about several types of therapy. They blend them to make a personal treatment approach for you. You can trust this way of working. Eclectic therapy can be very effective.


The Tough Part: The hardest step might be deciding to see a therapist. People with hidden depression often just keep going because they’re scared to stop and think about things. They worry everything will fall apart. Do you feel like this? Don’t let this fear stop you from getting help. A good therapist can help you look at your life clearly and find a way to feel better. They can give you advice, help you stop feeling so bad about yourself, and show you how to get your life back on track. You deserve to be happy.  A good therapist can help you get there.


Choosing the Right Therapist: It’s important to find a therapist who feels like the right fit for you. The person you talk to is more important than the kind of therapy they use. If your therapist doesn’t seem to get you, or if they seem cold or all over the place, you might need to find someone else. There are some really good therapists out there. You deserve to work with one. Check my article about this for more advice.


4 Types of Psychotherapy for Hidden Depression

  1. Acceptance and Commitment Therapy (ACT): ACT uses acceptance and mindfulness strategies. You learn to live according to your personal values, with kindness for yourself.
  2. Cognitive Behavioral Therapy (CBT): This talk therapy helps you challenge negative thoughts so you can behave differently and improve your mental wellbeing.
  3. Behavioral Activation (BA): BA helps you get moving and doing. When you complete more rewarding activities, you will feel more hopeful, and your mood improves. BA is simple and powerful. All by itself, it can be an effective treatment for severe depression. Here is how to get started.
  4. Mindfulness-Based Cognitive Therapy (MBCT): MBCT combines cognitive therapy with mindfulness. You learn coping skills to overcome negative thinking. MBCT training also protects people from having a second bout of depression, after the first cure.


A Personal Note

I know how tough depression can be. I had hidden depression for a year when I was in graduate school. I finally saw a therapist when the strain became too much. Things started to get better after I had professional support. We are all human; sometimes life throws us a big curve ball. Trust yourself, and also get advice from your family and friends. If they think you should try a therapist, be open to the idea. You deserve to feel better.



It is important to me that you find practical and trustworthy information. That is why I personally selected and reviewed all the sources for this article. My advice is also based on my decades of experience working in hospitals, treating clients, and mentoring other therapists and psychologists.

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (fifth edition.). Arlington, VA.
  • Barlow, D.H. (Editor). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, (sixth edition). The Guilford Press, 2021.
  • Dozois, D. & Dobson, K. (Editors). Treatment of Psychosocial Risk Factors in Depression. American Psychological Association. Washington DC. 2023
  • National Institute of Mental Health. Depression. (2024). Retrieved from: https://www.nimh.nih.gov/health/topics/depression.
  • American Psychological Association (2023, March) Overcoming Depression: How Psychologists Help with Depressive Disorders. Retrieved from: https://www.apa.org/topics/depression/overcoming.
  • American Psychiatric Association (October, 2020). What Is Depression? Retrieved from: https://www.psychiatry.org/patients-families/depression/what-is-depression.