Key Signs of Smiling Depression & How to Cope with Symptoms

signs and symptom of smiling depression

Written by Dr. Paul Kelly, PhD, C.Psych.              February 17, 2024

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


What is Depression?

Why This Matters: If you recognize depression, you can learn to overcome it.

Depression is a widespread yet severe condition. It changes how you feel, think, and go about your day-to-day tasks. It can affect your sleep, eating habits, and work life. It’s more than just being sad or facing tough times.

Sadness is short-lived. Depression sticks around for much longer and it can greatly affect your life. Those dealing with depression often experience intense sadness. They no longer enjoy things they used to love. Feelings of low self-worth or guilt are also common.


What Is Smiling Depression?

Why This Matters:  Knowledge can help you take care of yourself.

Smiling depression – someone feels really sad inside but looks happy on the outside. They look like they have everything under control, but they are secretly struggling. When they are with friends, they put on a smile and try to keep up appearances.

They go to school or work and seem to be doing okay. But when they are alone, sadness can break through, and they feel worried and empty. Smiling depression is also called walking depression.

Smiling depression is more than just feeling down. Typical sadness fades after some time. Smiling depression can last a long time if it’s not acknowledged and dealt with. Smiling depression is tricky because a person may not know they have it, and their friends can also miss it.


9 Warning Signs You Might Have Smiling Depression

Why This Matters:  You can help yourself better if you know what’s wrong.

These warning signs can help you figure out whether you have normal sadness or smiling depression. Normal sadness usually goes away on its own. Smiling depression can get worse if you don’t deal with it. Don’t worry. If you have smiling depression, there are things you can do to overcome it. Check my advice about lifestyle changes and treatment.


Here are some signs you might have smiling depression.

  1. Wearing a Mask: You wear a smile and pretend to be happy. But when you look in the mirror, you see sadness around your eyes.
  2. Loss of Joy: Nothing is fun or engaging anymore. When you are looking at your phone, you feel dull inside.
  3. Feeling Empty: You feel empty or sad even when things are going well. Sadness is always there in the background.
  4. Irritability: Little annoyances make you upset. You snap at people without meaning to.
  5. Tired All the Time: You’re constantly fatiqued. Sleep doesn’t help. It feels like you’re dragging yourself through each day.
  6. Change in Appetite: Food isn’t appealing, or you might overeat to feel better. Your weight is changing.
  7. Hard to Focus: Concentrating or making decisions is hard. It feels like you have brain fog.
  8. Feeling Worthless: You have harsh, critical thoughts about yourself. Your thoughts say, “You’re not good enough” or “You are a failure.”
  9. Anxiety: You feel more anxious or worried, even about small things. Your mind can’t settle.


7 Warning Signs of Smiling Depression for Friends and Family

Why This Matters: Your loved ones can help sooner if they know what to watch for.

The signs of smiling depression can be subtle. It can be hard for your loved ones to tell if you need help. If your loved ones see any of these warning signs, they could gently ask you how you are feeling. Let them help you. That is the best way to start your recovery.

  1. Fake Smiles: They see you smile, but they sense that the smile is not ‘real.’
  2. Always Saying “I’m Fine”:  You tell them that you are fine, but your voice has no energy or life in it.
  3. Irritability: They see how little things set you off.
  4. Lack of Energy: You try to keep going, but you run out of energy.
  5. Change in Sleep Patterns: Your partner notices that you sleep too much or too little.
  6. Eating Habits Change: They notice that you eat too much or not enough. They see you skipping meals or eating lots of snacks.


8 Risks of Not Recognizing Smiling Depression?

Why This Matters: You can make better choices if you know the risks of ignoring depression.

It’s important to recognize it if you have smiling depression. There are risks if you don’t catch it early. Here are some of the risks that I have seen in my clients.

Check the list. If any of these risks apply to you, talk to someone. A friend can support you and help you figure out what to do next.

  1. Getting Worse: Your depression might get deeper over time. Ignoring it won’t make it go away.
  2. Physical Health Problems: Stress and depression can contribute to problems like headaches, stomach pain or heart trouble.
  3. Relationship Issues: You might start having more fights or misunderstandings with friends and family because they don’t know what you’re going through.
  4. Work or School Trouble: Concentrating or caring about work or school might get harder. You could end up with lower grades or job trouble.
  5. Substance Use: Some people start using alcohol or drugs to feel better. This could lead to addiction and more problems.
  6. Isolation: You might pull away from people and feel lonely. This could make your depression even harder to handle.
  7. Self-Harm: You might start to hurt yourself as a way to deal with the emotional pain.
  8. Suicidal Thoughts: Ignoring depression can lead to thinking about suicide as a way out. It’s very important to get help before thoughts turn into actions.


How Friends and Family Can Help with Smiling Depression?

Why This Matters: Loved ones want to help, here are some tips to guide them.

Family and friends can help if they know you have smiling depression. Be willing to accept their help, even if they stumble a bit when they try to support you. Here is some advice for them – things to do and things to avoid doing. If they suggest that you consult with a mental health professional, be willing to consider their advice.


Advice for Loved Ones: What to Do

  1. Listen Without Judging: Let them know you’re there to listen, not to judge. Sometimes, just being heard can make a big difference.
  2. Encourage Sharing: Encourage them to talk about their feelings. People with smiling depression may be shy about talking about their emotions of sadness, shame, or guilt.
  3. Encourage Activities: Invite them to do things with you. Pick an activity that they used to enjoy – something for pleasure or a sense of accomplishment.
  4. Read the Lifestyle Section Below: Check the lifestyle advice in the next section. Can you help your loved one start some of these good habits?
  5. Suggest Professional Help: If they are really struggling, suggest that they see a psychologist or therapist. Help them find someone. Perhaps go with them to their first appointment.


Advice for Loved Ones: What to Avoid

  1. Don’t Overlook Their Feelings: Take their feelings seriously if they do open up. You don’t need to give advice, just show that you are with them.
  2. Don’t Push Them Too Hard: Give them space if they’re not ready to talk. People with smiling depression may need time to open up.
  3. Avoid Cliché Advice: Saying things like “Just cheer up” or “Look on the bright side” isn’t helpful. People with smiling depression have already tried that approach.
  4. Don’t Make Them Feel Guilty: Avoid making them feel bad about being depressed. It’s not their fault.
  5. Take Care of Yourself: Supporting someone with depression can be draining. Make sure you’re looking after your own mental health, too.


Lifestyle Changes to Overcome Smiling Depression

Why This Matters: Simple lifestyle changes can help you overcome smiling depression.

Now that you have figured out that you have smiling depression, you can start to help yourself feel better. These lifestyle changes can go a long way to help you overcome smiling depression. Have a look at the list. What would be the easiest place to begin? Pick any topic. They are all good choices. Take it slow. Try one thing at a time. That is the best way to move forward when you have been depressed. I know. I have been there.

You don’t have to do all of this on your own. Ask a friend or family member to support you. Perhaps they could do the activity with you. You might also work with a mental health professional. They have expert knowledge. You might also feel that it is easier to talk to a psychologist or psychotherapist.

  1. Regular Exercise: Physical activity, such as walking, running, or yoga, can significantly boost your mood. Strength training works as well as cardio.
  2. Healthy Eating: Eat a balanced diet. Omega-3 fatty acids found in fish and folic acid found in leafy greens are particularly helpful for depression.
  3. Limit Screen Time: Too much screen time can make you feel more depressed. Take a ‘phone vacation’ for 20 minutes. Go for a walk and be mindful as you walk.
  4. Connect with Others: Spend time with friends or family who make you feel good about yourself. Time with good friends is a great antidote for depression.
  5. Do Things You Enjoy: Engage in activities that you enjoy and find meaningful. This will help you feel better about yourself. It will boost your mood. Try something active like playing the ukelele, paint or draw, or embroidery.

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


Psychotherapy Treatment for Smiling Depression

Why This Matters: When people are stuck in depression, they mistakenly doubt that therapy can help.

Here is the Good News: Psychotherapy is a very effective treatment for smiling depression.  Have a look at the list below. Which type of therapy feels right for you? They are all safe choices. All of them can help you overcome depression. Most therapists are eclectic. They often know many ways to help and combine them to find the best treatment approach for you. This mix-and-match method is something you can trust. Eclectic therapy can be very effective.


Here is the Hardest Part: The hardest step might be starting to see a therapist. When you have smiling depression, you might just keep going because you’re scared to stop and think about things. You might 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 back to being you. You deserve to be happy, and a good therapist can help you get there.


A Tip About Therapists: Make sure you find a therapist who feels right for you. Who your therapist is matters more than the type of therapy. If your therapist is rigid, passive, cold, or disorganized, then you probably need a different therapist. 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 Smiling 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

Why This Matters: Here is why I care about giving you useful advice.

I know how tough depression can be. I had smiling 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 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:
  • American Psychological Association (2023, March) Overcoming Depression: How Psychologists Help with Depressive Disorders. Retrieved from:
  • American Psychiatric Association (October, 2020). What Is Depression? Retrieved from: