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Hidden Depression: What is it & Signs to Watch For

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 11/14/2022

Depression is probably more common than you think. According to the National Institute of Mental Health (NIMH), in 2020, 8.4 percent of American adults experienced at least one depressive episode. Despite how common it is, there are many reasons why some folks may not feel comfortable talking about it or struggle with hidden depression.

If you’re familiar with depression, you probably know that it can negatively affect the way someone thinks, feels and acts in their daily life. Some people may feel shame or guilt around their depression, and others may just not want people to know about it. 

So, how can you recognize whether or not someone in your life is struggling with hidden depression? Are there certain things you should look out for or be aware of? 

Read on.

What Is Hidden Depression? 

Hidden depression, also referred to as invisible depression or smiling depression, is actually no different than regular depression — with the exception of one thing. People with hidden depression work hard to conceal their symptoms. 

So, out in the world, someone with hidden depression doesn’t look like they have depression at all. But, behind closed doors, they exhibit the signs of symptoms of someone with depression. 

There are a number of reasons people may hide their depression. Some people may not want to worry their loved ones. Others may prefer privacy. And research shows that some people feel guilt or shame surrounding their depression. 

Hidden depression may also affect people who have depression but don’t know it. These people may have never been diagnosed or don’t even know that they’re at risk for depression

Who Is Most Vulnerable to Hidden Depression?

Technically, anyone can be at risk for hidden depression. As mentioned, people hide their depression for a variety of reasons. This means that there are a variety of people who may be vulnerable to hidden depression. 

Say, for example, you grew up in a family that didn’t talk about mental health issues or communicate about feelings. If you grow up and have depression, you may feel like you have to hide it.

There are also certain racial disparities that may put certain groups more at risk of experiencing hidden depression. For instance, when it comes to undiagnosed depression, people in the Black and Hispanic communities are more likely to experience it. 

Women who are postpartum may also be at risk for hidden depression. Postpartum depression  (PPD) affects approximately one in seven new parents. 

Symptoms of PPD include feeling highs and lows, irritability, big mood swings, guilt and crying, among others. Sometimes, these symptoms pop up right after childbirth, but they can also appear up to a year after having a baby. 

The stigma around PPD is still pretty large. After all, people think that having a new baby is the greatest moment of your life — and for many people, it’s exactly that. 

But it can also induce depression. Some women fear being judged for being in emotional pain post-baby, so they slip into hidden depression.

Signs of Hidden Depression

Hidden depression can have a huge impact on your daily life. Being a depressed person can affect your social life, your sleep, your work and more. 

Regardless of whether your clinical depression is out in the open or hidden, the signs are the same. Common symptoms of depression include:

  • Sadness, anxiety or hopelessness

  • Pessimism or guilt

  • Losing interest in your hobbies

  • Fatigue and low energy

  • Irritability or frustration

  • Shifts in your appetite

  • Weight gain or loss

  • Trouble concentrating

  • Issues falling asleep

  • Aches, pains or digestive problems

  • Thoughts of self-harm or suicide

A diagnosis comes when someone has felt these signs of depression on a daily or near-daily basis for a period of two weeks or longer.

What makes hidden depression tricky, however, is that your friend or loved one may be very good at doing just that — hiding it. 

So, pay attention to them. If you pick up on any of the following, it may be worth checking in with them to make sure they’re feeling okay:

  • Sharp weight fluctuations

  • Changes in productivity

  • Sudden changes in personality

  • Lapses in personal hygiene

  • Sleeping habit changes

  • Change in social interactions

These are just a few things to look out for. Unfortunately, there are plenty of others that differ uniquely between each individual. A good rule of thumb is to keep an eye on them — if anything seems off, it’s never a bad idea to check in.

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The Risks of Hidden Depression 

If you’re hiding your depression, it means you likely aren’t getting it treated — and that can have a detrimental effect on your life. 

A study from 2017 found that the longer that depression goes undiagnosed or untreated, the worse symptoms get — and those symptoms can become harder to treat. 

Not only that, untreated depression can be bad for your physical health. According to the National Institute of Mental Health, untreated depression can lead to illnesses like cardiovascular disease, diabetes, stroke, osteoporosis and more.

Finally, there are concerns that those with hidden depression are more at risk for self-harm or suicide because they do not get the help needed to address their mental illness.  

As you can see, the risks of hidden depression are serious. Because of this, it’s important to seek professional help so that you can start treating your depression and start living a healthier, happier life.

Treating Hidden Depression

Here’s some good news: If you get treatment for hidden depression, your life can greatly improve. And treatment really works. Around 80 to 90 percent of people with depression respond well to treatment at some point. 

So, what types of treatment are there? Therapy and medication tend to be the go-tos, along with lifestyle changes.

Cognitive behavioral therapy (CBT) is believed to be the preeminent treatment for depression, and there’s plenty of research out there to support its efficacy. 

With CBT, you will work with a mental health provider to find patterns of behavior that feed or worsen your depression. Then, you’ll come up with ways to make beneficial changes. 

Medication is another option. Antidepressant medications like selective serotonin reuptake inhibitors (SSRIs) are typically considered first-line treatments for depression. They can be used on their own or in conjunction with therapy.  

Antidepressants take between four to eight weeks before you may notice an improvement in your depressive symptoms, so it’s important to keep an honest line of communication with your provider, not stop taking them suddenly and also be patient while waiting to feel results.

And finally, there are several lifestyle changes you can make to help treat the symptoms of depression. Getting proper rest, getting at least 150 minutes of physical exercise every week and also eating a balanced diet have all been shown to impact the way we feel — inside and out. 

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Understanding Hidden Depression

Though hidden depression is not a medical term or condition, it is a very real thing for many people. It’s essentially when someone has depression but they hide it from others — or even from themselves. 

Whether you’re hiding your depression because you’re ashamed of it or because you just don’t know what to do about it, it can have a huge effect on your life. 

The symptoms of depression (even the hidden kind) include irritability, sadness, changes in appetite, sleep disturbances and more.

Thankfully, depression can be treated with medication, therapy, lifestyle changes or a combination of the three.

If you’d like to speak with a mental health professional about hidden depression, Hers offers online consultations that make it easy. 

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. What is Depression? American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/depression/what-is-depression
  2. 8 Hidden Signs of Depression. Psych Central. Retrieved from https://psychcentral.com/depression/hidden-signs-of-depression
  3. Pulcu, E., Zahn, R., Elliott, R., (2013). The role of self-blaming moral emotions in major depression and their impact on social-economical decision making. Frontiers in Psychology. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2013.00310/full
  4. Racial Disparities in Diagnosis and Treatment of Major Depression. Behavioral and Mental Health. Retrieved from https://www.bcbs.com/the-health-of-america/reports/racial-disparities-diagnosis-and-treatment-of-major-depression
  5. Postpartum Depression. Cleveland Clinic. Retreived from https://my.clevelandclinic.org/health/diseases/9312-postpartum-depression
  6. Gur, T., (2018). Why Some Women With Depression Aren’t Getting Help. The Ohio State University Wexner Medical Center. Retrieved from https://wexnermedical.osu.edu/blog/why-some-women-with-postpartum-depression-arent-getting-help
  7. Depression. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/depression
  8. Hung, C., Liu, C., Yang, C., (2017). Untreated duration predicted the severity of depression at the two-year follow-up point. Plos One. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5608308/
  9. Chronic Illness and Mental Health: Recognizing and Treating Depression. National Institute of Mental Health. Retrieved from https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health
  10. Coward, L., What You Need to Know About “Smiling Depression.” National Alliance on Mental Illness. Retrieved from https://www.nami.org/Blogs/NAMI-Blog/September-2016/What-You-Need-to-Know-About-Smiling-Depression%E2%80%9D
  11. Gautam, M., Tripathi, A., Deshmukh, D., Gaur, M., (2020). Cognitive Behavioral Therapy for Depression. Indian Journal of Psychiatry. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001356/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

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