Let’s Talk Depression

Mental health image. Various emotion and mind. Waste paper and head silhouette.

Written by Komalpreet Kaur

Mental and emotional health is just as important as physical health and well-being. It is crucial for you to be aware and accept your emotions, feelings and struggles. The everyday struggle to show up with a smile when you are not doing well is devastating and the pain behind that smile is unbearable. You don’t have to wear a mask and pretend to be happy when in reality your depression is choking the life out of you.

Let’s talk about depression and how it can make your world look grey and bleak.

Mayo Clinic defines depression as a mood disorder that causes a persistent feeling of sadness and loss of interest. It affects how an individual feels, thinks and behaves often leading to a variety of emotional and physical problems. Depression manifests in different forms and can be defined differently by people who have experienced depression or are still living with it each day.

To be diagnosed with clinical depression or major depressive disorder, the symptoms must be present for more than two weeks. You can also take the Beck Depression Inventory(BDI), a psychometric test to measure the characteristic attitudes and symptoms of depression. 

The terms Smiling Depression, high functioning depression or perfectly hidden depression (PHD) are not recognized as conditions in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because the symptoms of these conditions are atypical and in most circumstances, the person himself fails to recognize depression.

The smiling depression or perfectly hidden depression is dangerous because people with these conditions are capable of perfectly hiding their despair, hopelessness and pain. They live perfect lives for the outer world and never communicate their sadness to others and in worse case scenarios this sadness has a tight grip on the person, driving them to end their life.

Dr. Margret Rutherford Robinson describes in her book, perfectly hidden depression is a type of depression that may not fit the criteria or description for minor or major depression but is a depression that lays silently beneath the lifetime of acting as if everything is going perfectly well. The characteristics of perfectly hidden depression enable a person to hide or detach from emotional pain. Just because we cannot see the pain does not mean it’s not there and it is not affecting the individual.

Dr. Margret Rutherford enlists the 10 characteristics of perfectly hidden depression in her book and suggests that an individual is more likely to experience PHD, if…

  1. You are highly perfectionistic and have a constant, critical and shaming inner voice
  2. Demonstrate a heightened or excessive sense of responsibility
  3. Detach from painful emotions by staying in your head and actively shutting them off
  4. Worry or need to control yourself and your environment
  5. Intensely focus on tasks, using accomplishment to feel valuable 
  6. Focus on the well-being of others but don’t allow them into your inner world
  7. Discount personal hurt or sorrow and struggle with self-compassion
  8. May have an accompanying mental health issue, such as an eating disorder, obsessive-compulsive disorder, or addiction
  9. Believe strongly in counting your blessings as the foundation of well-being
  10. May enjoy success within the professional structure but struggle with emotional intimacy in relationships

Most often the psychiatrists or psychologist fails to identify people with perfectly hidden depression because they ask wrong questions. A person with PHD will never disclose how he feels even when they are the point of self-harm. Talk to your therapist or someone you trust, seek help. How can your therapist know what’s wrong if you don’t tell him?

To know if you are going through perfectly hidden depression click here for a questionnaire created by Dr. Margret Rutherford.


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Some measures for healing:

  • To accept your diagnosis or current emotional state
  • Practice mindfulness, dance in the present moment without being focused on the past or future
  • Recognize that change is a slow process and patience is required
  • Set some realistic goals, try to avoid your perfects inner voice here
  • Work in small steps to achieve these goals
  • Acknowledge success no matter how small it is
  • Connect with your inner self, journal every day
  • Develop a self-care routine
  • Practice self-compassion
  • Ask for help whenever needed

If professional help is needed contact a qualified psychiatrist or therapist.

It is very important to identify and accept your diagnosis and this particularly takes tremendous amounts of courage to confront your emotions. But hiding your feelings is not getting you anywhere but towards misery and despair. The loneliness that you feel is heart-wrenching.

When someone suddenly commits suicide, it often bothers us and we keep thinking of what might have happened, as to us everything was perfectly normal in his or her life.  

Edwin Shneidman defines psychache as the hurt, anguish, soreness, aching, and psychological pain in the mind that can drive a person to suicide.

If you ever feel like driving away from the pressure of your perfect life just know that killing yourself is never going to do any good to you and to people you love. You don’t have to go through psychache alone. It’s never too late to ask for help!

Some help resources are enlisted below.

Crisis services Canada (help available 24/7)



Canadian Mental Health Association

National Suicide Prevention Lifeline

Self-help Tools for Mental Wellness


Mental Health at Workplaces

As per the data from CAMH, 30% of disability claims in Canada are due to mental illness and 70% of all disability costs are due to mental illness.

CAMH suggests the following mental health strategies for workplaces:

  1. Create a long term organization-wide Mental Health Strategy
  2. Institute mandatory mental health training for leadership
  3. Develop tailored Mental Health Supports
  4. Prioritize and optimize your  Return-to-Work process checklist
  5. Track your progress

Be there for your co-workers.

Identify signs of distress → Show you care for them → Connect them to help.

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