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Depression
Are You "Fine"—or Emotionally Disconnected?
Understanding the dangerous difference.
Posted October 25, 2021 Reviewed by Devon Frye
Key points
- If you've learned to camouflage emotional pain by looking and seeming perfect, it can become an unconscious process that you can't easily see.
- The stories of my own patients and over 60 interviews I conducted reflect the pain and loneliness of perfectly hidden depression.
- You can begin to disentangle yourself from needing to look or seem "fine" by becoming aware that destructive perfectionism has real dangers.
"I'm fine" or, "All good here." That phrase flies out of your mouth so quickly you don't stop to think if that's really true. Are you fine? Is life "all good"?
What follows is an excerpt from my book Perfectly Hidden Depression (PDH). The stories are real, told to me by my patients in session or people who came forward to be interviewed, many of whom were behind locked office doors or whispering in their garage. Why did they reach out? Perhaps because something about my posts on PHD, or just something about the term "perfectly hidden depression," had spoken to them.
They might think, for example, "I have a perfect-looking life. I fear anyone seeing me as out of control. It's why I'm successful. But something is cracking open... and it scares me."
You may need to seem "fine." And you look more than fine to others. In fact, people may catch you at a ball game or at work: "I really admire you... I don't know how you do everything!" And you smile. Because you're "fine."
Excerpt: Perfectly Hidden Depression
One day as Brittany—a tall, attractive young woman—came into my office, I wondered (as I always do in a first session) what problem or issue would come forth.
“I saw you on Periscope talking about perfectly hidden depression,” Brittany said. “I’ve never been to therapy. But I know that you’re describing me, and I’ve got to get help because things are getting worse.”
She stopped abruptly, seeming to immediately regret telling me even that much about herself. Smiling brightly, she sat a little sheepishly on the sofa, one of her legs nervously pumping up and down. She didn’t know what to do, and she waited for me to respond.
“Well, if you identify with PHD, you’re not used to openly talking about yourself. So, I bet being here is hard.”
She nodded, looking down at her feet.
I reassured her, “We can take all this very slowly. I’m here to listen, but you’re in charge of just how fast or slow this goes. So, is there something that’s happened recently that’s made you more worried about yourself?”
Brittany didn’t tell me everything about her life in that session. In fact, it was months before I knew her whole story. Occasionally, she’d blurt out a hurtful secret that she’d been keeping, all the while very closely watching to see my reaction, as she gradually took more and more risks in sharing her real life. Still, her ability to openly express the emotions connected to those secrets was very limited. I’d see only an occasional tear, quickly covered by a blank look or a change of subject.
And that’s perfectly hidden depression. Shame, trauma, hurt, anger—so many of these experiences and feelings have been kept under wraps that opening up can be a slow process.
But there were others.
Elizabeth recounted a story about waking to find herself lying naked on a beach, having been drugged and raped. “I’ve never thought the story was all that important. It was a long time ago,” she told me, smiling hesitantly.
Linda hadn’t cried in years, even after her mother’s sudden death. “Crying makes me uncomfortable,” she said. “I think it’s a sign of weakness.”
Jackson talked about strange, secret impulses to drive off the road, then followed his confession with, “I have a good wife and family. I’m just a little stressed.”
Like the others, Brittany didn’t look depressed in the classic sense. She was extremely rational and highly organized (if a bit rigidly), her planner stuffed with sticky notes and extensive to-do lists. She stayed very busy with dinners with girlfriends and a steady boyfriend. She was professionally successful, although highly anxious about making the right decisions for her future. She didn’t look sad; in fact, she was often quite jolly and funny.
If you experience perfectly hidden depression, you don’t equate what’s going on as depression. Depressed people are sad. Depressed people have no energy. The very idea of you being depressed may seem ludicrous—at least before you started reading about PHD.
If you’re completely honest, you can confess nervousness about what others would think if you admitted feeling down or hopeless. You fear the stigma against mental illness. You’ve said to yourself, "Oh, my gosh, I’m not depressed. Crazy busy maybe. But not depressed." You’ve handled pressure after pressure, loss after loss, and you’ve carried on. You’ve worked hard, parented hard, volunteered hard.
Most important, admitting depression would be admitting a flaw. Flaws don't belong in your world.
You’re like Brittany. And Elizabeth. Linda and Jackson. Because yours is not the classic presentation of depression.
Yet you might be the person who might kill yourself, and no one would know why.
It’s depression all right—perfectly hidden depression.
***
You're not fine if this is you. You're emotionally disconnected. And if this resonates, please talk with someone.
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 contact the National Suicide Prevention Lifeline, 1-800-273-TALK, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.
If you wonder where you might fit on the spectrum of PHD, here's a questionnaire.
