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How Did Hiding Become Important? Nine Childhood Experiences That Lead To Perfectly Hidden Depression

Welcome to Perfectly Hidden Depression.  I’ve been describing what Perfectly Hidden Depression (PHD) ®  is and how I began writing about it. But, thus far, we haven’t discussed its origins. What happened in someone’s childhood that set up a need to mask painful emotion and become highly perfectionistic? As I’ve talked about this issue with many of my patients, some of them have shared their own thoughts, and I’d love to hear from you about other scenarios or stories that might create PHD. Please feel free to comment below.

Today, you’ll find a list of nine potential childhood contexts for the need to develop a personal of happiness and busy-ness that shields us from the eyes of others.

If you could read the personal emails I’ve received from all over the world, you’d hear the many different lifestyles of people who identify with PHD. They’ve come from doctors, advertising executives, teachers, chefs — people from all walks of life. The one thing they have in common? They’ve read my posts and listened to podcasts on PHD.  And their response…. “I am hiding. And doing it very well.”

What are the reasons you began to hide?

I’ve asked many, “So how did your hiding begin?” Here are nine of their answers.

1) I was sexually or physically abused.

It was at that point you began hiding your pain.  You were told to shut up.  Keep the secret. You’ve simply continued the practice. You’re filled with unspoken shame. You never talk about what is really going on with you — what hurts you, what angers you. The damage from being the target of sexual manipulation or violence silences you. You have a secret that eats away at you, and makes you feel out of control — so staying in control has become vital to your way of life.

You may have chosen an abuser as a partner, and you’re currently being scorned, or ridiculed. It’s become mandatory to not let anyone get to know you, or venture too much into your real world.

2) I was a child of alcoholics or addicts.

You learned to be hyper-vigilant because you never knew what kind of mood the addict would be in — whether they were on or off their drug of choice.  You kept your feelings completely to yourself because it was far from safe to communicate them. You may have devoted yourself to school or athletic activities, a job — anything to keep you away from home.  Or you might have become invisible to your parents to protect yourself. Thus you stay invisible as an adult, or morph yourself into who others need you to be.

3) I was emotionally abused or neglected.

You were told you weren’t going to amount to anything. There was overt condemnation and criticism. Or if neglected, you weren’t being taken care of at all. You got the message loud and clear – “You’re not important enough to me to make sure your basic needs are met.” So you create an invulnerable facade — the perfect, very successful life. It seemed far easier to have the attitude, “I don’t need to be loved well. I’m fine on my own,” than to allow such disdain to sink in.

4) I was an adult, even as a child.

Perhaps one or both of your parents suffered mental or physical illness, or was someone who couldn’t act as an adult. You took care of brothers and sisters. Maybe you were the eldest child, or maybe you were simply the one most innately responsible. You fed them, made sure they did their homework, and got them in bed.  You made sure a parent took their medication, or picked them up from the bar at night. You became someone who made sure tasks were accomplished, and you were good at it. Life was then, and still is, about these tasks. And you see your value in getting them done.

5) I was the the “star” in my family.

You were highly praised for your successes. “You never disappoint me.” “You’re always at the top of the class.” You’re labeled the smart one, the athletic one, the accomplished one. “He can do anything he sets his mind to.” You felt as if you could never fail or falter. The pressure of your childhood was immense as parents lived through your success.  You came to believe that you had to keep the thumb in your back, pushing and prodding, to remain being the star. Being perfect became your goal.

6) I’m a guy, raised by people who still believed in the masculine stereotype. 

You were taught that it’s unmanly to admit any kind of vulnerability. Or maybe you grew up in a highly gender-stereotyped environment or culture, where men and women had different rules or expectations. You put up a huge front of stoicism. If you happened to be more sensitive, or to have a different sexual orientation, your hiding became even more complicated and painful.

7) I wasn’t allowed to express painful emotions of any kind.

Things happened, even painful things like death, divorce, or disappointment, but no one talked about the pain of those losses. You were hushed for crying, punished for showing anger, sent to your room if you looked upset. “Don’t come down until you get yourself together.”  You were never comforted or supported for feeling hurt, or lost, or confused. So you hushed. You stopped asking for comfort, because there was none there. You stuck whatever hurt you had far away, and became expert at denying its presence. .

You were taught that things always needed to look perfect to the outside world, and to keep up the pretense at all costs.

8) I felt responsible for a parent’s happiness or fulfillment.

You spent your childhood emotionally propping up a parent. She’d say,  “I don’t know what I’d do without you,” or, “There’s no one who understands me like you do.”  So you had to be ever-constant, ever-caring. What then was love? It was attending to someone else’s insecurity or need, and ignoring your own. Very little was about you.

This dynamic is called “enmeshment,” when a parent’s needs overwhelm and govern a child. There’s not an appropriate boundary between the two. How can you ever leave, if it’s your job to make a parent happy?  So you may stay locked into that role. You hid your own struggles. Your life can become a tangle of hidden secrets.

And if you do leave –move to another city or are busy raising your own family — you walk around feeling as if you’ve failed at the one job you never applied for, but were given. The guilt can be crushing.

9) In my culture, being open about painful feelings wasn’t supported.

There’s a vast amount of difference between countries and cultures in what is stressed or allowed emotionally. Whether your ethnicity is Scottish, Chinese, Hispanic or South African, whatever region of the country where you were reared — all were important in shaping your response to painful emotional expression.

The good news… 

The good news is that none of us has to continue living out the strategy we used to survive growing up. Maybe it worked then, and you emotionally survived whatever situation you were born into. But that strategy may not work on your behalf now. And, your parents, your environment, or your culture are no longer in charge.

Or they certainly don’t have to be.


You can hear more about Perfectly Hidden Depression and many other topics by listening to Dr. Margaret’s new podcast, SelfWork with Dr. Margaret Rutherford.

Click here for a questionnaire to see if you experience Perfectly Hidden Depression.


How Did Hiding Become Important? Nine Childhood Experiences That Lead To Perfectly Hidden Depression

Dr. Margaret Rutherford

Dr. Margaret Rutherford is a clinical psychologist who's practiced in Fayetteville, Arkansas for twenty-five years. Her passion for researching Perfectly Hidden Depression began in 2014 and she's currently writing a book to be published next year by New Harbinger. Her work has been featured on Psychology Today, The Huffington Post, The Mighty and The Good Men Project, among others. She's the author of "Marriage Is Not For Chickens", a blogger (Https:// and podcaster (SelfWork with Dr. Margaret Rutherford). She welcomes your questions and comments -- [email protected]

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APA Reference
Rutherford, D. (2018). How Did Hiding Become Important? Nine Childhood Experiences That Lead To Perfectly Hidden Depression. Psych Central. Retrieved on September 18, 2020, from


Last updated: 21 Mar 2018
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