Depression, also known as major depressive disorder or clinical depression, is an all too common mood disorder. Individuals who suffer from depression experience ongoing persistent feelings of profound sadness and hopelessness, he or she often loses interest in activities they once enjoyed. In additional to the negative emotions and problems caused by depressive symptoms somatic issues are more likely to be present. Somatic issues associated with depression can include migraine headaches, chronic fatigue, body aches, digestive issues, etc. To be diagnosed with clinical depression, symptoms must be present for at least two weeks.
According to the DSM-5 the following criterion must be present to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. Organic as well as substance abuse concerns must also be ruled out in order to make a formal diagnosis of clinical depression.
• Depressed mood most of the day, nearly every day.
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
• Significant fluctuations in weight, e.g., significant weight loss or weight gain not associated with changes in diet or exercise.
• Significant change is appetite, e.g., significant decrease in appetite, or significant increase in appetite
• Interruptions in cognitive functioning
• Marked change or slowdown in physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness/hopelessness or excessive or inappropriate guilt nearly every day.
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
According to the National Institute of Mental Health (NIMH), risk factors for depression can include a family history of mood disorders and other significant mental health disorders, major life changes, past trauma, significant physical illness (such as cancer), or a side effect of certain medications.
Depression symptoms can appear differently from sufferer to sufferer, no two people with depression will look or behave exactly the same. Persons suffering from depression may not always appear sad to others. In fact, some sufferers feign happiness in an attempt to fool others, to avoid “letting others down”, or being “pitied”.
When someone suffers from depression it takes a lot of physical and emotional strength to “put on a happy face” or convince others “everything is fine”. For some sufferers, disclosing to others That he/she suffers from depression can be akin to admitting a weakness, flaw, or vulnerability. More often than not, individuals struggling with depression symptoms wear a mask of happiness to hide the true emotions that are stirring inside of them.
Potential Reasons with Depression Feign Happiness Include:
• Feeling they may be letting others down if they aren’t doing well
• Not wanting to alarm or cause others to worry about him/her
• Fearing disclosure of depression conveys weakness, personal flaw, or vulnerability
• Feeling if they act the part of “being happy” they will be happy
• Feeling like they are alone in their unhappiness, e.g., others will not understand
• Feeling they need to live up to other people’s expectations of who they are
• Intense need or desire to make other people happy, although, they do not feel happy
• He/she is ashamed of being depressed
• He/she doesn’t recognize they are clinically depressed but hide behind a façade of normalcy
• He/she is concerned about what others may think of them or view them, e.g. personal image.
When persons with depression acknowledge and accept that depression is an issue, rather than trying to hide it, the suffer becomes better equipped to manage depression symptoms. By finding appropriate ways to manage depression and developing appropriate coping skills, individuals can work towards not having to prove to everyone else how they feel, but actually feel the way he/she deserves to feel. Suffers that find themselves having to force a smile or put on a façade of happiness are creating additional stressors in their life as it takes a lot of work to portray and convince others of something he or she is not feeling.
Reasons why Wearing Mask Does Not work Include:
• You have to force yourself to convey a feeling/emotion you do not feel genuinely
• You have to put it on and take it off often, it does not stay in place
• Wearing a mask becomes more difficult to wear over time
• The reasons behind the need to wear the mask still exist
• Putting on the mask becomes increasingly exhausting
• The only person we are fooling are ourselves
• Whatever we are trying to hide will eventually come to light
• We are not able to live to our fullest potential because we are hiding, form others including ourselves
• By pretending to feel or be anything other than ourselves we are living an inauthentic life
• When you attempt to escape from depression without actually dealing with it you are feeding it
• Once the sufferer removes the mask or feels he/she no longer needs it at that particular time feelings of anger and anxiety typically follow
• Unresolved negative feelings will eventually catch up with you
• Suicidal thoughts or ideations can increase
It is important to understand that untreated depression can lead to an exacerbation of symptoms. Negative emotions typically do not resolve themselves on their own but require assistance. To treat clinical depression, a mental health professional should be consulted to help the sufferer manage symptoms and emotions he/she has been avoiding. Professionals can also assist sufferers with identifying and developing appropriate coping skills to manage negative emotions and build skills to manage future problems should they arise.