You have seen her.
She looks great. Smiling. Not overly done up. She has what looks like a good marriage, maybe a couple of kids. Maybe she has her own career outside of being a mom, maybe not. Her life looks balanced. She’s still close with her parents. Involved with the school, knows what’s going on with her children. She’s in organizations that help others. Maybe church-based, maybe not.
She’s in a book club and goes out with the girls. They all talk about needing to lose a little weight.
She looks like she’s got it all together.
Maybe you are her, or some version of her. Maybe you know someone like her.
Her friends will tell you, “She’s a fantastic friend, always there for you when you need her.” Strangely enough, they don’t seem to know what kind of deeper issues she might have.
No one really sees her.
There’s nothing innately unhealthy with the picture I have just painted. A woman who is devoted to being a mom and a daughter. A wife, a friend or a professional. Maybe she is someone who is more introspective or less likely than others to be vulnerable. Or maybe you’re a guy with a similar lifestyle.
If it’s a choice, that’s one thing. But could she be intentionally creating this persona?
She might be a Perfectly Hidden Depressed Person. PHDP. Or almost perfectly hidden.
We all develop a persona of how we handle ourselves in public. I myself have the persona of “jokester.” I try to make people laugh to ease my own anxiety. People do other things. There are “wall-huggers.” “Big talkers.”
The PHDP is more likely to be the “hostess,” to take care of everyone’s needs. She doesn’t make anything about her at all.
Perfectly hidden depressed people feel trapped by their own secrets.
They may finally end up in my office. “I don’t know why I am here. My life is so blessed! I think I am just whining.”
Tears may appear but not always. I hear about self-loathing or thoughts that creep into her thinking of just going away.
You can have blessings in your life. And feel their weight. Just because you are admitting that doesn’t mean you are not grateful for those same blessings.
That’s ludicrous.
If I won the lottery, that might seem outstanding. Would I also feel fear? Anxiety about that? Sure. If you are a great beauty, our culture would deem that a stupendous blessing. But would it be hard to garner all that attention? Yep. Doesn’t mean you’re ungrateful.
“I have many close good friends.” “I have four wonderful kids.” “I am extremely involved in my career.” “I survived breast cancer.” All great things.
They can involve anxiety at the same time.
There is another extremely important aspect of PHDP. Frequently, something has happened before all these “blessings” occurred. Something painful that has never been healed or even addressed. That, coupled with the energy it takes to maintain the perfect-looking life?
It’s a set-up for someone trying to look fantastic on the outside – and feeling quite another way on the inside.
The PHDP needs understanding, coping and self-care strategies as much as the next guy. Whether man or woman.
It’s learning to balance. To accept. To admit vulnerability. To talk.
Before your depression gains more power.
So please, count your blessings. But know you don’t have to hide.
***
This post was made extremely poignant in the last months. A well-known woman took her life in our community. Apparently no one, or few, knew she was struggling. I didn’t write this post in response – it was already written. My thoughts and prayers are with those who loved her and were loved by her.
If you experience these feelings, I would love to hear from you. I am going to be interviewing people who have PHD, Perfectly Hidden Depression, in the coming months for a book I am writing. All information will be confidential, and anonymity is guaranteed. This is open to men and women. If interested, email me directly at askdrmargaret@drmargaretrutherford.com. Thanks! You can visit my website here.
If you or someone you know needs help, see our suicide prevention resources.
If you need support right now, call the Suicide Prevention Lifeline at 1-800-273-8255.
Dr. Margaret Rutherford is a clinical psychologist, who has practiced for over twenty-five years in Fayetteville, Arkansas and the author of the new book Perfectly Hidden Depression. Since 2012, her work has been found on her own website (http://drmargaretrutherford.com). She hosts a regular FB Live video session on depression for The Mighty. Her expertise can also be found on The Huffington Post, Reader’s Digest, Prevention, Psychology Today, Psych Central and the The Gottman Blog. Dr. Margaret is the host of the highly popular podcast, The SelfWork Podcast, which has earned over 3M downloads and attracts over 100,000 listeners each month.
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