Questionnaire: Do You Have Perfectly Hidden Depression?

Editor’s note: The following can not be used as a diagnostic tool. If you think you might have depression, please see a doctor. 

It’s a kind of depression we in psychology are missing.

It’s not easy to detect, because people who have it, hide it. They know what they are doing, in a way. But it’s been their go-to way of coping for so long, it simply seems like who they are — or who they have become.

They may not even realize it’s depression. I call it Perfectly Hidden Depression (PHD).

If they enter therapy, they won’t meet criteria for chronic depression, or what is called dysthymia, because they will look far too confident, too well-connected, too into what they are doing. They’ll tell you that their lives are going great, and that they have so much to be grateful for.

They won’t qualify as having major depression, because they are far from isolated, they don’t cry or seem to have no energy. They won’t admit any feelings of wanting to hurt themselves. They love a lot of what they’re doing, they have high expectations that they have set and work very hard on reaching them.

So how could they be depressed? A little high-strung, or not getting enough rest. Perfectionistic. Maybe worry is something they do a lot.

It’s depression all right. It’s simply hidden beneath a lifetime of acting as if everything was and is fine. It’s not true contentment or authenticity…

Because there are secrets. And where there are secrets, there is loneliness.

Because there is little self-care or compassion for self. And where there is lack of compassion, there is criticism.

Because this way of life, the perfectly hidden life, doesn’t feel like a choice. And where there is lack of choice or freedom, there is enslavement — there are “shoulds,” “musts”  and “have to’s” that govern their lives.

What follows is a questionnaire for you to take, to help you identify, or not identify, with this group, or syndrome, of behaviors. If you do, I hope you will read my other posts on the topic, and seek help.

How do you know if you have Perfectly Hidden Depression? Take this short questionnaire to find out. Try to be honest with yourself. Scoring instructions are at the end. You can also click here to download the questionnaire.

•  Do you struggle with confiding in others — especially about your real-life difficulties and problems? Yes______ No______
• Do you obsess about things looking perfect, both for yourself and through others’ eyes? Yes______ No______
• Do you avoid talking to your partner (or your friends) about feeling hurt by them, or about a growing resentment you might have? Yes______ No______
• Do you have trouble sleeping or turning your mind off at night? Yes______ No______
• Do you have trouble admitting when you’re feeling overwhelmed? Yes______ No______
• Do you push yourself to get the job done, regardless of the cost to you? Yes______ No______
• Do you respond to the needs of your friends even when it can short-change your own? Yes______ No______
• Did you grow up in a family where feelings of sadness or pain were avoided, or where you were criticized or punished for expressing them? Yes______ No______
• Have you ever been hurt emotionally, physically or sexually, and told no one? Or if you did tell someone, you weren’t believed or supported? Yes______ No______
• Did you grow up in a family (or are you still experiencing a family) where you felt like you had to meet defined expectations rather than being allowed to be yourself? Yes______ No______
• Do you like to have control of a situation if you’re going to be involved? Yes______ No______
• Do you have a growing sense that it’s becoming harder to maintain an organized structure in your life? Yes______ No______
• If so, do you feel anxiety or even panic? Yes______ No______
• Do you tend to not cry or rarely cry? Yes______ No______
• Are you considered ultra-responsible, the one that can always be counted on by your co-workers or family and friends? Yes______ No______
• Do you think that taking time for yourself is selfish? Yes______ No______
• Do you dislike people considering themselves “victims” — that it’s not their fault when something goes wrong? Yes______ No______
• Did you grow up being taught you were supposed to handle painful things on your own? That asking for help reflected weakness? Yes______ No______
• Do you strongly believe in focusing on the positives in your life, or “counting your blessings”? Yes______ No______
• Do you have a critical, nagging inner voice telling you you’re not good enough, or that you could have tried harder, even though you accomplished your goal? Yes______ No______
• Do you outwardly seem hopeful and energetic while, at times, you struggle with a sense of being trapped? Yes______ No______
• Do you make lists of tasks to get done during the day, and if they are not completed, feel frustrated or like a failure? Yes _______ No_______
• Were you an older child in a family where parents weren’t available, and you took care of your younger siblings? Yes_______ No _______
• Did you have to care for an alcoholic or otherwise dysfunctional parent as a child? Yes _______ No_______
• Were you told that you were extremely special to one parent, and felt that you needed to please them in order to maintain their emotional stability? Yes_______ No _______

Count your positive answers to the questions above. If you answered “yes” to five to eight questions, you’re likely to be a very responsible person, though you may need to consider taking more time for yourself. A “yes” response to eight to eleven questions indicates that your life is being governed by highly perfectionistic standards, which may be detrimental to your well-being. Twelve or more positive responses may reflect the presence of PHD, or a depression that you deny (or are unaware of). You do this by intentionally creating a happy, perfect façade. Lots of driven, accomplished people share these traits, or have these dynamics in their history. Often, they lead to success and happiness.

When many of them are present, you are likely to experience PHD.

If you’d like to know the first steps in addressing PHD, click here.

See more from Dr. Rutherford on her site.