Skip to content

10 Characteristics of Perfectly Hidden Depression

Characteristics of Perfectly Hidden Depression

What is perfectly hidden depression? How would you know if you’re suffering from it? Perhaps you have a perfect-looking life outwardly, yet inwardly you struggle with a sense of something being wrong, or even more dangerously, you have fleeting thoughts of suicide or escaping your very busy life.

However, you’ve also become an expert at keeping your true feelings from others. You like your feelings being under control. You may be aware you’re intentionally hiding pain (as in what’s termed “smiling” or “high-functioning” depression), but it’s also possible that you have no real clue.

The dynamic may have entrenched itself so far into your very being that you may be largely unconscious of its presence, except for a deep tug in your gut that whispers to you that something’s terribly wrong. 

You may have even searched online, trying to understand what that tug could be. You looked at the criteria for depression and when you didn’t fit into them, you might easily have felt shame at how obviously ungrateful you are for your success.

What may be intriguing in the exploration of perfectly hidden depression (PHD) is this question: If you don’t know how to reveal your pain, how do you figure it out yourself? And how would anyone else know? 

So, let’s talk about a set of characteristics commonly present in perfectly hidden depression. Remember, PHD isn’t a diagnosis. But perhaps in a grouped set of behaviors and beliefs, or syndrome as it’s called, you’ll find yourself there. And be relieved that finally, there’s a name for what you’ve been experiencing. 

Related: 6 Questions To Ask Before You Believe You’re Depressed

10 Commonly Shared Characteristics Of Perfectly Hidden Depression

Following are ten primary characteristics of PHD. They’re not all present in every person who might recognize themselves in PHD. But they’re fairly consistent.

1. You Are Highly Perfectionistic, With A Constant, Critical Inner Voice Of Intense Shame. 

Having a perfectionistic streak is one thing. You try to do your best: “If it’s worth doing, it’s worth doing well.” Yet if you silently berate yourself if you’re not at the top at all times, there’s a problem. You may allow yourself one area in which you’re not proficient; for example, you may laughingly admit you couldn’t skate if your life depended on it. Or you can’t tell a joke.

But if it’s an activity or a pursuit that’s meaningful to you, it needs to appear perfect, especially if it’s going to be evaluated or seen by others. You’re the perfect parent, most accomplished lawyer, head of the class, or best friend.

You consistently measure and evaluate your status, and if you’re not meeting perceived expectations, you ramp up the pressure. Inner shame pummels you every hour of every day.

10 Characteristics of Perfectly Hidden Depression
Perfectly Hidden Depression

2. You Demonstrate A Heightened Or Excessive Sense Of Responsibility.

You’re very aware of duty, obligation, and loyalty, and can be counted on in a crunch. You’re the first to notice when something’s going wrong and look for solutions.

You’re a good leader, although not the best delegator. This sense of responsibility can turn painful, as you may readily blame yourself, rather than taking a moment to understand the entire picture. 

Related: What Being Depressed Looks Like: The Hard-Hitting Truth

3. You Have Difficulty Accepting And Expressing Painful Emotions.

I know when I’m sitting across from someone who may struggle with PHD as I watch them smile brightly at me, while simultaneously describing a significant loss or disappointment. Not always. But it’s a question I begin to ask myself as a therapist.

Anger is avoided or denied. Sadness is banished to the back of the closet. Disappointment is for whiners. You may not even have the words to express these emotions. You stay in your head most of the time, rather than connecting with your heart — analyzing, decoding, thinking through things.

Pages: 1 2 3

Dr. Margaret R Rutherford

Dr. Margaret Rutherford, a clinical psychologist, has practiced for twenty-six years in Fayetteville, Arkansas. Earning the 2009 Arkansas Private Practitioner of the Year award for her volunteer work at a local free health clinic, she began blogging and podcasting in 2012 to destigmatize mental illness and educate the public about therapy and treatment. With her compassionate and common-sense style, her work can be found at, as well as HuffPost, Psych Central, Psychology Today, The Mighty, The Gottman Blog and others. She hosts a weekly podcast, The SelfWork Podcast with Dr. Margaret Rutherford. And her new book, Perfectly Hidden Depression: How to Break Free from the Perfectionism that Masks Your Depression, is published by New Harbinger and available at Amazon, Barnes, and Noble or your local bookstore.View Author posts