Are You Depressed But Only You Know It? 5 Steps To Unmask Depression

Steps To Unmask Depression

Depression wears many faces. Far too often, no one can see it because it doesn’t look like classic depression; instead, it’s cloaked beneath the facade of the perfect-looking life. The mask of looking in extreme control hides your actual reality from everyone around you…and perhaps even yourself.

Who wears this face?

She’s Janet, the professionally successful young woman who years ago woke up alone and naked in a hotel room, not remembering how she’d gotten there. She knew she’d been raped, but she quickly found her clothes, went home, and stayed silent. Why? The shame and fear were too great and she’d been taught as a child that pain needs to be shuttered away.

I put it out of my mind,” Janet tells me now, smiling. “Plus it was so long ago.”

But why was she in therapy? She throws up at least twice a day – and has for years. 

Then there is Vanessa, the impeccably dressed mother and wife who’s very active in the volunteer community; everyone relies on her, respects her, and loves her. They don’t know that she’s developed a growing panic that makes her dread social gatherings. She swallows Xanax and wine to cope. I ask her when her depression began and she looks at me, somewhat surprised, ”Oh, I’m not depressed. I don’t cry or anything. I have far too many blessings in my life to be depressed.”

Or he’s Jay, the man you can always count on; always willing to go the extra mile for someone else. He’s a divorced and remarried father, a successful lawyer who came into therapy because his wife dragged him into couples counseling, which went well. He called back months later, ”I’d like to talk to you by myself.”

Old hurts had been banished from his psyche. He’d been sexually abused by a grandfather who’d also been his major go-to support, teaching him to fish and hunt. He’s confused and doesn’t know why he constantly has to be busy. 

Related: 13 Habits of People With Concealed Depression

Perfectly hidden depression…

Each one of these people is experiencing what I termed perfectly hidden depression. Janet, Vanessa, and Jay had learned that emotional survival – a kind of pseudo-safety – could be found in seeming as if they were in control – looking as if nothing was painful. Or even that they had the world by the tail. And the most recent research on perfectionism shows that this trap of “the better I do, the better I’m expected to do” can lead to true danger.

Does this sound familiar to you? Do you recognize yourself in these stories? And if so, how do you change? How do you stop hiding?

Here are the five steps I recommend for healing.

These five things can lead you into acknowledging your own vulnerability and finding self-acceptance, which is the antidote for shame. 

Are You Depressed But Only You Know It? 5 Steps To Unmask Depression
Are You Depressed But Only You Know It? 5 Steps To Unmask Depression

1) Become aware or conscious of how perfectionism is a problem in your life.  

Don’t get me wrong. Striving for excellence isn’t bad in and of itself, but shame doesn’t have to govern your life. 

If you don’t realize that perfectionism is encroaching on your joy, if you don’t recognize that you’re growing lonelier and more despairing, then it’ll be difficult to address it as something you need and want to change.

Instead, you could be escaping your pain in various ways: alcohol, prescription medications, eating problems, or obsessive behaviors are some of the most common. But all of that is kept secret from others, and perhaps even from yourself.

Are You Depressed But Only You Know It? 5 Steps To Unmask Depression

2) Face your fear of letting go of perfectionism. Commit to the change. 

Make a commitment to changing your facade of perfection. This is very hard with perfectly hidden depression. After all, on the surface, all seems fine. No one is worried about you, or texting, “Hey are you okay?”  No one. So it’s easy to hide. It’s easy to put out another smiling selfie and pretend that the gnawing sadness isn’t really there.

But you can do it. And you’ll make mistakes. You’ll relapse into your striving for perfection. And that’s okay.

Related: How to Stop Perfectionism From Controlling Your Life

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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