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9 Paths That Lead To Perfectly Hidden Depression

paths that lead to perfectly hidden depression

How did you learn to hide pain? Maybe you took your pain, or any sign of vulnerability or sadness, and hid it behind a camouflaged persona of happiness and productivity that shielded the real you from the eyes of the world. Maybe you pushed yourself relentlessly to build a life that looks perfect from the outside. 

Maybe you’re aware of this destructive adaptation. And maybe, you’re not — until you stop and you allow yourself to notice there’s no one who really knows you because you don’t allow them in. If this sounds like you, perhaps you’re experiencing what I call perfectly hidden depression.

You’re Not Alone…

I wish you could read the personal emails I’ve received; there are thousands from the United States, but also from all over the world: Malaysia, South Africa, India, France, Brazil, Ireland, Australia…

They’ve been written by doctors, advertising executives, teachers, chefs, people from all walks of life. The one thing they have in common? They’ve read or listened to my posts and podcasts on perfectly hidden depression. And their response, “I’m hiding. And doing it very well.”

Perhaps one of those emails has come from you…or perhaps you’ve thought of writing but haven’t yet. Perhaps you were relieved to find yourself relating to the concept of perfectly hidden depression because you’d searched in the past for answers but couldn’t find them because you didn’t meet the standardized criteria for depression. 

Related: 13 Habits of People With Concealed Depression

9 Common Pathways To Destructive Perfectionism

But how did your hiding begin? There are nine common pathways that set the stage for this kind of adaptation, where you coped by creating a perfect-looking persona. 

1) You were sexually or physically abused.

The damage from being the target of sexual manipulation or violence can silence you, particularly if you were told to shut up and keep the dark secret of your family. Whether or not your abuse was secret from others besides your abuser, your life was out of your control.

You weren’t safe as a child (or perhaps you’re not safe even as an adult). Staying in control has become vital to your way of life, and you’ve remained silent and absorbed shame that didn’t belong to you. 

2) You were a child of alcoholics or addicts.

You learned to be hyper-vigilant and kept your feelings completely to yourself because it was far from safe to communicate them to the ones who were supposed to nurture and protect you. You may have devoted yourself to school or athletic activities, a job — anything to keep you away from home.

You might have done whatever you could to become invisible to your parents to protect yourself from their toxicity, never making waves to attract their attention. Now as an adult you remain cautious, looking as if you’re doing ‘fine” but waiting for others to disappoint. 

3) You were emotionally abused.

You were told you weren’t going to amount to anything, or that you were too sensitive, a whiner, a bother, unwanted, perhaps even unloved. Those words can be etched in your mind for quite a long time; you’re left obsessed with proving that parent, teacher, or coach wrong.

So you create a perfect, very successful life, and you avoid admitting vulnerability like the plague.

Related: Why Successful, Confident People Still Feel Inferior Or Incapable

4) You took a pseudo-adult role in your family as a child.

It was your job to take care of all the others in your family. Perhaps one or both of your parents suffered mental or physical illness or was someone who couldn’t act like an adult. Maybe you were the eldest child, or maybe you were simply the one most innately responsible.

You took care of your brothers and sisters, making sure they were fed, did their homework, and were asleep at a decent hour. You made sure a parent took their medication, or you picked them up from the bar at night. You became someone who made sure necessary tasks were accomplished, cleaning the house and doing the grocery shopping…and you were good at it.

You began hiding how lonely and in need of comfort you were. You had to be okay — so you were okay. 

Perfectly hidden depression
Perfectly hidden depression
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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