Have you ever heard of the term smiling depression, that so many talented artists tend to suffer from, but rarely ever speak of?
He’s one of the country’s best-loved comedians, leaving audiences in stitches with his fizzing sense of humor.
A month before his death, Robin Williams admitted he’s suffered from depression for much of his life.
‘I go through periods of intense self-loathing,’ he said.
Williams is one of a long line of funny men and women who have battled depression. These include Stephen Fry, Ruby Wax, Lenny Henry, and, perhaps most famously, Tony Hancock, who committed suicide aged 44.
These comedians chose to mask their inner torment with a ‘happy’ public persona — and experts believe millions of Britons are doing the same, victims of what they call ‘smiling depression’.
‘Smiling depression is a term often used to refer to a patient who you think is depressed, but doesn’t look it and often won’t admit it,’ says leading London psychiatrist Dr. Cosmo Hallstrom.
‘Sometimes they tell you, “No, I’m not depressed” — and they smile. But it’s a sad smile.’
To the outside world, they give no hint of their problem — often holding down a full-time job, running a family home, and enjoying an active social life. But underneath they are suffering secret panic attacks, insomnia, crushing low self-esteem, and even suicidal thoughts.
It’s a state that Alison Cowan recognizes only too well. An attractive, high-flying marketing consultant from South London, she was diagnosed with severe and chronic depression at the age of 19 but hid it from friends, partners, and colleagues for nearly ten years.
‘My depression was never a lying-in-bed, sleeping type thing,’ she says.
‘I worked hard and played hard — I had an active social life. But inside I felt worthless and utterly ashamed of myself.’
This ability to carry on with life despite everything is what distinguishes ‘smiling’ (or high-functioning) depression, explains Bridget O’Connell, head of information at mental health charity Mind.
‘The recognised symptoms of depression tend to be crying a lot, feeling lethargic, perhaps even not being able to get out of bed. But not everyone with depression displays these symptoms.’
These ‘smiling’ patients might not actually be aware that they’re depressed — or they might have a diagnosis, but refuse to tell anyone, she adds.
‘I go through periods of intense self-loathing,’ said Robin Williams.
The condition is quite distinct from a British stiff-upper-lip attitude to day-to-day troubles.
‘You need to ask yourself, am I struggling to cope today, or have I been struggling to cope for the past three months? These people could be going to work and seeming fine, but going home and literally collapsing,’ says O’Connell.
The latest research shows that one in 20 of us will experience depression.
Yet many live undiagnosed, unsupported, and untreated for years, with potentially devastating consequences, she says.
‘Putting on a brave face is the worst thing to do because you’re just compounding the pressure and not recognizing you’re ill, all of which means you’ll get more ill, take longer to get better and be more likely to have repeat episodes.’
There is another risk, adds Dr Hallstrom.
‘As a doctor, you worry about whether they’ll kill themselves, that it’s all part of a plan and they’ve already decided they can’t be helped, so they smile but they’re already planning suicide. That’s the worry with smiling depression.’