Are you smiling on the outside but suffering on the inside? Let's learn about (Smiling Depression)!

You have a friend, family member, or someone you know who is always smiling, joking, and seems so happy. We may think that there are no problems in their life, that everything is going well. But did you know that behind that beautiful smile, there could be a lot of sadness, loneliness, and stress? Today we are going to talk about such an important topic. That is 'Smiling Depression'.

What exactly is 'Smiling Depression'?

If you look at the official books that classify mental illnesses, you won't find a condition called 'smiling depression'. Because it's not an official medical term. However, mental health professionals use the term to describe a specific group of people. Those are people who act happy on the outside, even though they're suffering from depression on the inside.

Simply put, you feel very sad and empty inside, but you tell others, "I'm fine." You don't look like you're in any trouble. You go to work, do household chores, and laugh and talk to friends. This is sometimes called 'high-functioning depression.' This means that you go about your daily activities as normal as possible, so your family and friends don't realize that you need help. Sometimes you may not even realize that this struggle in your mind is a symptom of depression.

Who is most affected by this condition?

Since 'smiling depression' is not an official diagnosis, there hasn't been much research on it. However, according to doctors, these symptoms are most common among the following people:

• People in cultures where talking about mental health issues is scary and embarrassing: Even in our society, if you say "I'm feeling down," you're afraid of being labeled "crazy." That's why many people hide their sadness.
• Perfectionists: People who think, "I can't do anything wrong," "I always have to be strong," and don't want to show their weaknesses.
• People who live successful lives on the outside: those who have a good job, a family life, an education, and no outward signs of weakness.
• People who suffer from mild or moderate depression that has been going on for a long time: We medically call this condition ``Persistent Depressive Disorder''.

In general, depression can affect anyone, regardless of age or gender. However, certain groups are at higher risk. For example:

• Women
• People belonging to the LGBTQI+ community
• If you or someone in your family has had depression before
• People who face major setbacks, traumas, and high levels of stress in their lives
• People with serious illnesses such as diabetes, cancer, and heart disease.

What are those hidden symptoms?

If you have 'smiling depression', you may experience the typical symptoms of depression. The difference is that you hide them from others. Let's take a look at what these symptoms are.

The important thing is, you don't have to have all of these symptoms. If several of them affect your life for more than two weeks, even if it doesn't seem obvious to others, you may have depression.

What's the danger in keeping this a secret?

When you hide your grief, people around you may not realize that you need help. This can delay the treatment you need. Here are some things that can happen when you don't get treatment:

• Increased risk of addiction to alcohol or other drugs.
• Abnormal changes in body weight.
• Increased risk of physical illness.
• Self-harm, for example, cutting oneself.

The most dangerous thing about all of this is that depression increases the risk of suicidal thoughts. Because it takes a lot of strength to even smile and act. When that strength is gone, the chances of making a dangerous decision are high.

If you or someone you know is having thoughts of suicide, please don't go it alone. Seek help immediately.

• Talk to your family doctor.
• Go to the nearest hospital's Emergency Department (ETU).
• Call the Sri Lankan Friends (Tel: 0112692909). They are ready to listen to you.
• In the event of an overdose, call the National Poison Information Centre (0112686143) located at the Colombo National Hospital immediately.

How do you know for sure if this is a disease?

If you suspect you have depression, the first step you should take is to see your family doctor . He or she will ask you questions and possibly do some blood tests to check for other physical causes, such as a thyroid problem. Then, if necessary, he or she will refer you to a mental health professional, such as a psychiatrist.

There, they may give you a series of questionnaires to learn more about your thoughts, feelings, and behaviors. After looking at all of this, they will determine what type of condition you have, according to the official mental health classification manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). That diagnosis may be either Major Depressive Disorder or Persistent Depressive Disorder.

What are the treatments for this?

The good news is that 'smiling depression' is also a completely treatable condition . There are two main treatment options:

1. Medications: The most commonly used class of medications is called selective serotonin reuptake inhibitors (SSRIs). These work by balancing the activity of neurotransmitter chemicals in the brain, such as serotonin. It may take some time to find the right medication for you.

2. Psychotherapy: This is also called simply 'counseling'. Here, you talk to a trained professional about your problems, help them change their thinking patterns, and help them learn new ways to cope with their problems. Cognitive Behavioral Therapy is a popular method used for this.

Things you can do yourself (Self-help)

Along with treatment, there are several things you can do yourself to improve your mental well-being:

• Exercise: Even walking for 30 minutes a day can make a big difference.
• Regularize your sleep: Get into the habit of going to bed and waking up at the same time.
• Eat a healthy diet: Eat meals on time, eat nutritious things.
• Talk to someone you trust: Share what's on your mind with a friend or family member.
• Stay away from alcohol and drugs.

How can you help a friend of yours if they are in this situation?

It can be difficult to recognize someone with 'smiling depression.' However, you may notice subtle changes like these:

• Changes in sleep patterns (sleeping too much or too little).
• Changes in appetite.
• Not responding to calls and messages as quickly as before.
• Frequent complaints about headaches and body aches for no reason.

If you suspect someone like that, here's how you can help:

• Talk to the person: "I see you're not the same as you used to be, is there something wrong?" Ask lovingly.
• Explain that depression is not something to be ashamed of, but a treatable illness.
• Suggest seeing a doctor. You can go with him if you want.
• Stay with that person. Saying "I'm with you" is also a great strength.

Depression, Mental Health, Smiling Depression, Stress, Sri Lanka