Keeping depression out in the open requires constant attention.
Ignoring it, or worse, assuming I am “over it,” has dire consequences. As I learn to live with depression, I am learning more and more about how it works. I am learning how secretive it wants to be, and how tempting it can be to follow its ideas.
Understanding this has helped me see that depression isn’t only about the big picture choices. It is infused in every small, seemingly innocent thought and decision I make. My thought process has been built with depression as the architect, creating elaborate processes that guide my thinking towards the unhelpful.
And if that wasn’t bad enough, depression wants me to take the credit for all of its handiwork. So, when the s^%t hits the fan, I am the one getting sprayed. By my outward appearance, you would never know all that was going on just beneath the surface. I am the poster boy for “never let them see you sweat.”
And let’s be honest, that is not always a bad thing.
The world needs people who can remain calm in the face of adversity, who can make rational decisions in the middle of chaos, who can take hold of situations that are out of control and restore order. These are all valuable traits in any culture, society, business, or family.
But the cost of my being able to do that has been enormous.
Doing a lot of reading about depression, I came across another great article. It turns out there is another trademarked name for my concealed depression. I have already learned about ‘high-functioning depression.” I immediately identified with the bullet points the author laid out.
Now I am learning that I have at least 8 of the 10 traits of Perfectly Hidden Depression.
Perfectly Hidden Depression. It is almost like the author saw the movie of my life and then wrote the article. My knee-jerk reaction is that it pisses me off. How can this be me? I get the good parts, but how can I be the person described in the article? Even the first point is at least 50%. You try to do your best: “If it’s worth doing, it’s worth doing well.” I do not feel I am a perfectionist, but I am in it to win it, every time.
Point 5 in the article hits home with me.
You intensely focus on tasks, using accomplishment as a way to feel valuable.
“You’re only as good as your last success.” You count on activity and accomplishment to distract yourself from any inner insecurities or fears that might try to seep out of hiding.
I keep lists, I check things off the list, I add new things to the list. I compare my daily success to how much of the list I have accomplished. Sometimes, I will write something I have done on the list, just so I can cross it off. Crossing things off the list gives me positive endorphins. Here is the article that has me thinking all over again about my relationship with depression.
10 commonly shared characteristics of perfectly hidden depression
Following are 10 primary characteristics of PHD. They’re not all present in every person who might recognize themselves in PHD. But they’re fairly consistent.
If you identify with PHD...
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 you can silently berate yourself if you’re not at the top, at all times. You may allow yourself one area in which you’re not proficient — for example, laughing and saying 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 is 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 governs your choices and your world
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. This tendency can leave you vulnerable to manipulation.
3. You have difficulty accepting and expressing painful emotions.
I know when I’m sitting across from someone who’s smiling brightly at me while simultaneously describing a significant loss or disappointment that I may have tripped over someone else who’s hiding. 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 heart — analyzing, decoding, thinking through things.
4. You worry a great deal and avoid situations where control isn’t possible.
You aren’t someone who can stay easily in the present. If you do yoga, you may hate the final position, for which the suggestion is to breathe and relax. You may love to cook but have a very hard time sitting with guests and enjoying the meal.
The need for control is strong, and so a lot of time is spent worrying about the things that might occur to interrupt that control. Ironically, it’s important to hide this worry. So, it might not be obvious to others that it exists. People will shake their heads and wonder aloud, “You never seem to have a care in the world. You don’t sweat the small stuff.”
You bet you’ll look as if things move easier for you, and without much effort; your worry is hidden, right under the smile.
5. You intensely focus on tasks, using accomplishment as a way to feel valuable.
“You’re only as good as your last success.” You count on activity and accomplishment to distract yourself from any inner insecurities or fears that might try to seep out of hiding. We all do this to a certain extent. If you’re having a bad day, it feels good to get something done that perhaps you’ve been putting off. Or you get a promotion at work. Or someone emails you about how your kindness was so meaningful to them. There’s value in purpose and effort.
But you carry it too far. You may not know what brings you a sense of esteem, except for those accomplishments and tasks. And that’s the problem.
6. You have an active and sincere concern about the well-being of others while allowing few if any into your inner world.
This isn’t a fake concern, and it’s not pretend or insincere. It’s real: Caring for others is what you do very well. However, you don’t let others sense any vulnerability. You don’t reveal pain from your past. Your spouse might know, but it’s not discussed. There’s a wall up against anyone discovering that you’re lonely or fatigued, empty or overwhelmed.
This can be especially frightening when suicidal ideation is present. And you can’t let anyone in. Devastatingly, even if you do, you may not be believed. “What, you? Depressed? You’ve got everything in the world going for you.” And that could lead to devastating consequences.
7. You discount or dismiss hurt or abuse from the past or the present.
Compartmentalization is a skill. It’s the ability to be hurt, sad, disappointed, afraid, or angry about something and to put those feelings away until a time when you can deal with them better. Healthy people do it all the time. You can even do it with joy or happiness. Sometimes it’s not the time to burst out singing.
However, if you identify with Ph.D., you rigidly over-compartmentalize. You’ve developed very strong boxes where you lock painful feelings in, consciously or unconsciously, shoving them into a dark recess of your mind. This allows you to discount, deny, or dismiss the impact of life experiences that caused pain in the past, or the present.
One woman identifying with Ph.D. emailed recently that she’d been diagnosed with PTSD, and that she totally dismissed it. “What happened to me was no big deal,” she wrote. “Much worse things have happened to other people.” That may or may not be true, but the pain is still pain.
8. You have accompanying mental health issues, involving control or escape from anxiety.
You live your life in a very controlled, well-governed fashion. So actual psychiatric diagnoses that might co-exist with Ph.D. might be disorders having to do with control, such as eating disorders and/or obsessive-compulsive traits. Alcohol or sedative medications could be used to escape anxiety as well.
9. You hold a strong belief in “counting your blessings” as the foundation of well-being.
I believe in counting your blessings. You bet: It’s healthy, and it can keep you optimistic and grateful. However, if you’ve read this far and identify with Ph.D., you may feel guilt or even shame if you are ever anything but rigidly positive. Expressing compassion toward yourself? That’s out of the question; you’ve got too many blessings in your life. And any suggestion of self-compassion gets designated as whining or complaining. And that’s not allowed.
10. You have emotional difficulty in personal relationships but demonstrate significant professional success.
The vulnerability that is linked to true intimacy is hard for you. While driven to be productive and achieve, you aren’t likely to be someone who can easily relate on an intimate level. And you may have chosen a partner, who in fact, doesn’t allow vulnerability, either, or doesn’t have that capability. Your relationship will be based primarily on what you do for each other, rather than who you are for each other, with the emphasis staying on the kids, your careers and being the perfect-looking couple.
Margaret Rutherford, Ph.D., is a clinical psychologist with more than 25 years of experience in treating individuals and couples for depression, anxiety, and relationship issues. My thanks to her for the wonderful article.
My inner perfectionist, accomplishment voice wants me to show examples of each of the ten traits.
But my practical voice says that I need to get a shower and get reading for work. So I will leave examples of how I exhibit the other traits for a future blog post.