If they enter therapy, they won't meet criteria for minor depression, called dysthymia, because they will look far too confident, too well-connected, too into what they are doing. They'll tell you that their lives are going great, and that they have so much to be grateful for.
They won't qualify as having major depression, because they are far from isolated, they don't cry or seem to have no energy. They won't admit any feelings of wanting to hurt themselves. They love a lot of what they're doing, they have high expectations that they have set and work very hard on reaching them.
So how could they be depressed? A little high-strung, or not getting enough rest. Perfectionistic. Maybe worry is something they do a lot.
It's depression all right. It's simply hidden beneath a lifetime of acting as if everything was and is fine. It's perfectly hidden depression.
It's not true contentment or authenticity ...
Because there are secrets. And where there are secrets, there is loneliness.
Because there is little self-care or compassion for self. And where there is lack of compassion, there is criticism.
Because this way of life, the perfectly hidden life, doesn't feel like a choice. And where there is lack of choice or freedom, there is enslavement - there are "shoulds," "musts," and "have to's" that govern their lives.
Count up your 'yes' and 'no' responses. If you had:
5-8 'Yes': You're likely to be a very responsible person, though you may need to consider taking more time for yourself.
9-11 'Yes': Your life is being governed by highly perfectionistic standards, which may be detrimental to your well-being.
12+ 'Yes': May reflect the presence of PHD, or a depression that you deny (or are unaware of). You do this by intentionally creating a happy, perfect façade.
Lots of driven, accomplished people share these traits, or have these dynamics in their history. Often, they lead to success and happiness. When many of them are present, you are likely to experience perfectly hidden depression.
Check out Dr. Margaret on her new podcast, Self Work With Dr. Margaret. In each episode, Dr. Margaret takes a direct, solution-oriented approach to depression, anxiety, trauma or grief to guide you toward the changes you want.
Dr. Margaret Rutherford is a clinical psychologist in Fayetteville, Arkansas. In 2012, she began blogging, focusing on mental health topics. Her work can be seen on The Huffington Post, The Good Men Project, Better After 50 and Readers Digest. She also has published one eBook, “Seven Commandments of Good Therapy.” You can listen to Dr. Rutherford on her podcast, SelfWork!