When it comes to smiling depression, there are a few social factors that contribute to why someone may not feel comfortable expressing their true emotions with others. Despite the growing acceptance of being candid about mental health struggles, there is unfortunately still a social stigma. According to a 2007 article published in Social Science & Medicine, mental health stigma refers to discriminatory attitudes and behaviors, as well as biased social structures, towards people with mental disorders. The internalization of public stigma can also bring about self-stigma, which describes the negative perception one has towards themselves for having a mental disorder.
This combination of social stigma and self-stigma doesn’t make it easy for someone to ask others for help. As described by PsychCentral, individuals with mental disorders may fear being seen as weak and worry about being judged by others if they open up their symptoms. Consequently, they may prefer to hide behind a smile and deal with their pain alone.
Cultural expectations also factor into why someone may hide their depression. Due to the harmful societal message that men should “toughen up,” PsychCentral explains that men may be less likely than women to open up about their mental health struggles or seek out professional help. Additionally, some people hide their symptoms because they believe they can simply self-medicate with drugs and alcohol. However, this can lead to substance use problems that can exacerbate symptoms of depression.