CHRISTMAS is meant to be the merriest time of the year.
But thanks to family rows, the stress of cooking the turkey, and the cost of buying presents, we can all end up feeling a bit burnt out by New Year’s Eve.
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It’s even harder if you’re trying to slap on a smile for the sake of everyone else, which is what lots of people with ‘smiling depression’ will be doing this Christmas.
We all feel low sometimes, but around one in 10 people suffer from depression.
And it’s thought that up to 40 per cent of those could be suffering from ‘smiling depression’.
The condition sees people pretending to be jolly and telling everyone they’re full of festive cheer, when actually on the inside, they’re really struggling with their mental health.
What is ‘smiling depression’?
“Smiling depression is not an official clinically diagnosable condition, but a term used when someone, whatever their gender or background, is struggling with depression yet masking this by smiling and giving the impression of being happy,” explains Anita Gohil-Thorp, a coach and mental health first aider.
“With smiling depression, your loved one is aiming to give the impression that they’re fine.
“They seem to have things in control, and, at work, they may be performing well.
“Deeper down inside, they are suffering.
“They want to fit in and think that pretending to be happy helps keep what is really going on, hidden.”
This can all build up and lead to people feeling increasingly lonely, isolated and low – despite the smiles on their face.
In severe cases, people can even have suicidal thoughts.
Olivia Remes, a PhD candidate at the University of Cambridge, told The Sun that the condition can actually put people at even greater risk of suicide – the biggest killer of Brits under the age of 35.
That’s why The Sun launched its You’re Not Alone campaign, to raise awareness of mental health and suicide, and to remind anyone struggling that there is help out there.
What are the signs of ‘smiling depression’?
“If your loved one is masking how they’re truly feeling with behaviours that we connect with happy people, smiling depression will not be easy to notice,” says Anita.
Here’s what to be alert to…
1. Fatigue
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We’re all pretty tired at the end of the year, but do they seem more shattered than you’d expect?
“Keeping a smile on our face when we don’t feel like it uses up energy and resources,” says psychologist Toby Ingham.
Trouble sleeping, problems with concentration and difficulty remembering things, can kick in too.
2. Headaches and tummy problems
Yes, your tummy pain could be too many mince pies or overdoing it on the Baileys, but it could also be smiling depression.
“There may be a coincidental increase in other psychosomatic type problems such as headaches or stomachaches,” says Toby.
3. Overeating
We all tend to eat too much over Christmas.
But people with smiling depression may take it to excessive levels.
4. Sense of heaviness in the arms and legs
Is your loved one barely getting up off the sofa and just watching Christmas films back-to-back?
This could be another warning sign.
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5. Extra sensitive to criticism or rejection
Family rows are part and parcel of Christmas.
But do they seem to be particularly affected by the fallout?
6. Sleeping longer than usual
Are you unable to get them up, even for presents or Buck’s Fizz?
Sleeping for longer than usual is another potential red flag.
7. Withdrawal, less interest in self-care or hobbies
Slowing focus and a reduced ability to fully function cognitively in typical day-to-day activities can also be warning signs, says Anita.
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What should you look out for specifically at Christmas?
Switch the telly on or walk down the high street and you’ll be inundated with images of super happy families having an amazing time together around the Christmas tree.
It’s lovely and festive, but this can make people with smiling depression feel even worse and under even more demand to appear merry at all times.
“During the festive period and the weeks leading up to Christmas Day, there are often greater pressures to appear happy,” says Anita.
“It can be overwhelming for anyone, let alone someone already in a dark place.”
Your loved one might express little interest in the festivities or try to put you off committing to too much – while tonally they seem fine – and suggest it’s in your best interests.
“For example, they might say: ‘You always do so much for everyone, how about it’s just us this year?’” warns Anita.
“While we may all get exhausted at this time of year, someone masking depression will feel even greater fatigue, mental stress and exacerbated ailments, such as headaches or body pains.
“Pay attention, therefore, to behavioural signs or facial expressions of pain, even if your loved one is outwardly cheerful.”
What help is available?
At Christmas, it can be harder to get to speak with your GP and harder to get an appointment.
Nonetheless, it may be helpful to get one in the diary for after the holiday, that way you know you have a plan.
In the meantime, encourage your loved one to look after themselves, or if you’re struggling with smiling depression yourself, try to do more things you enjoy.
Take a bit of time to put yourself first.
Your loved one’s GP may suggest counselling or refer them for Cognitive Behavioural Therapy (CBT) – a treatment often used to treat depression by helping you reframe thoughts.
Over the festive period, services like The Samaritans (call 116 123) and Mind, the mental health charity, as well as the Campaign Against Living Miserably, are still running and are on hand to help.
Anita adds: “You may notice they are over-compensating, for example, trying too hard in conversations, trying to be the life and soul of the party, which is out of character.
“Changes in what you know to be their usual behaviour can be a sign that things are not as they seem on the surface.”
Toby says to look out for “someone putting a smile on their face even when things are not going so well” – which, from the turkey being undercooked to arguments over board games, is guaranteed to happen at some point.
“Christmas is a complicated time involving all sorts of complicated agendas,” he adds.
“Try to keep track of how your mood, or that of someone close to you, is changing.
“Are they starting to behave in ways that are not like them?”
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How can you support a loved one?
“If you notice your loved one’s starting to show signs that things don’t look as good as they are making out, see if you can find time to talk with them on their own and find out more about what’s going on,” says Toby.
“Tread carefully because they may not be as aware as you are that something is wrong.”
“Remember that the pressures of the festive period can lead a person with depression to experience their depressive thoughts and feelings more strongly,” adds Anita.
“They may well have heightened feelings of hopelessness – it’s important to check in with them.”
She recommends starting a conversation with them gently, without judgment, to help them open up.
“Ask an open question, with a compassionate tone, such as: ‘How are you finding things as we get closer to Christmas?’,” she says.
“Be mindful that your loved one likely does not want to be a burden and so may continue to mask how they feel.”
Anita adds: “If you are worried about your loved one, consider gently raising the topic of contacting their GP who will assess them.
“This can, of course, be trickier during the festive period but, if it feels like an emergency, attend your local urgent care centre or A&E.”
Remember…
“It’s normal that we might go through times where we lose some of our confidence and energy,” says Toby.
“All kinds of events can trigger a change in mood, and Christmastime is often more pressured and full of memories and emotions than we realise.
“Remember, it’s normal to not like or want to go along with everything.
“If you give yourself one gift this Christmas, make that the gift of not having to like and smile at everything.”
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