Because of the continuing stigma, we don’t always recognize when people in our lives are struggling with this illness. Worse, too many people go undiagnosed because of erroneous assumptions about how depression manifests and what to look for. This results in a number of people who’s depression is hidden, either from others or from themselves. Especially when a person with depression is undiagnosed, they may develop ways of coping with their problems that conceals their illness from those around them or keeps the person from recognizing their symptoms for what they are. We need to unlearn the assumption that suffering is always clearly visible to us, so that we can better understand and help those who struggle with illnesses that go unseen. Here are some signs that someone might have hidden depression.

1. They might not “look depressed”

Due to media and cultural stereotypes, most of us have assumptions about how someone behaves and looks if they’re struggling with depression. We imagine someone who rarely leaves their room, doesn’t dress themselves well, and constantly looks miserable, but people with depression do not all behave in the same way. All people are, of course, different from each other, and the symptoms and coping abilities of people with depression also differ. Many are able to keep up a facade of good mental health to protect themselves, but they aren’t suffering any less simply because they can do this. Similarly, those who are unable to keep up such a facade are not “weaker” than those who can.

2. They may often seem exhausted or complain about always being tired

A prevalent side effect of depression is constant exhaustion. Not everyone with the disorder struggles with it, but it’s extremely common. For those who experience this symptom with their depression, it’s often one of the hardest side effects to cope with. Also, if someone is living with an undiagnosed depression disorder, the cause of their exhaustion can be baffling. They can get plenty of sleep each night and still wake up every morning feeling like they only slept a few hours. Worse, they may blame themselves, believing it to be laziness or some other personal fault that’s causing their low energy levels. This is also a symptom that’s difficult to conceal for those who have been diagnosed with depression but are attempting to keep it from their peers, as it often affects their workload and personal relationships.

3. They can be unusually irritable

A depressed person’s behavior might be interpreted as melancholy even if that’s not what they’re really feeling. Irritability is a frequently overlooked symptom of depression that is also very common. This should be understandable, since depression is a health problem you can’t “see” or strictly measure, making it hard to combat. The constant work it takes to keep up all the necessary aspects of life while dealing with depression also drains the person, and leaves little room for patience or understanding. If someone you know discovers they’re clinically depressed and shares this with you, you may initially be confused if their previous behavior didn’t fit the common misconception of the shy, silent depressed person. If they tend to have a short temper and are quick to annoy, that’s actually a side effect of depression.

4. They could have a tough time responding to affection and concern

The main misconception about depression, which has been hinted at in the paragraphs above, is that it’s about “feeling” sad. On the contrary, depression is mostly not feeling anything, or only partially and briefly experiencing emotions. It depends on the individual, but some people with depression report feeling almost “numb,” and the closest thing to an emotion they experience is a kind of sadness and/or irritation. Because of this, appropriately responding to gestures or words of affection will be difficult for them, or they just don’t think about it any more. They may even get irrationally irritated or annoyed with you over it, because it may simply be too difficult for their brains to process and respond to your loving gestures.

5. They might frequently turn down activities they used to love or would otherwise enjoy

Unless other explanations could equally be possible, an uncharacteristic lack of interest in activities over an extended period of time could be a sign that someone has depression. As mentioned above, depression is just as physically draining as it is mentally draining, which makes enjoying all the things you usually do difficult. Previously-loved activities can even lose their appeal in general, because depression also commonly makes it difficult to enjoy or feel fulfilled by much at all. If you have no other way of explaining their decreasing interest, it could be a symptom of clinical depression.

6. They can develop abnormal eating habits

Abnormal eating habits mainly develop for two reasons: as a form of coping, or as a side effect of lack of self-care. Eating too little or too much is a common sign of depression. Overeating is often shamed the most, when food can be the one source of pleasure a depressed person is able to give themselves and thus causes them to eat excessively. When a depressed person is eating too little, it’s often because their depression is affecting their appetite and making eating unappealing. It can also be a subconscious need to control something, since they cannot control their depression. If someone is undiagnosed or has not shared that they have depression, people will assume their eating habits are a personal fault and judge them for it, making the person feel worse.

7. They may start needing more from you

A depressed person legitimately can’t function like a mentally health person. There will be things they will no longer be able to do as much of, as often, or at all. Pestering or shaming them about it will only hurt, not help. If they’ve been keeping their depression private, it will be that much harder to deal with others getting irritated with them because they can’t perform at the level that’s expected of mentally healthy people. This is why it’s always best to be understanding with those in your life, both work and personal. You don’t know if someone isn’t just slacking off, but is struggling with a real health problem.

8. They can have bad days, and “better” days

Depression can have its ups and downs. If someone has hidden or undiagnosed depression, they might seem like they get random mood swings, depending on if their depression is consistent or not. To you (and to them, if they are undiagnosed), the changes in mood seem without cause, but it’s simply how some people’s depression manifests. If you know the person has depression, it’s possible to falsely believe they’re permanently better because of a few “good” days. While it’s always great if someone has a day that’s better than the one before it, you should always let them tell you what they’re ready to handle and when. Assuming they’ve completely recovered and pushing them too quickly into things might overwhelm them and make them retreat into themselves again. Be supportive of your friends and family who have depression, but let them make the calls. Featured photo credit: in a cold room I/Casey Muir-Taylor via flic.kr