Can major depressive disorder hide behind a smile at 35?

Question

Hello doctor,

I am 35 years old and have major depressive disorder, and most people around me think I’m doing fine because I still manage to go to work every day. What they do not see is that the moment I get home, I completely fall apart.

I keep asking, “Can major depressive disorder hide behind a normal appearance?” I laugh at work and make conversation, but inside I feel completely drained. I do not know if this condition means my treatment is not working or if I am just pretending too well. It is getting really exhausting trying to act like everything is okay all the time.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and understand your concern

Yes, people suffering from depressive disorder often look normal from the outside, but I understand that there is a lot more pain and suffering inside.

Depressive disorder is a very manageable condition. What you are already doing well is going to work. This activity is also a form of therapy. This technique is called behavioral activation, in which performing certain activities improves our maladaptive negative thoughts. For instance, if you visit a friend and talk to him, you may feel better at that time; similarly, when you do some chores, fatigue plays a crucial role.

Please take part in all three kinds of activities daily, such as pleasure seeking, mastery, and responsibility. Going to work is a responsibility; do one activity you used to enjoy and one that strengthens your skills. It can be cooking. Start with the small and easiest one, and then gradually increase the time. It will surely help. You can find more about it on Google.

Similarly, medicines are also available depending upon the need and even in resistance cases. Therefore, help is always there. This disorder creates hopelessness, which is a symptom, and that actually forces you not to help others, as you cannot get better. Your condition is not your fault, but it can lead you to think that way.

I need details regarding your mood, appetite, sexual function, weight, physical symptoms, sleep, your social life, any medical comorbidities, substance abuse, any medicines you may be using, any labs you might have undergone, duration of illness, and previous and current medications.

Please share it with me, and I can be more helpful to you.

So please try to follow up if you feel this answer would be helpful for you.

And I hope you will feel better soon.

Thank you.