How Could I Be Depressed When I Was Upbeat, Cheerful, and Happy?
You can be depressed even if you’re not sad
10:00 P.M. I was sitting on my couch, tired, and wanting to go to bed.
11:00 P.M. Still on the couch, exhausted, and desperate for sleep.
Midnight. Passed out on the couch. I was unable to string together the actions necessary to stand up, walk down the hall, get ready, and climb into bed.
I was depressed.
The road to depression
A few months earlier, I’d been diagnosed with uterine cancer. To remove the cancer, they did a complete hysterectomy.
This is major surgery. Not only are multiple organs removed, but the doctor has to cut through the abdominal wall to reach them. For the first week after surgery, you don’t have the strength to sit up. You have to use your arms to pull yourself upright.
They removed both ovaries along with my uterus. This sent me into surgically induced menopause.
That was a lot of strain on my body. I was given a long list of post-operative symptoms and complications to look out for. Chief among those were things like night sweats and hot flashes. These would be signs that I needed to adjust my hormone replacement therapy.
The doctor also warned that I might experience postsurgery depression. Call at once if I had profound sadness, uncontrollable crying, or suicidal thoughts.
But I wasn’t the least bit sad. I was happy! I had good friends, a job I loved, and I’d just beaten cancer.
Every day seemed to have a new landmark representing my healing. I could sit up on my own. I could reach above my head. I could get dressed in real clothes that had a waistband.
After two weeks, I was back on the job, although working from home via laptop. Two weeks after that, I was able to go into the office again.
I even managed to turn in the story my publisher had contracted for before my surgery. It wasn’t my best writing. In fact, it was the only one of my books not to win a single award. But it was good enough.
My life was getting back to normal. I could put this whole episode behind me.
I was wrong.
As the days went on, I found myself struggling harder and harder to put together thoughts. My brain just seemed to be working slower… and slower… and slower.
I could follow simple instructions. I could do things that had long ago become habit, such as getting ready for work and driving to the office. Since I worked in database support, I just had to write the code changes my customers asked for. They told me what they wanted me to do, and I did it.
But any sort of a decision threw me for a loop. I would struggle for three hours over what to make for dinner. Eventually, I’d rip open a bag of chips when hunger demanded I eat something right now.
I wasn’t sleeping, because even though I wanted to go to bed, I couldn’t make the decision to do it.
Smiling depression
The common name for depression not obvious to those around you is smiling depression. The depressed person is active and high-functioning. They have a steady job, healthy family, and good social life. To all outward appearances, they are cheerful, optimistic, and generally happy.
Often, the depressed person knows they are depressed. Rather than let others see their sadness and negative feelings, they put on a happy face.
In some cases, like mine, the person honestly does not know they’re depressed. Because while sadness is the most common symptom of depression, you can be depressed and not sad.
The clinical name for this is major depressive disorder with atypical features. It’s sometimes also called atypical depression.
Some of the classic symptoms that may present in smiling depression are:
- Loss of interest in things that you previously enjoyed
- Loss of pleasure when doing things you previously enjoyed
- Fatigue or lethargy
- Difficulty concentrating
- Changes in appetite (increase or decrease)
- Changes in weight (increase or decrease)
- Changes in sleeping (increase or decrease)
- Feelings of hopelessness
- Feelings of low self-worth
- Feelings of being a “burden” on others
- Suicidal thoughts
I knew I was tired — deeply, continuously tired, with constant brain fog. But I didn’t think I was depressed, because I was still happy. I would laugh at television comedies. I would get excited for my friends’ good news.
I just didn’t laugh as hard as I had before. I wasn’t as excited as I would have been before.
This is one of the crucial distinctions of smiling depression. Traditional depression does not lift, even with good news or pleasant situations. Good news or situations can lift the spirits of someone with smiling depression. They just won’t lift as much as they would have before the depression.
The road to recovery
After my midnight collapse, I confided in my best friend.
“I think there’s something wrong with me,” I said. Then I described how I hadn’t been able to think clearly enough to get off the couch.
“Do you think you might be depressed?” she asked.
“But I’m happy.”
“But not as happy as you used to be.”
With her encouragement, I called my doctor. I needed her help, because the long list of steps was too much for me to process.
First, I had to locate my doctor’s name. (He was a specialist, not my normal doctor.) Then, I had to find the name in the phone book, and write down the number. (This was in 2001. People still used phone books.) Then I had to call the number, and leave a message for him to call me.
When he called back, I explained what was happening, and he made time to see me that afternoon. My friend took me to the appointment.
He quickly agreed that I was depressed, with postsurgery depression. After making sure that I was not having thoughts of suicide or self-harm, he asked about my health. How was I recovering from my surgery?
“Excellent,” I told him. “I took it easy for the first month or two, but then I was able to do everything I’d been doing before.”
He started nodding as I described how I worked a full-time job, then went home and wrote in the evenings.
“You might be able to get by on 6 hours of sleep a night when you’re healthy. But it takes up to a year to fully recover from major surgery. You need at least 8 hours of sleep a night. Preferably 9.”
He also had me taking vitamins, especially Vitamin D, and the over the counter supplement SAMe. And he made me promise to eat healthy food, not bags of chips.
Drawing badly helped me beat depression
The other part of my cure was surprising. I needed to set small, realistic goals, then celebrate my wins.
I suspect he meant with regard to my health and healing. I went in a different direction with his advice, however.
I got a book called Mark Kistler’s Draw Squad. It was a how-to-draw book aimed at kids. It taught you how to draw alien cities, spaceships, and a couple of different types of aliens.
Each page had a very basic lesson on it, and a blank page to practice the lesson. I mean, very basic. Like, “Draw a square” basic.
Every day, I would complete one of the lessons. Then, the next day at work, I’d draw whatever it was for my friend.
I started looking forward to showing off my new skills.
Every day, I got a little better.
And one day, about 2/3 of the way through the book, I didn’t need to draw anymore. I was no longer depressed.
A lifetime of maintenance
I’m fortunate. Because my depression was brought on by surgery, it went away when I healed. I didn’t need any prescription medication. But I am still prone to depression.
My husband and I have learned the warning signs that indicate when I’m pushing myself too hard. Irritability, inability to make complex plans, and, bizarrely, cleaning.
You see, I internalized that lesson of small positive wins as being important for healing. As a result, when I start to feel depressed, even before I consciously recognize it, I look for a win. I see the spots on the bathroom mirror or the soap scum in the sink, and whip out the cleaner. Ten or fifteen minutes later, it’s shiny clean, and I feel great.
That’s my red flag. When that happens, I run a quick self-check. Have I been getting enough sleep? Have I been eating healthy? Have I been taking my vitamins?
Usually, a good night’s sleep and a double dose of vitamins is enough to put me right. But I’m vigilant, because I never want to be lost and wandering in that sea of gray, ever again.
If you think you might be depressed
If you recognize any of these symptoms in yourself, even if you’re not sad, get help. Make an appointment to talk to a medical professional who can diagnose you.
The issue may be as simple as an imbalance in your vitamins and a need for more sleep. Left untreated, depression can get dangerously worse.
There’s no need to suffer if you don’t have to.
Ready to have a better tomorrow?
I’ve created a cheat sheet to help you increase your confidence and get control of your life. If you follow this daily, you will level up your life very quickly!
