Top 7 Reasons Why People Hide Anxiety and Depression

Are you someone who struggles with anxiety and depression inwardly, but outwardly presents a happy persona to the world? Do you worry that your anxiety symptoms or depressive symptoms will scare people away or jeopardize your career? Do you feel there’s something weak or shameful about having mental health issues?

If you answered yes to any of these questions, you’re not alone. It’s not uncommon for individuals with anxiety disorders and clinical depression to hide their conditions from others.

In fact, a recent survey by Kantar research, commissioned by the mental health organization See Change, found that more than half (53%) of young people would contemplate hiding a mental health disorder from family or friends.

More than half (53%) of young people would contemplate hiding a mental health disorder from family or friends. Click To Tweet

Sometimes an individual struggling with depression symptoms will appear outwardly cheerful, smiling often, thus masking the condition from others. This is termed “smiling depression,” which can exacerbate depression and associated anxiety and even lead to suicidality. Indeed, the cost for hiding anxiety and depression is great.

Mental health experts have found that there are significant reasons why people conceal mental health disorders. Here’s what may be driving smiling depression and hidden anxiety in you or a loved one.


Not everyone who has depression fits the stereotype of being sad, isolated, and unable to get out of bed. In fact, brain scans using a technology called single photon emission computed tomography (SPECT) at Amen Clinics have revealed there are 7 types of depression.

Smiling depression may be considered a form of “high-functioning depression.” Individuals who exhibit smiling depression may inwardly experience some of the core symptoms of depression, such as:

  • Low mood
  • Loss of interest in pleasurable activities
  • Changes in weight
  • Slowed cognition and movement
  • Fatigue
  • Feeling worthless or guilty
  • Indecisiveness
  • Suicidal thoughts/plans
  • Digestive issues
  • Aches/pains

Despite their internal symptoms, these people appear “normal” to the outside world.

Often co-occurring with depression, an individual hiding anxiety may inwardly experience some of the less visible symptoms of anxiety:

  • Tension/nervousness
  • Sense of impending doom/panic
  • Feeling fatigued or weak
  • Uncontrollable worry
  • Increased heart rate
  • Difficulty concentrating
  • Sleep problems
  • Digestive issues
  • Avoidance

Outwardly, they try to appear calm, although that can be difficult if they experience more visible core symptoms of anxiety such as being easily startled, rapid breathing, sweating, or trembling.


There are many understandable reasons why you might hide symptoms of anxiety and depression. Gaining insight, empathy, and acceptance about what drives this behavior will help you or your loved ones seek help and treatment.

1. Fear of burdening others

Guilt is a major feature of depression. This tends to create a feeling of being burdensome in those who are struggling inwardly with the pain of depressive or anxious symptoms.

If you have a caretaking personality, it can feel especially wrong to ask for help. If you appear to have a great life, you may additionally feel guilty about not being happy. Instead, you silently struggle while outwardly acting as if everything is okay or by appearing happy.

2. Shame or embarrassment

Internalized stigma about mental illness, called “self-stigma,” may lead some individuals to think depression and anxiety are signs of weakness or a moral failing. This is very common for people who grew up in a family that did not talk about mental health openly or maintained a “stiff upper lip” approach to psychological pain.

This type of individual may feel tremendous shame about not being able to handle their depression and/or anxiety. Pretending they are okay and appearing outwardly “normal” is their solution.

Additionally, perfectionists—often driven by shame—may find a mental health disorder intolerable and unacceptable, preferring to appear fine at all costs.

3. Denial

We all have a psychological defense mechanism called denial. It’s a protective tool the mind reverts to when things get difficult or overwhelming.

On the one hand, it allows us to have time to adjust to a difficult or disturbing change in our reality. With depression and anxiety, smiling or acting calm serves to keep the reality of potentially having a mental health condition at bay. Yet, it also inhibits us from acknowledging there’s a problem and making a needed change by getting treatment.

Some people struggle to admit that there might be something wrong with them. Pretending like they’re fine is a better choice than being vulnerable and opening up about how they really feel.

The protective shield of denial may be strong in individuals who came from families where denial was modeled. Mental health issues can be a big trigger for denial, experts report.

Denial can also stem from fear about side effects of medication, cost of treatment, or mistrust of medical doctors due to past experiences.

4. Negative feedback

Mental health experts have observed that individuals who struggle with anxiety and/or depression may unconsciously learn to hide their symptoms when they receive negative feedback from others in response to their depressive symptoms, negative thinking, or anxious thoughts and behaviors.

Sometimes it’s a conscious decision to smile and act “okay” to protect themselves from rejection or pain. People with anxiety and depression may worry that they’ll overwhelm friends, partners, or family members or they will be judged

The negative thoughts and paranoia that are symptomatic of depression and anxiety can make you feel hypersensitive to criticism from others furthering the desire to conceal your inner struggle.

5. Stigma

Although public understanding of mood disorders like anxiety and depression has increased in recent years, stigma still exists.

Mental health stigma has existed for centuries and has been reinforced by Influences such as inaccurate portrayals of mental health disorders in media, our country’s history of institutionalizing individuals with mental illness, our former criminalization of suicidality, and more.

Too often, public stigma causes individuals with mental health conditions to think of themselves as defective or having caused their illness. The cultural stigma becomes self-stigma, as mentioned above, where an individual carries a negative perception and internalized shame about their own mental health disorder.

Unfortunately, our culture doesn’t fully understand that depression and anxiety are illnesses with neurobiological underpinnings caused by a number of factors, including brain function and genetic predisposition. As a result, you may hide your depression and anxiety symptoms from others or yourself, or both.

6. Fear of discrimination

People with anxiety and depression will go to great lengths to keep their symptoms hidden in the workplace out of fear of being passed over for a promotion or worse, being fired. Of course, this causes tremendous stress as they struggle to focus and perform while privately grappling with low energy, fatigue, concentration, worries, low mood, and other symptoms.

These fears are not unfounded. Even though people with mental health disorders are supposed to be protected under the law, discrimination does exist.  Recent data shows that complaints in workplace discrimination based on mental health disorders have increased. A large portion of these complaints are related to anxiety disorders.

That said, disclosing a mental health disorder with an understanding employer or supervisor can be very beneficial. Many informed employers/bosses will readily make accommodations to support the well-being of employees struggling with depression and/or anxiety.

7. Unaware of being anxious/depressed

Here’s a surprising reason: Some people don’t realize that they’re anxious or depressed! They may have less recognizable symptoms of depression or anxiety. Or, in some cases, their symptoms may increase slowly over time, making them harder to notice.

According to a report from the National Alliance on Mental Illness, there are hard-to-identify symptoms of depression, such as:

  • Brain fog
  • Irritability
  • Body aches and pains (headaches, stomach distress, etc.)

There are some surprising physical signs of anxiety too, including dental health issues, poor libido, brittle nails, inflammation, and a more pronounced stress response.


Smiling and pretending to be fine are ultimately a risky way to respond to feelings of depression and anxiety. Untreated depression and anxiety increase your chances of developing other mental disorders and health issues, substance abuse, eating disorders, panic attacks, relationship problems, work problems, suicide, and more.

The great news is that anxiety and depression are treatable with psychotherapy, medication (when necessary), and lifestyle changes such as meditation, healthy diet, nutritional supplementation, restorative sleep, exercise, and social connections.

If you suspect you or a loved one might be hiding depression or anxiety, don’t continue to suffer. Reach out to a qualified mental health professional for help.

Anxiety, depression, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

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