I’d like for you to introduce me to someone. 

The person is not a stranger; you’ve gone to bed with them every night for years. They’re right there waiting for you when you wake up in the morning, as you rub the sleep out of your eyes and face another day of trying to achieve perfection. You spend all day with them, every day.

This person is you, or at least the part of you that stays hidden — the you who cannot reveal or express emotional pain. The you who camouflages any perceived vulnerabilities with a shield of perfectionism. The less-than-perfect you from which you constantly run.

What made you start hiding this part of you?

As a means of survival – of avoiding being hit, or ignored, or mocked – you adapted.. Maybe you had an alcoholic parent, or there wasn’t enough food in the house. Maybe you had a family where no one ever talked about anything sad or painful, especially not when Dad would sneak into your bedroom at night, and you were told to stay quiet, or when Mom would emotionally fall apart, and it was your job was to prop her up. Maybe the praise you did get was for what you accomplished; if you didn’t make the highest score, then came withdrawal or uneasy silence. Maybe you felt invisible and you strived for affirmation by becoming highly successful. 

The message from you family or from your culture was absolutely clear: your job was to please, to accomplish, and to keep your own pain to yourself. So, you began stowing away troubled, confusing experiences, and donned the camouflage of the perfect-looking life, crafting a face that you’d allow the world to see.

You’ve now become someone who needs to look completely put together. You’re very successful as you work to stay in control. You’re a great friend to all, the face you show to the world is happy. You’ve got a loving family, a good job and a life that appears extremely stable. If life has handed you struggles, you’ve come through them like a champ. 

That other part of you…

Yet there’s another you…the “you” no one knows, the one that remembers the hurt and pain you experienced. Sometimes, you don’t want to believe it’s there; you may actually deny its presence. You may be so disconnected from pain, you’ve completely detached from that you. Yet, in a brief moment of quiet, if you wonder why you become anxious, and feel the need to get busy doing something, or your gut whispers that something seems wrong, you may shame yourself for not counting the many blessings in your life or demean yourself for not being grateful.  

What is perfectly hidden depression? 

I call this way of being perfectly hidden depression.

It’s depression, all right. There’s self-loathing, fatigue, shame, worry, sadness, sleep problems, even possibly suicidal thoughts. But these are very skillfully covered up.

It’s trauma-based perfectionism.

If indeed you seek therapy, you might even be able relate your story of that trauma without shedding a tear, as matter of factly as if you were sharing your grocery list. You know it’s there, but you don’t feel it.

How is perfectly hidden depression different than the classic presentation of depression? 

Perfectly hidden depression isn’t a psychiatric diagnosis; it’s a syndrome of behaviors and beliefs that mask depression. It looks different than classic depression. For example, one of the two major features of classic depression is “anhedonia,” which is the diagnostic term for a lack of pleasure in or apathy toward previously pleasurable activities. If you’re a person who’s perfectly hiding your depression, you don’t look like that at all. You’re the popular coach of the soccer team, the chairperson of the PTO, or the one organizing the neighborhood potluck; you’re everywhere, doing, volunteering, filling needs in the community or church.

No one even suspects your depression…perhaps not even you.

If you’re hiding, you can stop. It takes breaking a life-long habit. It involves emotional risk. Vulnerability is a must. So why do it? Why risk it? Because eventually loneliness and despair can infiltrate your life in ways you can no longer control. And that can lead to tragedy. 

What can you do?

Four steps to begin to work with your perfectionism… 

1) You can challenge the belief that focusing on yourself is selfish.

As someone recently told me, “I can’t be in the center ring.” You’ve focused so long on the needs of others. you’re convinced even good self-care is “selfish.” Realizing that self-awareness is far different from selfishness is a must. 

2) You can risk telling someone about this other “you.”

I’ll often hear,  “I can talk to you because I know you can’t legally tell anyone about it,” That’s fine by me. Therapy is a great place to start risking and learning how to connect with your emotions safely.

But often, one person will come to mind that you could risk telling, and one person is a great start.  

3) Realize that the childhood strategy you created to emotionally survive is now self-destructive.

Your strategy to look perfect worked great as a child. Now it’s keeping you pressured, anxious, always on and available  for others. But not seen. You can choose to identify and replace this strategy with one that works for you now.

4) Accept that change may be difficult.

Your world is built on you performing at your peak, all the time, for everyone else. Changing that can be difficult at first. Others may resist you changing or not know how to take the “new you.” Risking vulnerability is very hard when you’re an expert at being stoic and silent. 

 it’s up to you whether or not you come out of hiding. I hope you do. I, and others, would like to meet you.

The real you. 

You can hear more about perfectly hidden depression and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive one weekly newsletter including my weekly blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!

My book entitled Perfectly Hidden Depression is available and you can order here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life.

And there’s a another way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!

Originally published October 22, 2016; updated and republished on January 23, 2022.

Perfectly Hidden Depression (aka Trauma-Based Perfectionism): Four Basic Ways To Heal via @doctormargaret
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