People have asked me if I struggled with perfectionism and perfectly hidden depression.
After all, I’ve spent more than a decade of my life researching and writing about it. I even put my intense performance anxiety all on the line and stood my ground on the red dot of a TEDx talk. Truly my worse nightmare. But the message was that important to me to offer.
What was that message? That depression doesn’t always look the same. Yes, there’s a classic version, that’s well described by the psychiatric community through its list of symptoms in the DSM5: TR (Diagnostic and Statistical Manual…).
But perfect-seeming people can use their perfectionism and tight emotional control as camouflage for underlying despair and loneliness. They’re the people that you’ve heard about or know who killed themselves, with no one knowing what was wrong. In fact, their life seemed highly successful and even perfect.
My mother didn’t die by suicide. But she had some kind of trauma that she never talked about. How could anyone see it then? You couldn’t unless you knew her back story. And she never told that story. She escaped its power – or tried to – with medications that eventually robbed her of any joy – or really of seeming to feel anything at all.
I thought that today… I’d share an excerpt from the Perfectly Hidden Depression Workbook about her. We’re coming up on Mother’s Day and I will remember her with a mix of love, compassion, and great sadness.
She could’ve had such a different life. If she hadn’t been hiding underneath such a finely-woven camouflage of perfectionism.

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An excerpt about my mom from the Perfectly Hidden Depression Workbook…
People have asked me whether I wrote Perfectly Hidden Depression about myself. I am perfectionistic. But no, it’s not my story.
Instead, the person I thought of often was my mother. Her life was defined by needing to meet others’ expectations. She was beautiful, talented, smart—and believed none of those things. Like many white Southern women in the 1950s, she did everything she could to run a perfect home, be perfectly thin, be perfectly dressed.
One afternoon at a ladies’ church circle meeting, most likely held in some other perfect-seeming woman’s very stiff living room, she felt the onset of panic. Confused, she saw her doctor a week later, who said it was “nerves” and handed her the first of what would become multiple misused and abused prescription drugs to “calm her down.” But they kept her looking assured and even happy on the outside. And she was following society’s rules: They were “prescription” meds. So, they were allowed.
There were clues about what lay underneath. I never saw her cry. She worried a lot. I could see her trying to please her own mother, who was frequently very critical. She confided that she could only be herself when she and my dad were out of town. I didn’t understand it at the time, but now the reason seems very apparent. That’s where she felt much freer to laugh loudly, to enjoy her Bloody Mary at noon, to live outside the tiny box of what was acceptable for a “lady” to do in my hometown.
Perfectly hidden depression can be accompanied by other true mental illnesses…
There were other signs of trouble, for the pills weren’t enough to keep her from compulsively buying multiples of everything from hair spray to toothpaste, explaining that “we can’t run out.” As a child, I thought everyone’s mother must do the same thing. As she grew older, the signs of a deeper problem with anxiety became evident. The house still looked perfect to the casual visitor. Yet open a closet and it would be stuffed with old clothes or new clothes never worn.
She could be lovely to others; at her funeral, many told me of her kindness toward them. She read. She laughed. But her struggle was hidden. Through the years, I gradually watched any happiness she seemed to enjoy disappear. And when she was forced to go off the medications, she vanished. She was physically alive but emotionally empty.
Writing this, I fight feelings of betrayal. I’m telling some of her secrets.
Yet I know what hiding her struggles did to her. Risking being open and honest about what she felt deep inside—anger, sadness, grief, loneliness—wasn’t something she ever considered.
So, I’m reaching out to those of you who are living a similar life as my mom. With gratitude toward her. And love.
By the way…
Send me a message about what your own mom was like!! 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!
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Margaret, You don’t share your inner feelings about how your mother’s inner turmoil affected you as a young child. I would love to hear more! Learning how you were exposed to her grief would help me understand my experience more. Did she have an enormous impact on your emotionally, as her daughter? I am 70 and I have spent the lasty 50 years, yes, you read that correctly, trying to understand my inner sadness, the emptiness and lonliness i developed as a child, due to my mother’s emotional neglect and inablity to see me. She was extremely limited in showing her love, both physically or verbally. I was never told, “I love you”, nor was I carressed, tenderly. Very insignificant sense of attachment. She was ruled by how everything “appeared” ! Her perfection had control. Still does, to this day. At nearly 96, she is still not enough. She has hidden within the walls of shame and never had the inner motivation, or ability to take the innitiate to figure it out which has been so incredibly frustrating for me! Instead, she has lived with her unwillingness to “do the work”, to discover a better understanding of who she is and why!!!! On the other hand, I continue to figure out the influence she had on me. As I child, I didn’t know who I was, due to being consumed about who she was! So much more I would love to really comprehend. Group work on this specific subject would be extremely helpful. Thank you for being here!
Hello Patty. That would be a very long answer I’m afraid. First of course, I’m so sorry that your mother could only (or can only) think of herself. And again, of course, that would cause you emotional pain. What I might suggest is that you read my book on PHD; I give lots of examples of how it develops and where it can come from. Maybe that would give you the sense of “group work” that might be helpful to you or offer a perspective that would be helpful. As far as my own feelings and experiences, I was very slow to emotionally mature and my life was pretty chaotic for more than a decade. My mother and I were very enmeshed; she saw me (unlike your experience) but I had a more pseudo-adult role in her life – as her confidante and “therapist.”