Perfectly Hidden Depression and the Denial Of Loneliness 4 Ways To ConfrontThere are a lot of shower scenes in movies.

Some of them are scary. Some sexy.

Other times, the character is crying tears that they aren’t allowing anyone else to see.

I remember such a shower scene. The Big Chill. 1983. It was about old friends getting together after the unexpected death of one of their former troope. The scene didn’t even make it into the trailer for the movie, so perhaps it was inconsequential for many. But Glenn Close, sitting with the water pummeling her body, and silent sobs coming out of her throat, tore me up.

People with Perfectly Hidden Depression (PHD) are lonely. They don’t cry, or rarely cry. If they do, it’s when they are all alone.

“What do you mean lonely? Me, depressed? Gosh no. My life is so busy, I don’t have time for that.

Maybe they’ve become accustomed to the loneliness. Maybe they’ve convinced themselves they prefer it. Maybe they’ve spent so much time caring for others’ needs, that they fall exhausted into bed every night, and don’t have any time or emotional energy to address the disconnection.

What disconnection?

Someone with PHD has to disconnect from their own need for nurturance, for care, for empathy and understanding, in order to believe that their life is normal — that what they’re creating is good, and that the connections they have with others are enough.

[tweetthis hidden_hashtags=”#PerfectlyHiddenDepression, #drmargaret”]You give. The world receives. And you remain unknown.[/tweetthis]

You can remain in denial about what your life could be, or what you’re missing by doing this.

Until you feel the loneliness of no one really knowing who you really are, you’re not ready for change.

When you do recognize the depth of that aloneness, then maybe, just maybe you will want to stop hiding, and connect with yourself and others in a real way.

Just how do you face your own denial?

1) Consider yourself in the same light you consider others.

Would you really tell someone else that their feelings aren’t important? Or that it is better to shoulder immense responsibility alone, without ever talking about the difficulty of it?

When you stop and ask yourself these questions, the answer is clear. You would tell someone else that they need support — that you don’t get water out of an empty jug.

So look in the mirror, and remind yourself that being known, even if it reveals some vulnerability, is a good thing.

2) Things happen that get your attention,  such as panic attacks, compulsive or addictive behavior.

Bit by bit, you’re losing control of the life you’re trying so hard to control. The fear of that is strong, and feels threatening. You’re almost forced to admit that you’re fighting against anxiety and worry, because of these symptoms that you’re experiencing.

You’re secretly drinking more, having panic attacks, spending hours online, or cleaning constantly. Your anxiety is rising and you’re trying to escape.

If you look objectively and honestly at these behaviors, they can help you confront your denial. Things are out of balance. If you listen, your own behavior can lead you to a calmer, less anxiety-ridden place.

Until you feel the loneliness of no one really knowing who you really are, you're not ready for change.3) You over or under-respond emotionally to something in your present, due to being triggered by secret pain from your past.

Let’s say you get a promotion at work. Instead of being happy about it, all you can do is obsess about new things that you’ll be asked to do, that you’ve never done before. You feel caught off-guard. Maybe your “true” self will be exposed. Maybe you’ll make a mistake. (This is triggering old insecurities about needing to look perfect to avoid something painful.)  You can’t deny that you ought to be happy, but you’re not really. (Although everyone thinks you’re very happy about it — that’s what someone with PHD does.)

When you respond to something in a way that doesn’t make much rational sense, it’s tied into something from your past that’s unresolved. Your actions and emotions are being governed by that past, not what’s really happening in the present. In the above situation, it’s rational to believe or to know that if you’re learning new things, others expect that there will be a learning curve. The instantaneous fear you have (that you hide…) isn’t rational.

You can’t deny that you over-reacted, or reacted irrationally.

Those connections between past and present can be made. You can start seeing where those insecurities come from and how you maintain them. You can admit or accept whatever shame or sadness you’ve been hiding.

4) You can become suicidal.

This is obviously the most dangerous way — because once you’ve crossed the line of considering suicide as an option, it’s difficult to turn back. It’s hard to deny suicidal thoughts when they’re in your head. You can try to push them away, but somehow you begin to rationalize that the struggle is too hard — that others would be fine without you.

Hopefully, these thoughts would scare you, and would lead you to finally reach out to someone. Ask for help. Recognize that it’s not normal to sit around and ponder how you might kill yourself.

You don’t have to be lonely.

You can risk someone knowing who you really are, and how you really feel. But you have to admit, first, that you are lonely — that so much of the activity that is in your life is just that.


You may love your children intensely. You may work very hard at your job. Others know you as happy, successful, and there for others.

Please do for you, what you would do for them.

Pay attention to your own aloneness.


You can hear more about depression and many other topics by listening to Dr. Margaret’s podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to this website and receive her weekly blog posts and podcasts, as well as  free downloadable ebook, “Seven Commandments of Good Therapy.”!

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My new book entitled Perfectly Hidden Depression will be arriving November 1, 2019! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the 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. More to come.