Perfectly Hidden Depression

Early in my career, a patient sat across from me and described her life. She was accomplished. Well-liked. The person many others in her life leaned on. Full of gratitude for what she had..
When I gently asked how she was really doing, she smiled and said. “I’m fine,” she seemed a little embarrassed to admit, “I don’t know why I’m here really.” She was far from fine.
Over the years, I noticed more people just like her. They did not fit the presentation of depression that most clinicians were trained to see and diagnose.
They were not withdrawing from life. They were not staying in bed. In fact, they were doing more, achieving more, performing more…and keeping more and more of their struggles… secret.

I named this phenomenon “Perfectly Hidden Depression.” 

I spent years researching and interviewing many who identified with the pattern. In November of 2019 I published my first book on the topic, “Perfectly Hidden Depression: How to Break Free from the Perfectionism That Masks Your Depression,” published in November 2019. It has been translated into multiple languages and has given thousands of readers the awareness and language they’d needed all along.

Perfectly Hidden Depression Book
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  • “For anyone exhausted from acing life but secretly flatlining inside, this workbook is your permission slip to drop the act and actually feel alive. Dr. Rutherford turns perfectionism’s prison break into an art form―equal parts therapy, truth serum, and liberation manual. A must-read for anyone ready to trade flawless for fulfillment.”

    ―Jodi Wellman, MAPP, founder of Four Thousand Mondays, and author of You Only Die Once

  • “A perfect-looking life can hide deep exhaustion and pain. Drawing on decades of clinical experience and hard-won wisdom, Dr. Margaret Rutherford delivers a powerful workbook for anyone who seems to have it all together but feels secretly overwhelmed inside. With effective exercises, relatable storytelling, and quiet kindness, she will guide you through the self-work that―finally!―brings genuine peace of mind. A deeply humane and hopeful companion for anyone ready to heal.”

    ―Ellen Hendriksen, PhD, clinical psychologist at the Center for Anxiety and Related Disorders at Boston University, and author of How to Be Enough
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  • “So many of us struggle with ‘perfectly hidden depression’ on our own, fearing potential stigma and trapped in a lifetime of desperate habit. In this seminal workbook, Dr. Margaret Rutherford uses profound but simple wisdom to show how to break free of the prison of perfectionism, and find the acceptance and self-compassion that will make life more fulfilling―and so much easier.”

    ―Terri Cheney, author of the New York Times bestseller, Manic: A Memoir
  • “Dr. Rutherford’s continuing education program deepened our understanding of toxic perfectionism, encouraged us to ‘normalize’ the oftentimes difficult—and therefore perilously avoided—conversations about thoughts of suicide, and motivated us to move beyond insights to behavior change because forward momentum evokes true hope.”
    —Robert Clark MD, Medical Director of Victory Clinic TS and SPRAVATO Treatment Centers.

  • “So many of us struggle with ‘perfectly hidden depression’ on our own, fearing potential stigma and trapped in a lifetime of desperate habit. In this seminal workbook, Dr. Margaret Rutherford uses profound but simple wisdom to show how to break free of the prison of perfectionism, and find the acceptance and self-compassion that will make life more fulfilling―and so much easier.”

    ―Terri Cheney, author of the New York Times bestseller, Manic: A Memoir

  • “Margaret Rutherford cracks open a conversation so many workplace leaders have been afraid to initiate―the quiet pain of performing behind a mask. This book is a powerful permission slip to reclaim the parts of ourselves we’ve hidden to stay ‘strong.’ Her clarity, compassion, and practicality make this book a lifeline for anyone who’s exhausted from being everything to everyone but themselves.”

    ―Sally Spencer-Thomas, PsyD, psychologist, keynote speaker, trainer, consultant, and founder of the Headspace for the Workplace podcast―elevating leaders’ confidence in mental health conversations