10 Ways Perfectionism Can Mask Depression — Almost Perfectly

First, perfectly hidden depression isn't a diagnosis. It's a syndrome or group of behaviors and beliefs that are found together, sort of like salt and pepper. Or red hair and freckles. Many of its 10 traits can be healthy in moderation; it's when they're tightly interwoven and lead to complete denial and avoidance that the actual depression hiding underneath can remain silent. 

If you identify with PHD...

Striving for excellence is one thing. Your motto: "If it's worth doing, it's worth doing well." But striving fueled by an almost constant voice of shame isn't simple striving. Your eye is on the goal. Those shameful voices can viciously berate you if you're not the perfect parent, most accomplished lawyer, head of the class, or "best" best friend. You consistently measure and evaluate your status, and if you're not meeting perceived expectations, you ramp up the pressure. Even though perfection is unattainable, your shame can whisper differently, and your own critical beliefs can hold you hostage. 

You honor duty, obligation, and loyalty. You're über-responsible, and you rarely say no. You may seem as if you simply "like to be busy" or "enjoy a challenge." And if given one more responsibility, you'll pile it on your plate with the rest. Yet the actual motivation for assuming that new task is that it provides further distraction from anything painful.

You may be able to describe your emotions. You can say, "My best friend's husband was diagnosed with cancer. We're all shocked." But you struggle to actually express any sadness or fear. You can feel it for an instant, but it disappears before any tears can come to your eyes. You may even believe that tears signify weakness rather than intensity. And with this emotional drought can come intense loneliness. 

Your need for control is strong, and so a lot of time is spent worrying about the things that might occur to interrupt that control. Yet you must not seem as if you're worrying. People will shake their heads and wonder aloud: "You never seem to have a care in the world. You don't sweat the small stuff."

But you carry it too far. You're struggling to feel an innate sense of self-worth, not one based on what you can do but based on who you are. Since you tend to believe that if anyone knew your vulnerabilities, you'd be judged or rejected, then you require the next accomplishment as a tangible sign of your value. 

This can be especially dangerous when suicidal ideation is present, and you can't let anyone in or ask for help. Devastatingly, even if you do, you may not be believed. "What, you? Depressed? You've got everything in the world going for you." 

However, if you identify with PHD, you rigidly over-compartmentalize. You've developed very strong boxes where you lock painful feelings away, either consciously or unconsciously, shoving them into a dark recess of your mind. This allows you to discount, deny, or dismiss the impact of difficult or even traumatic life experiences.

You live your life in a very controlled, well-governed fashion. So, actual psychiatric diagnoses that might coexist with PHD are disorders having to do with control, such as eating disorders or anxiety disorders. Use of alcohol or sedative medications might also be a problem as you seek escape from pressure. 

Counting your blessings and expressing gratitude is healthy. But what's termed rigid positivity is a problem here, where expressing self-compassion is out of the question. Instead of acknowledging the reasonable and rational impact past struggles or abuse had on you–a gift you easily give to others–you don't choose to do it for yourself. That would be viewing yourself as a victim or being a whiner. And that's unacceptable. 

Perfectly Hidden Depression® is a registered trademark. If you're wondering where you might stand on the spectrum that is PHD, take this questionnaire.