Walking Depression: Definition, Symptoms, & Treatment

What Is Walking Depression?

Walking depression, sometimes called smiling depression, manifests as a seeming ability to maintain routines, work, and social activities while suppressing recognizable symptoms of depression. While not a clinical diagnosis, walking depression can be a debilitating and exhausting experience for those with the condition.

Symptoms of walking depression may include:

• Avoidance of social interaction
• Fatigue
• Difficulty concentrating
• Increased irritability
• Anxiety
• Loss of interest in hobbies or activities
• Insomnia
• Loss of appetite or increase
• Feelings of hopelessness
• Low libido

Walking Depression Vs. Major Depressive Disorder

Major depressive disorder (MDD) and walking depression are both forms of depression that impact a person’s ability to function. However, walking depression can be more difficult to notice because the person appears high-functioning on the outside, which is atypical of MDD. For example, they continue to get out of bed, take their kids to school, and show up for work. But inside, they struggle with hopelessness, lack of energy, and battles to keep one foot in front of the other.

Unfortunately, those with depression often attempt to convince others they are fine. According to the World Health Organization (WHO), 3.8% of the population suffers from depression, with more than 700,000 people completing suicide every year.¹

8 Signs of Walking Depression

The signs of walking depression can be challenging to identify because a person’s behavior appears normal to others. Still, you can look for subtle changes in behavior and self-expression if you suspect you or a loved one struggles with depression.

Here are eight signs of walking depression:

1. Becoming Easily Irritated

There is a connection between depression and anger. Those struggling with walking depression may seemingly lack patience or become upset easily, even over small things. Allocating your energy to forcing a smile and suppressing depression takes a toll on your mind and leaves little capacity to regulate emotions.

2. Feeling Empty or Sad

Feelings of emptiness can appear as decreased interest in things that used to spark joy, excitement, or happiness. You may feel emotionally numb as if you are taking the necessary steps to get through the day rather than being present and actively engaged.

3. Low Sex Drive

Low sex drive can also be a sign of walking depression. Perhaps you’ve lost interest in sex altogether. Depression can impact your sex life by causing low libido in both men and women, so look for changes in your or your partner’s intimate behavior.

4. Difficulties Sleeping

Sleep difficulties can be a sign of depression, whether you struggle to fall asleep, stay asleep, or wake up on time. Insomnia is common with depression and can significantly influence symptom severity, longevity, and recurrence. One study showed that about 90% of people with depression report experiencing a sleep-related issue at some point.²

5. Lack of Motivation

A lack of motivation can leave you feeling entirely drained, even leading you to stay in bed because nothing seems interesting. You don’t feel the urge to engage in hobbies you enjoy or complete an exciting project.

6. Difficulties Concentrating

Those with walking depression may lose track of time, zone out, or lose their train of thought in conversations. For example, you may clock out of a discussion only to wonder what the person said over the last few minutes.

7. Social Withdrawal

Another sign of walking depression is social withdrawal. You may find yourself dreading gatherings or avoiding them altogether. This behavior may be especially alarming if you typically feel drawn to social connections. You may also start avoiding your partner or loved ones by staying in your room, not responding to calls or texts, or self-isolating.

8. Changes in Eating Habits

It is common for eating habits to change when feeling down, sad, or anxious. You may see self-care as trivial because you dedicate your energy to masking your depression. You may feel too exhausted to cook or even think about what to eat. On the other hand, you may mindlessly eat and snack when feeling depressed.

What Causes Walking Depression?

Many different factors cause depression. For instance, a toxic environment or life stressors can trigger symptoms in those with a genetic predisposition to depression. Substance abuse, pregnancy, or hormone shifts can also contribute. Some people may also learn from parents or caregivers that negative emotions are shameful, leading them toward walking depression.

Risks of walking depression:^{3, 4}

• Family history of depression
• Sudden life changes
• Traumatic experiences
• Physical illnesses
• Interpersonal problems (i.e., struggling socially and in romantic relationships)
• Financial instability
• Life transitions
• Having other mental health disorders
• Stress
• Substance use
• Pregnancy & giving birth
• Menopause

Treatment Options for Walking Depression

Fortunately, there is hope for those struggling with walking depression, and various evidence-based treatments are available. Those struggling with walking depression hide symptoms, so treatment aims to help them open up about what they are experiencing.

Healthy life changes can help improve your mood, sleep, and view of life. If you have exhausted your ability to cope with depression, consider seeking professional support. Therapy and, if recommended by a clinician, medication can help you cope with your struggles.

Therapy for Walking Depression

Many effective forms of evidence-based therapies can help those with walking depression. Explore different options when determining which treatment approach works best for you.

Therapy options for walking depression include:

• Cognitive behavioral therapy (CBT): CBT for depression identifies cognitive distortions, helping the clients reframe these thoughts through practical problem-solving and therapeutic homework.
• Exposure therapy: Exposure therapy exposes individuals to the negative beliefs and anxieties underlying their depression. Therapists help clients learn emotion regulation techniques as they face their fears.
• Acceptance and commitment therapy (ACT): ACT helps people accept difficult emotions and experiences by determining value-based goals.
• Dialectical behavioral therapy (DBT): DBT for depression involves skills training around mindfulness, emotion regulation, and interpersonal effectiveness.
• Eye movement desensitization and reprocessing (EMDR): EMDR for depression targets the underlying negative beliefs contributing to depression. Through the desensitization process, negative ideas or experiences become unstuck and are no longer having an impact.
• Interpersonal therapy (IPT): IPT works to repair interpersonal relationships and promote positive relationships.
• Art and music therapy: Art therapy and music therapy allow people to express themselves through creativity and rhythm.
• Internal family systems (IFS): IFS taps into our inner systems created due to previous traumas and life stressors. With IFS, the individual will work to access the Self to heal wounded parts and bring balance back to the mind.
• Sensorimotor therapy: Sensorimotor therapy is a holistic approach that connects the mind, body, and spirit to increase understanding of how the body reacts to and contributes to maladaptive behaviors like avoidance, numbness, and relationship difficulties.

Medication for Walking Depression

Medication is a helpful option to consider when experiencing symptoms of walking depression. You can discuss various depression medications with your psychiatrist.

Medications used to treat walking depression may include:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs* increase serotonin levels in the brain by stopping the reuptake into cell membranes. SSRIs are often the first medication treatment option for depression.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs* affect serotonin and norepinephrine in the brain to improve depressive symptoms.
• Tricyclic antidepressants: These anti-depressants also block neurotransmitters in the brain. These medications are older, and physicians infrequently prescribe tricyclic antidepressants* due to side effects and the potential for overdose.⁵
• Monoamine oxidase inhibitors (MAOIs): MAOIs prevent dopamine, serotonin, and norepinephrine from leaving the brain, helping to decrease depressive symptoms.⁶

*This medication has a black box warning, the most serious kind of warning from the FDA for a risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

Habits & Lifestyle Changes

Lifestyle changes can promote a healthier mental and emotional state. These changes will not replace traditional treatment methods but can be beneficial in helping you cope with symptoms outside of therapy.

The following lifestyle changes can help you manage walking depression symptoms:

• Improve your diet: Some studies suggest healthy foods and nutrition can positively impact depressive symptoms. Foods that help depression are high in omega-3, like salmon, tuna fish, or walnuts, and vitamin D, and can support a more positive mood.⁷
• Seek support from friends and family: Allow others to be there for you and remind yourself that you aren’t alone. Being vulnerable allows others to be open with you and share similar experiences.
• Avoid self-isolating: Get out of the house, grab a coffee, or visit a bookstore. Allow yourself to be around other people. Oxytocin is released when we connect and socialize with others, which can be the antidote to stress.
• Set goals: Make daily intentions to get out of bed, get ready, and feel productive. Break important tasks into small steps until they feel more manageable.
• Stay physically active: Engaging in movement that aligns with your values can help improve your mood. Exercise increases oxygen flow to our brains and produces feel-good hormones dopamine and serotonin.⁸
• Meditation: Meditation for depression can help because it allows you to get unstuck from negative thoughts and remain in the present moment. Meditation brings attention back to your body and surroundings so your depression can’t consume you.

When to Find Professional Help for Walking Depression

If you or a loved one are experiencing hopelessness, self-harm, or thoughts of suicide, reach out for support. You can find the right therapist using an online therapist directory. If you feel like you or your loved one are in immediate danger, contact 911 or the crisis hotline at 988.

In My Experience

In my experience, we all carry our own baggage of struggles and different mental health conditions, and some of us are more capable of hiding our problems than others. If you notice that you or your loved one are experiencing any of the symptoms mentioned above, check in with them and yourself. There is hope, and you don’t have to struggle with walking depression alone.