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

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 or increase of appetite
• 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 high-functioning 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

10 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 10 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 a project that would have excited you in the past.

6. Low Energy

Walking depression, like regular depression, can come with feelings of fatigue. The difference with walking depression is that the person may feel pressured to still complete their normal tasks. They may even be able to complete these tasks and look accomplished to those around them. However, the fatigue and feelings of exhaustion are still present underneath their ability to fulfill these responsibilities, leaving them with nothing left to pursue any interests outside of the tasks they have to complete during the day.

7. 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.

8. 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.

9. 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.

10. Despite All This, You Hide Your Feelings From Others

When experiencing depression, it is common to feel the need to isolate yourself from others. Depression often comes with feelings of shame and inadequacy, which can leave a person feeling vulnerable to experiences of rejection. This fear of rejection sometimes leads people to isolate, even from important friend and family relationships. Hiding feelings from others acts as an extra layer of isolation, unfortunately keeping the person from experiencing any validation about their emotional experience.

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 misuse, 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.

Risk factors for developing walking depression can include:^{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
• Stressful life transitions
• Having other mental health disorders
• Stress
• Substance use
• Pregnancy and giving birth
• Menopause

Treatment Options for Walking Depression

Fortunately, there is hope for those struggling with walking depression, and various evidence-based depression treatments are available. Those struggling with walking depression hide symptoms, so treatment aims to help them open up about what they are experiencing. 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 for depression can be helpful. 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 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 for depression 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.
• Mindfulness-based cognitive therapy (MBCT): MBCT is a cognitive-based therapy which uses principles of mindfulness to help people develop more nonjudgmental and neutral thinking patterns.⁵ Through MBCT, a person might use meditation and CBT strategies to engage in the present moment and challenge unhelpful thought patterns.⁵
• Behavioral activation (BA): Behavioral activation is an evidence-based intervention for depression that helps a person decrease unhelpful behaviors that contribute to depression and increase adaptive behaviors that stop the depressive cycle from occurring.⁶ Behavioral activation might include activities which are enjoyable such as spending time with friends and family, taking walks, engaging in hobbies, or using movement, and then rating one’s emotional experience.⁶

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 primary care doctor or a 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.⁷
• Monoamine oxidase inhibitors (MAOIs): MAOIs prevent dopamine, serotonin, and norepinephrine from leaving the brain, helping to decrease depressive symptoms.⁸

How to Cope With Walking Depression

Lifestyle changes can promote a healthier mental and emotional state. Using self-care strategies for depression will not replace traditional treatment methods, but they can be beneficial in helping you cope with symptoms outside of therapy.

The following tips can help you manage walking depression symptoms:

• Don’t feel ashamed—depression isn’t your fault: Depression often comes with intense feelings of shame. Remembering that depression is a combination of genetics and environment, and is not entirely within your control, can help reduce feelings of personalizing depression.
• Limit your screen time: Constant stimulation and comparison through social media can contribute to depressive episodes and rumination. Limiting screen time is one strategy to manage a potential trigger for ruminative episodes.
• Don’t stop doing things you enjoy: Depression can decrease the motivation to engage in your normal hobbies. It might be helpful to still challenge yourself to engage in these activities, as behavioral activation is one evidence-based strategy for reducing depressive symptoms.
• Improve your diet: Some studies suggest healthy foods and nutrition can positively impact depressive symptoms. Foods that can help with depression are high in omega-3, like salmon, tuna fish, or walnuts, and vitamin D, and can support a more positive mood.⁹
• 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 can help with depression by increasing oxygen flow to our brains and producing the feel-good hormones dopamine and serotonin.¹⁰
• 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 or by asking your doctor for a referral. If you feel like you or your loved one are in immediate danger, contact 911 or the crisis hotline at 988.

Helping a Loved One With Walking Depression

You may wonder why your loved one is able to still function in work or personal life with their symptoms, but it is important to remember that this is part of how their walking depression continues. Encouraging them to still seek help and asking how you can support their recovery may help them to acknowledge the reality of their walking depression.

Here are tips for helping a loved one with walking depression:

• Encourage them to seek professional help: Encourage your loved one to seek a professional psychological evaluation to determine the severity of their symptoms. Walking depression can sometimes encourage a person to minimize or ignore symptoms that may warrant a professional’s care.
• Create a safe environment: Creation of a safe emotional environment might include practicing validation of your loved one’s emotional experiences. Through validation and reflective listening, your loved one may feel more able to open up about their experience of walking depression.
• Listen and be patient with them: Deeply listening to your loved one’s experience and being patient with their symptoms are strategies for creating a safe emotional environment for their recovery. Although it can be difficult while they learn new strategies for recovery, becoming frustrated with them may only cause more isolative episodes.
• Offer to help them with treatments: Depression may make your loved one scared of the judgment of seeking help. Offering to help them access treatment may be a step toward encouraging them to recognize and ask for professional guidance around symptoms.