Perfectly Hidden Depression by Margaret Robinson Rutherford

No one knows the real you because you never let them in. You’re not comfortable with the reality of you so you pretend it doesn’t exist.  If this sounds all too familiar to you, then you need this book.

5/5 stars.
ARC, ebook, 232 pages.
Read from May 29, 2019 to May 31, 2019.

You always meet your deadlines regardless of how you’re feeling, you push forward through difficult circumstances and hide behind a facade in order to keep an appearance of having it all together. All because you don’t want to be perceived as incompetent or weak, yet inside you’re constantly battling with yourself, your feelings, and your self-worth. You’ve tried to line yourself up with the standard definitions of depression yet you never fully fit it due to your heightened sense of responsibility, your inability to recognise or share your feelings, and the high sense of control you constantly try to implement in your life. No one knows the real you because you never let them in. You’re not comfortable with the reality of you so you pretend it doesn’t exist.  If this sounds all too familiar to you, then you need this book.

After some harrowing experiences with patients, the author of this book noticed a pattern and began to put together the shape of this unique type of depression that often goes unnoticed and undiagnosed. Coined by the author, Perfectly Hidden Depression (PHD) can be the result of a variety of factors such as upbringing, ingrained beliefs, and personality traits. The author states that there isn’t anything in the Diagnostics and Statistics Manual (DSM) on this type of depression but that this is an acknowledgement and an observation from her own professional experiences (which she details and provides resources for). The author believes PHD is a subset of depression that many practitioners miss because it doesn’t present the way the DSM has listed. The author gives this list of defining features that make up someone with PHD:

  • Are highly perfectionistic and have a constant, critical,
    and shaming inner voice
  • Demonstrate a heightened or excessive sense of
    responsibility
  • Detach from painful emotions by staying in your head
    and actively shutting them off
  • Worry and need to control yourself and your
    environment
  • Intensely focus on tasks, using accomplishment to feel
    valuable
  • Focus on the well-being of others but don’t allow them
    into your inner world
  • Discount personal hurt or sorrow and struggle with
    self-compassion
  • May have an accompanying mental health issue, such
    as an eating disorder, anxiety disorder, obsessive-compulsive disorder, or addiction
  • Believe strongly in counting your blessings as the foundation of well-being
  • May enjoy success within a professional structure but
    struggle with emotional intimacy in relationships

Think of some of the shocking celebrity suicides that have happened recently, Anthony Bourdain, for example. Everyone thought he has this dream life and that he seemed like a generally happy and satisfied person. What if Anthony was the epitome of PHD? In that, he felt his personal value was only in his accomplishments, driven by how grateful he thought he should feel, and then feeling burdened and overwhelmed by the mask of achievement and perfection that he felt he had to wear. He also had addiction problems. If we knew more about people that presented with this perfectly masked depression we could provide them with better treatment and save them and those around them an immense amount of suffering.

“Anthony Bourdain was apparently not physically ill, not financially destitute, not concerned about getting his next meal, and not lacking in fame. In fact, he remarked he had “the greatest job in the world.”” – Toronto Sun, July 7, 2018

It’s hard not to get personal in reviewing this book as I picked it up from Netgalley out of my own personal interest. After reading The Gifts of Imperfection eight years ago I worked through my own PHD, which at the time was just learning to be vulnerable again. I started talking and writing about my issues and the condition, dermatillomania, that still plagues me, something that would have been unthinkable before. I made steep headway with Brené Brown’s book but it wasn’t enough. This book feels like the acknowledgement and the validation I need to press forward in my own personal growth and happiness in terms of the regressions I have made at this point in my life.

The author of this book is shedding light on an area of depression that requires some serious attention. Her writing is personable, concise, insightful, informative, resourceful and clinical. I have already recommended this book to at least three people I know and I anxiously await its publication as I look forward to adding this to my permanent bookshelf.  At this time, I have not done the reflections recommended in the book as I was excited and anxious to get through all the content because of how alarmingly relevant I found it. I am now looking forward to re-reading the book and diligently doing the reflections which I believe will be immensely valuable. I’ve already started recommending this book which is due to be published on November 1, 2019. I highly recommended this book to anyone who feels they fit this description, and if you do, chances are you’re reluctant to reach out for help, so start with this book, no one has to know.