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Perfectly Hidden Depression

Perfectly Hidden Depression

How to Break Free from the Perfectionism that Masks Your Depression
by Margaret Robinson Rutherford 2019 216 pages
3.88
500+ ratings
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Key Takeaways

1. Perfectly Hidden Depression: Recognizing the Masked Struggle

Perfectly Hidden Depression is not a diagnosis you'd receive from a doctor or a therapist. It's not a mental disorder. It's a syndrome, or a set of characteristics that, when they appear together, suggest a specific disorder or problem.

A silent epidemic. Perfectly Hidden Depression (PHD) is a syndrome characterized by outward success and happiness, masking inner pain and struggle. Individuals with PHD appear to have it all together, but internally battle intense loneliness, emptiness, and perfectionism. This disconnect between external appearance and internal experience can lead to severe consequences, including suicidal thoughts.

Hidden in plain sight. Unlike classic depression, PHD is not easily recognizable by others or even by the individuals themselves. The perfectionism and drive to appear successful often prevent those suffering from seeking help or acknowledging their pain. This makes PHD particularly dangerous, as the struggle remains invisible until it reaches a critical point.

2. The Ten Characteristics of Perfectly Hidden Depression

You are highly perfectionistic and have a constant, critical, and shaming inner voice.

The perfectionist's prison. The ten characteristics of PHD form a complex web of behaviors and beliefs that trap individuals in a cycle of hiding and self-criticism:

  • Intense perfectionism and self-criticism
  • Excessive sense of responsibility
  • Detachment from painful emotions
  • Worry and need for control
  • Focus on tasks and accomplishments
  • Difficulty with emotional intimacy
  • Discounting personal pain
  • Possible accompanying mental health issues
  • Strong belief in counting blessings
  • Success within professional structures but struggle in relationships

A double-edged sword. These traits often lead to outward success but inward turmoil. The constant drive for perfection and fear of vulnerability create a barrier to genuine connections and self-acceptance.

3. Breaking Through Denial and Gaining Awareness

Consciousness is about developing an awareness and acceptance that something is a problem.

Recognizing the mask. The first step in healing from PHD is becoming aware of the disconnect between your outward appearance and inner struggles. This involves acknowledging that your perfectionism and need to appear "fine" may be causing more harm than good.

Overcoming denial. Many with PHD struggle to see their behavior as problematic, as it has often served them well in achieving success. Breaking through this denial requires:

  • Honest self-reflection
  • Willingness to question long-held beliefs
  • Openness to feedback from others
  • Recognition of the toll PHD takes on mental and emotional well-being

4. Confronting Your Rulebook: Challenging Beliefs and Behaviors

Rules often reside in what you were taught or what you decided for yourself is what you have to do to be okay.

Rewriting the rules. Individuals with PHD often operate under a strict set of internal rules that govern their behavior and self-worth. Confronting these rules involves:

  • Identifying spoken and unspoken rules from childhood and current life
  • Evaluating whether these rules serve you well in the present
  • Replacing destructive rules with more flexible, compassionate choices
  • Experiencing the emotions that come with letting go of old patterns

Embracing flexibility. The goal is not to eliminate all rules, but to develop a more balanced, compassionate approach to life that allows for imperfection and vulnerability.

5. Connecting with Emotional Pain for Healing

Either feel it or live it. You either connect with pain or you mask it.

Breaking the emotional dam. Many with PHD have spent years disconnecting from their emotions, particularly painful ones. Healing requires reconnecting with these suppressed feelings through:

  • Developing self-compassion
  • Creating a timeline of significant life events and their emotional impact
  • Practicing mindfulness to stay present with emotions
  • Allowing oneself to grieve past hurts and missed opportunities

The power of vulnerability. By allowing yourself to feel and express pain, you open the door to genuine healing and connection with others.

6. Moving from Perfectionism to Self-Acceptance

Acceptance of vulnerability brings with it freedom.

Embracing imperfection. The journey from PHD to a more authentic life involves:

  • Recognizing that mistakes and vulnerability are part of being human
  • Challenging the belief that perfection equals worth
  • Learning to sit with discomfort and uncertainty
  • Developing a more compassionate inner voice

The freedom of authenticity. As you learn to accept all parts of yourself, including flaws and struggles, you create space for genuine happiness and connection.

7. Navigating Relationships with a New, Authentic Self

You want to create relationships in which you can be real.

Breaking the silence. Opening up to others about your journey can be both liberating and challenging. It involves:

  • Choosing trusted individuals to share your experiences with
  • Being prepared for various reactions, from support to confusion
  • Allowing relationships to evolve as you become more authentic
  • Setting boundaries and communicating your needs

Building genuine connections. As you learn to be more open and vulnerable, you create opportunities for deeper, more fulfilling relationships based on mutual understanding and acceptance.

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Review Summary

3.88 out of 5
Average of 500+ ratings from Goodreads and Amazon.

Perfectly Hidden Depression receives mostly positive reviews, with readers praising its insightful approach to perfectionism and hidden depression. Many find the book relatable and helpful, appreciating the practical exercises and real-life examples. Readers note the book's accessibility and its potential to benefit those struggling with perfectionism, even if they don't have depression. Some criticisms include a perceived harsh tone and questions about the validity of the "perfectly hidden depression" concept. Overall, reviewers recommend the book for those seeking self-improvement and understanding of mental health.

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About the Author

Dr. Margaret Robinson Rutherford is a psychologist with over 30 years of private practice experience. She began writing online in 2012 and published Perfectly Hidden Depression: How to Break Free from the Perfectionism that Masks Your Depression in 2019. The book has been translated into several languages. Rutherford hosts the SelfWork podcast and has been researching and writing about perfectly hidden depression for a decade. She is passionate about raising awareness of how perfectionism can mask depression. Rutherford is a TedX speaker and welcomes opportunities to address organizations on this topic.

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