Perfectly Hidden Depression Explained | Dr. Margaret Rutherford
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What is perfectly hidden depression and how does it manifest?
You have to change your definition of depression. We have been so pummeled with the importance of the symptom checklist in the DSM, in the Diagnostic and Statistical Manual of Psychiatry. That if someone doesn't fit those criteria, they must not be depressed, right? In fact, I have had people tell me their therapist look at them when they say, I've got this perfectly hidden depression thing. This is me. No, you're not depressed. They're not depressed in the classic sense. That's true. Their lives are going to be full of energy, full of success, well-liked. People probably walk up to them and say things like, you know, how do you get everything you do done? I wish I had your life. I wish I had your energy.
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Today on We're Out of Time, I'm joined by Dr. Margaret Rutherford. clinical psychologist and author who's brought global attention to something called perfectly hidden depression, where people who seem to have it all together are actually struggling in silence. Her TEDx talk has reached millions and her new workbook is helping people recognize and break free from perfectionism that hides real pain. Dr. Rutherford, welcome. I'm delighted to be here. I want to read to you the short overview that I had done for me, letting me know who you were. Okay. I looked at this 20 minutes ago. Okay. Which lets you know the level of preparation I do for the show.
You should be able to, you know, figure me out in 20 minutes.
That's okay. I figured you out in less than 60 seconds. Dr. Margaret Rutherford is a clinical psychologist known for her work on perfectly hidden depression. A condition where high functioning, successful people mask deep emotional pain through perfectionism and achievement. That's what you deal with. That is your specialty. Is it not?
Yes, it is. It has been something, Richard, that I never intended to write a book. I never intended to do a TEDx. I never intended to do any of that. But this topic found me. I was writing, I had started a website and I was writing about these people that I'd worked with over the years that were exactly that. They were very successful, high achieving. They'd come into therapy and kind of go, I don't really know why I'm here. I'm just kind of anxious and something. I mean, they... If I would ask them about depression, they would immediately say, oh, no, I am so lucky to be living the life I'm living. And yet what I began figuring out was that these people didn't know how to express, they didn't know how to access emotional pain because of this camouflage that had protected them for years.
The why is multifaceted, if I can use a graduate school word. could have been for a lot of reasons it could have been because they were in an abusive home uh alcoholic parents it could have been that they uh you know their mother or father didn't take care of them and so they they took care of their siblings so they became sort of a pseudo adult that's because they what about shame what about shame what about the fact that these people are so excellent
in their fields and what they've accomplished that it feels like shame to not be able to have a successful relationship or find a fit, right? That feels shameful. It feels a little shameful to me.
Yeah, it's not my central point, but it's a good point. I mean, the shame comes when you feel like you have this highly perfectionistic, again, successful persona, and you don't want anybody to see underneath that because there's shame underneath that, just like we all have shame. We all have things that we've screwed up or whatever. Yeah. So the perfectionist, this kind of perfectionist, which the researchers would call destructive perfectionism, it stands, that shame is what drives them, what keeps them having to look busy and having to look like they don't have trouble in the world.
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Chapters
8 chapters
1
What is perfectly hidden depression and how does it manifest?
0:00–8:55
2
Why do high-achieving individuals often mask their emotional pain?
8:55–15:53
3
How does toxic positivity affect mental health?
15:53–22:26
4
What role does shame play in perfectly hidden depression?
22:26–28:17
5
How can emotional transparency aid in recovery?
28:17–37:29
6
What coping mechanisms can help those battling hidden depression?
37:29–49:54
7
How does perfectionism relate to substance use disorders?
49:54–53:52
8
What steps can individuals take to foster self-acceptance?
53:52–1:03:59
Speakers
2 identifiedMore from We're Out of Time
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