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Your Life Seems Perfect – But Could You Be Hiding from Depression?

Therapy at 60 can seem a bit daunting. There’s a lot of life to talk about. Yet I’ve seen many older people delve into emotional struggles quite successfully.

Yet therapy might not seem needed to someone whose life looks perfect. “It’s my time to enjoy life. I wouldn’t change a thing.” Maybe that’s true. If so, that’s wonderful.

But it’s also true that perfect-seeming can be far from perfect.

Perfectly Hidden Depression

I’ve been researching what I term perfectly hidden depression (PHD) for several years. If that phrase brings you relief, or intrigues you, then you may be someone whose secrets have been hidden by a perfect-looking life.

If you’ve never been able to turn off a nagging voice of self-criticism and shame, if you don’t know how to connect with painful emotions, or believe that if your true feelings were known, you’d lose others’ respect, then you might far too easily identify with PHD.

There are many reasons to break your silence.

The Outside Doesn’t Match the Inside

The pressure you can feel is immense. You can’t ever let anyone down because you’re only as important and successful as your last project.

No matter that you get more tired than you used to or you’re grieving friends that have died, you have to be the penultimate grandmother, the consummate advocate for whatever cause you’ve taken up.

You can be surrounded by friends, involved in a job or multiple activities where you’re highly engaged – and no one would look at you and believe you might be hiding shame, anxiety, or fatigue.

Even if you tried to tell them, they’d likely say, “What, you? You’re the epitome of what every woman wants to be at 60.” Your own loneliness – knowing that no one knows the real you – could easily lead to despair.

Are You a Marie?

Let’s talk about Marie. She was 62 when she walked into my office.

I’d met Marie socially many times in my hometown in Arkansas. When anyone spoke of her, her multiple accomplishments were touted – having a highly successful legal career; building a non-profit support program for young mothers with substance abuse issues; creating a loving family and a network of great friends; even surviving the early death of her husband.

Everyone knew her as a fighter, a brave heart – someone who cared and who could influence other people to do the same.

She sat, smiling, in front of me, and said, “I’ve heard you’re pretty direct.”

I laughed. “Yes, I have that reputation.”

“Well that’s what I need. Because I don’t understand, when I have so many blessings in my life, why I feel this dread. Yes, I’ve had some health issues. But I’m okay now. It’s as if I can never do enough. I feel panicked that I’m still trying to prove myself. And yet, I know I have already proven myself. Why can’t I let up?”

When I asked about her past, she looked away for a second, and then looked back. “I promised myself I’d be honest with you today. But it’s very hard.”

An hour later, there were tears in her eyes as she got up to leave. She’d been vulnerable and real. She’d realized she’d always failed to earn her demanding mother’s love or her absentee father’s attention.

The coping strategy that she’d devised to handle her childhood pain, to be extremely accomplished and always look in control, was now escalating into panic as she grew older. She began to glimpse the damage done that she’d never allowed anyone, perhaps not even herself, to see.

Self-compassion began in that hour. “That’s what my constantly trying to ‘do more’ has meant, hasn’t it? Oh my gosh. I want to stop. But I don’t know another way.”

What It All Means – for You

Like Marie, you can choose to risk stirring that pot – to look into the recesses of your heart and mind for hurt and grief that you’ve had “no time for,” and to challenge the rigid rules that still govern you.

Because it is your time. It’s time for freedom from shame.

It’s time to give yourself the gift of vulnerability.

And it’s time for genuine self-acceptance.

If you wonder where you might be on the spectrum of perfectly hidden depression, take this questionnaire.

If you want to delve deeper and understand how PHD might be affecting your life, you can read more on the topic in Perfectly Hidden Depression: How to Break Free from the Perfectionism that Masks Your Depression.

And if you’re looking for a therapist, why not check out Better Help’s online matching service. It’s always a good idea to have someone empathetic to share your burden.

Let’s Have a Conversation:

How often do you mask your true feelings so you can appear perfect to the people around you? How often do you find time for yourself? Are you hiding unresolved pain? Is your perfectly-looking life too stressful? Please take a moment to share in the comments below.

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Many thanks for this article. It is spot on. There is an emotional toll of carrying all of the expectations of others and ourselves. Appreciate the inflection point of “60” to put much of this in the rear-view mirror.


Since the pandemic I had a falling out with my one older brother and has been just over a year since we visited in person. My husband and I moved in 200o and until 2017 we are within 4 hrs away. I think I overstayed my welcome and once the regulations were lifted Tempers were shor5 and feelings hurt. I want to let go of this pain and move on, I believe I tried to get back too much lost time, depression sadness

The Author

Dr. Margaret Rutherford, a clinical psychologist, has practiced for over twenty years in Fayetteville, Arkansas . Her work is found on her own website, as well as HuffPost, Psych Central, Psychology Today, The Gottman Blog and others. She's the author of "Marriage Is Not For Chickens", a perfect gift book on marriage, and hosts a weekly podcast, SelfWork with Dr. Margaret Rutherford.

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