The Double Burden of Depression: Suffering While Pretending to Be Fine

It is a friend's birthday party. You haven't arrived late, and you won't leave early. When someone makes a joke you laugh, a moment after everyone else, and carefully enough that no one notices. They ask how work is going and you give your ready answer: "Not bad, I've been busy." Two hours later you turn the key in the lock, close the door behind you and sit down on the floor beside the shoe rack. Nothing of the evening remains in your memory except exhaustion. A social gathering that felt light to everyone else was, for you, a full shift of work.

Depression drains energy; everyone knows this. What is less visible is the second job performed that same night: appearing normal. In that very moment, a depressed person is doing two things. One is bearing their own state; the other is making sure that state goes unseen. The title of this piece, "the double burden," points to these two tasks.

The Stage That Never Closes

Erving Goffman likened social life to theater. In the presence of others, each of us presents an image of ourselves, and others either accept that image or do not. The analogy may seem ruthless, but Goffman does not intend it as an exposé. Performance is the condition that makes interaction possible: if everyone said everything all the time, no conversation would ever reach its end.^[1] The decisive point is the distinction between the "front stage" and the "backstage." The backstage is where the performer sets the role aside, drops the face, and is allowed to be tired.^[2]

The depressed person is usually deprived of a backstage. The home that ought to be the backstage becomes a stage itself: a spouse who asks "why are you so quiet?", a mother who calls and gauges the sound of your voice, a housemate who has cooked dinner and expects thanks. Under these conditions the only place where the role can be dropped is a room with the door shut, and even there no one can explain why a closed door is itself taken as a sign of trouble.

Why We Conceal

In his book "Stigma," Goffman points to two situations: some people carry a mark that gets them stigmatized, and others notice it easily. These people must cope with the reactions and tensions that arise in encounters with others. Others, however, are able to hide the mark from those around them. Their central difficulty is how to prevent their condition from being disclosed and how to monitor what information they hand over to others.^[3] Depression usually belongs to the second category. The illness is not written on the body, and for a time a person can keep it out of sight. Goffman calls this possibility "passing": crossing the boundary as a member of the normal group.^[4]

Passing has a cost. In every conversation the person must gauge what can be said, in what tone to answer which question, and how to explain yesterday's absence. Sentences like "I was swamped" and "I had a headache" come from here. Every small lie needs another lie to protect it, and the depressed person, who is already barely getting through the day, must also keep the archive of these explanations in mind.

Concealment is rooted in another aspect as well: the reaction of others. Someone who discloses their depression usually meets one of two things, either hasty advice ("go out, get some fresh air") or fear and distance. In both cases the person has to look after the listener's feelings: accept the advice politely, or soothe the worry. Telling the truth is work too, and after a few experiences the depressed person calculates that hiding is cheaper.

A Smile with a Ledger

Arlie Hochschild turned to an aspect of social life that Goffman had paid less attention to: the gap between the feeling a person actually experiences and the feeling they outwardly show others. She explained that society sets rules for our emotions as well. At a funeral we are expected to be sad, and at a wedding celebration, joyful. If a person's real feeling does not match these expectations, they may try to change the feeling, or at least behave as though they have the expected one. Hochschild called these expectations "feeling rules" and the effort to bring feelings and behavior into line with them "emotion work."^[5]

She identifies two ways of doing this work. In "surface acting," the person adjusts only the appearance: smiling, raising the tone of voice, nodding. In "deep acting," they try to change the feeling itself, for instance by recalling something pleasant or by persuading themselves that things aren't all that bad.^[6] The depressed person knows both. Surface acting at the party, and deep acting the night before, when they reason with themselves that their friends love them and so they ought to be happy.

A conceptual caution is needed here. Hochschild reserves "emotional labor" for work that is sold, like the flight attendant whose smile is part of the job description, and calls emotional effort in everyday relationships "emotion work."^[7] What a depressed person does among friends or family is emotion work. But in the workplace, where the smile is a duty and one is paid to smile, the same person faces both layers. An employee who is pleasant with a client in the ten o'clock meeting, and at two o'clock is too exhausted to write an email, is performing emotional labor and also the hidden emotion work of concealing their state.

The Energy Ledger

These tasks demand energy, and energy is exactly what depression takes. A healthy person draws the performance from a reserve that is cheap for them. A depressed person runs the same performance on a currency they do not have. After an ordinary social encounter, their exhaustion is far greater than the actual amount of conversation would explain, and others, who have seen only the front stage, do not understand why they cannot answer messages the next day.

Messages are a smaller instance of the same cost. A simple message from a friend, "Where are you? I haven't heard from you in ages," is one sentence for a healthy person. For a depressed person it is several decisions: not replying brings resentment, a short reply brings worry, a long reply requires narrating their state in some other way. So the message sits on the screen for hours, and with every hour that passes replying becomes harder, because now an explanation for the delay must be constructed too.

This situation creates a cycle. To keep up appearances, the person skips invitations so as not to pay the cost of performance. Absence demands explanation, and explanation is another performance. Others, who know nothing, grow annoyed with them, and their annoyance is a new burden to be managed. In the end, the original suffering is pushed to the margins by the effort of managing others' reactions to that suffering. Why should someone who is enduring something also be responsible for the feelings of those who are upset at seeing them endure it?

The Guilt Charged to Depression's Account

Mark Fisher, in "Capitalist Realism," offers a social answer to this question. He reminds us that depression and anxiety are reported in contemporary capitalist societies in ever-increasing numbers, and yet the dominant way of confronting them is to redefine them as personal problems: a defect in each individual's brain or way of thinking. Fisher calls this process the "privatization of stress."^[8] Once suffering is traced back to brain chemistry or an individual's mental habits, questions about working conditions, job insecurity, urban loneliness and the pressure to succeed are no longer asked.^[9]

The consequence of this individualization is tangible for the depressed person. If the problem lies in them, then recovery is their duty too. They must exercise, sleep early, see a therapist, think positively. Every day without improvement is a personal failure. To the suffering of depression, which itself comes with a sense of worthlessness, is added another guilt: they cannot even manage to get themselves better. And because failing to recover has been defined as shameful, hiding it also makes sense. The system of stigma, emotion work and individualization is a circle: each reinforces the others.

This logic is directly tied to the experience of concealment. In such a system incapacity is a personal matter, and someone who becomes unable to cope with work and everyday relationships does not see themselves as representing anything larger than their own incapacity. They consider only themselves to blame. Concealment in this case is not merely fear of others' judgment; it is complicity with a judgment the person has already passed on themselves.

The Right to Not Be Okay

Part of the depressed person's suffering stems from the expectation that they always behave normally and not show their low mood to others. Individual treatment alone cannot remove this part of the suffering, because its source lies in how others respond and in the expectations society holds of individuals. For this reason, accepting the depressed person's right not to be okay is not merely a sign of kindness; it is a necessity for recognizing their experience and situation.

A depressed person has the right not to laugh at a party. They have the right to leave a message unanswered and write no explanation for it. They have the right to decline an invitation without giving a reason, and the right not to know the reason. They have the right, when someone asks "how are you?", to answer "I'm not okay" without needing to add immediately that it is no trouble to anyone. These rights follow from the same analysis: if performing normality is work that consumes energy, and it has been demanded of them without anyone recognizing it as work, then the person may refuse to do it.

These rights do not mean release from all relationships. The depressed person, too, wants to be seen and not to be alone. But the condition for being seen should not be that they first appear bearable.

The Double Burden Once More

Let us return to the same party. A friend sitting beside you, who knows what is going on, says "you don't have to laugh," and for the first time that night you take a deep breath. Nothing has changed. The depression is just as heavy. But of the two burdens you were carrying, one has been set down.

That is what the double burden means: the suffering that is there, and the suffering that comes from hiding it. The first is made by depression, and the second by us, with the rules we have written for feeling, with the stigma we have attached to mental illness, and with a gaze that charges every social pain to the individual's account. The first burden cannot be lifted by willpower. The second can, but only when others decide not to demand a performance from them.

^[1] Erving Goffman, The Presentation of Self in Everyday Life (Garden City, NY: Doubleday, 1959), chapter 1 ("Performances") and chapter 3 ("Regions and Region Behavior"), on the "front stage" and "backstage."

^[2] Goffman, The Presentation of Self in Everyday Life, chapter 3; in this chapter Goffman treats the "backstage" as the place where the performer can set the role aside.

^[3] Erving Goffman, Stigma: Notes on the Management of Spoiled Identity (Englewood Cliffs, NJ: Prentice-Hall, 1963), chapter 2 ("Information Control and Personal Identity"), on the distinction between the "discredited" and the "discreditable" person.

^[4] Goffman, Stigma, chapter 2, on "passing" and information management; and chapter 3 ("Group Alignment and Ego Identity") on the difficulties of living with a concealed identity.

^[5] Arlie Russell Hochschild, “Emotion Work, Feeling Rules, and Social Structure,” American Journal of Sociology 85, no. 3 (1979): 551–575. The concepts of "feeling rules," "surface acting" and "deep acting" are formulated in this article.

^[6] Hochschild, “Emotion Work, Feeling Rules, and Social Structure,” 551–575; see also: Arlie Russell Hochschild, The Managed Heart: Commercialization of Human Feeling (Berkeley: University of California Press, 1983), chapter 1, in which a distinction is drawn between "emotion work," with use value in private life, and "emotional labor," with exchange value in the labor market.

^[7] Hochschild, The Managed Heart, chapter 1. Hochschild reserves "emotional labor" for wage relations; for this reason, in this article, gatherings and private relationships are described as "emotion work."

^[8] Mark Fisher, Capitalist Realism: Is There No Alternative? (Winchester: Zero Books, 2009), the section on mental health, in which Fisher speaks of the "privatisation of stress."

^[9] Fisher, Capitalist Realism, same section; Fisher shows that the biomedical and individual explanation of depression sets aside the question of its social causes.