Awareness of common mental health conditions and their symptoms has generally increased in recent years. By now, most people recognize the key symptoms of depression:
- persistent sadness
- loss of interest in daily life
- an overall low mood
This knowledge can be beneficial — not least because it makes it easier to recognize when a loved one might be having a hard time.
Yet this rise in awareness does have one unfortunate side effect: It can sometimes lead to judgments about someone’s mental health based on their observable symptoms.
Depression, like most mental health conditions, is complex. The wide range of symptoms involved extend far beyond sadness and lethargy to include:
- irritability, anger, and increased restlessness or agitation
- sleep issues, ranging from insomnia to oversleeping
- feeling slower than usual, in speech and movement
- changes in appetite
- weight loss or gain
- memory and concentration difficulties
- trouble making decisions
- hopeless or pessimistic outlook
- feelings of guilt, worthlessness, or emptiness
- aches, pains, and digestive concerns that keep coming back
In short, someone might not seem to have a low mood, but that doesn’t mean they’re faking depression. You can absolutely have depression without showing any outward signs.
You might wonder, then, how to tell when someone’s actually faking depression — and whether it really matters. We offer a few important considerations below.
Although depression falls under the umbrella of common mental health conditions, it’s still exactly that: a mental health condition.
Not everyone feels safe or comfortable disclosing their mental (or physical, for that matter) health status. Plenty of people make a significant effort to keep this information private.
For the most part, mental health awareness continues to move in the right direction, but there’s still a long way to go.
Stigma remains all too common, so people who want to escape judgment, inappropriate or prying questions, and unwanted advice tend to get good at hiding mental health symptoms.
Others may simply not want to talk about their symptoms or condition — and they certainly don’t have to. Everyone has the right to make this choice for themselves.
If they do end up having to share their condition for some reason, though, you might feel astonished. Whether you say, “You don’t seem depressed to me,” or keep the thought to yourself, it still invalidates their experience.
It’s not always possible to entirely understand how someone feels. You only get what they offer, and some people have spent years carefully constructing a mask to present to others.
Depression can present in very different ways
Not only can depression show up differently from person to person, but several types of depression exist. Symptoms of these subtypes might not always line up with the “classic” presentation of depression.
- Someone living with dysthymia, or persistent depression, might have milder symptoms that never really go away. These symptoms won’t always have a major impact on day-to-day life. People could even assume they just have a more introverted, pessimistic personality.
- A person living with seasonal depression might not experience any symptoms at all during most of the year — but that doesn’t make their symptoms any less serious when they do show up.
There’s also “smiling depression.” While this term doesn’t represent an actual diagnosis, it’s often used to describe people living with depression who seem mostly happy and content with life. They may have no trouble getting to work every day or spending time with family and friends.
But behind this mask, they might experience typical symptoms of depression, including thoughts of suicide.
In some cases, people who don’t have depression do end up exaggerating mood symptoms, or inventing them entirely. This doesn’t necessarily mean they’re out-and-out faking — even manufactured symptoms often relate to emotional distress.
Keep in mind that some people living with mental health conditions might choose to say they have depression instead of offering detailed information about their actual symptoms.
They may consider this explanation a better route for dodging unwanted questions and stigma due to greater awareness (and acceptance) of depression compared to other mental health conditions.
Two mental health conditions are commonly linked to what someone might think of as “fake” depression:
People living with this condition exaggerate or fabricate physical or mental health symptoms, often with no real reason for doing so. The key motivation for making up symptoms seems to revolve around having others notice the “illness.”
Factitious disorders can develop after illness or stressful life events, like a breakup or loss. Someone who previously had episodes of depression might even say they’ve had a relapse in hopes of getting similar support.
Someone who has factitious depression might:
- talk a lot about their symptoms, often in an exaggerated way
- report symptoms inconsistently
- see many different therapists
- try every available treatment but report that none of them work
It’s important to understand that, while people with factitious depression might not actually have depression, they do have a mental health condition.
They might not know what drives them to make up symptoms, and they might not find it possible to stop on their own.
Somatic symptom disorder
Somatic symptoms refer to physical symptoms that:
- are real, not faked
- often don’t have a clear medical cause
- cause significant distress and difficulty in everyday life
Many people with depression won’t always feel sad or have a low mood. They might mainly experience physical symptoms, like:
- chronic body pain
- severe headaches
- digestive problems
- lingering fatigue
As noted above, these symptoms also make up part of the diagnostic criteria for depression.
With somatic symptom disorder, these physical concerns also provoke extreme worry and distress, even after healthcare professionals rule out serious medical conditions.
Excessive concern or fixation on these symptoms is generally part of the diagnosis, but keep in mind that unexplained symptoms can, without a doubt, prompt plenty of frustration and concern on their own.
People with somatic symptoms might face accusations of “faking it” twice over — first, because they may not have clearly recognizable depression symptoms, and second, because their physical symptoms seem to lack any explanation.
Of course, some people do fake medical or mental health conditions, usually for some type of personal gain. There’s even a term for this: malingering.
Malingering refers to a specific and intentional behavior, not to a mental health condition. In basic terms, someone who malingers depression fakes it intentionally, for any number of reasons:
- to get sympathy and support
- to avoid potential consequences for not completing school or work responsibilities
- to receive disability payments or other financial benefits
Malingering doesn’t involve any specific symptoms, so it can be difficult to recognize.
In a 2018 study, researchers attempted to develop a tool to identify faked depression.
Their results supported previous findings that suggest people who fake depression symptoms tend to report more symptoms overall — both of depression and other psychiatric concerns.
Maybe you suspect malingering if someone’s symptoms first appear at a convenient time, like:
- during a court case
- after cheating or other relationship problems
- when failing a course or having trouble at work
But any of these situations can easily lead to (and sometimes result from) anxiety or depression.
At the end of the day, it’s always best to avoid making assumptions about someone’s mental health — even if they do seem to benefit from their depression.
So, you think your friend, partner, or family member is potentially faking depression. What to do next?
If they’re an adult
Saying nothing might be a better option.
For the most part, someone’s choice to fake depression (if that’s really what’s happening) likely won’t impact your day-to-day life.
Calling them out could put them on the defensive, and it might not do anything to improve the situation. They might end up avoiding you, making it much harder to offer any kind of support.
Remember, even if they don’t really have depression, it’s quite possible they’re dealing with something else. If you’re concerned, you can still offer support.
- Asking how they’re doing. Listening with compassion can go a long way toward helping someone feel supported and less alone. Your willingness to listen could also encourage them to open up about the real issue.
- Reminding them you care. Telling someone how much they matter to you helps emphasize that you still think of them and care for them — even if they don’t have depression.
- Spending time together. Someone who feels lonely or neglected could just need a little extra attention and friendship. They could be having a hard time with feelings they can’t entirely explain.
If they’re a child
It’s not unusual for children to “fake sick” at some point, perhaps to get out of going to school or other activities. But it’s best to avoid dismissing depression symptoms in children, even if you suspect they’re exaggerating.
Kids don’t always know how to talk about what’s on their minds. They often don’t have all the words to describe how they’re feeling, or worry about getting blamed for things that aren’t their fault.
If, say, a teacher keeps singling them out unfairly, or a peer begins teasing or bullying them on a regular basis, manufacturing depression symptoms might seem like a safe way to avoid more distress. These challenges can also contribute to depression.
If your child is experiencing any kind of emotional turmoil, start with a conversation by:
- setting aside some time for just you and your child
- letting them know you plan to mute or ignore all distractions and give them your full attention
- starting with something like, “I’ve noticed things seem rough for you lately. Can we talk about how you’re feeling?”
- keeping an open mind (Depression symptoms can show up differently in children, too.)
- asking open-ended questions and encouraging them to elaborate in detail
- letting them use their own words to describe their feelings
Even if their concerns don’t seem all that terrible, remember that even minor crises may feel particularly devastating for a child and even lead to depression.
Saying things like, “That’s no big deal. Stop worrying,” or “That’s nothing to feel sad about,” can have major consequences, now and down the line, by:
- invalidating their distress
- teaching them to suppress emotions instead of working through them productively
- making it less likely they’ll turn to you for support in the future
Having an open conversation about how their feelings not only allows you to figure out what’s going on, but it also helps your child learn how to talk about their emotions.
Depression isn’t a one-size-fits-all diagnosis — but then, what is?
Someone’s symptoms may not align with a “classic” presentation of depression, but that doesn’t make those symptoms fake.
And if they are, in fact, faking it? Their invention of symptoms may matter less than the fact that something is troubling them. Your compassion and kindness could help them feel safe enough to open up in a more honest way.
Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.