Depression is a common psychological disorder, known as the “number one psychological killer”, and it has been speculated that the famous artist Leslie Cheung died of depression. After causing a sigh of relief, the public also has a certain awareness of depression. People have the impression that depressed patients are always depressed, downcast, unresponsive, uninterested, unmotivated, hopeless, helpless, slow in thinking, and less active, etc. Few people associate depressed patients with smiles. In clinical practice, it is true that a small percentage of depressed patients have a veil of smile over the surface of their depressed state of mind. Although this part of the patients feel extreme pain, depression, sorrow and sadness deep inside, the external expression is as if nothing is wrong, with a “smile”, this “smile” is not from the heart of the real feelings, but out of coping with social interactions, coping with work, coping with family members, for the sake of face. This “smile” does not come from the heart, but from the heart to cope with social interactions, to cope with work, to cope with family members, and to put on a happy face for the sake of saving face. This kind of smiling depression favors those who are highly educated, have considerable status and position, and have successful careers. There is also a part of recovering depressed patients, due to the prejudice of the society, there is discrimination against the mentally ill, some patients, when they are about to return to the society, fear that because they have had mental illness, they cannot lift up their heads in the society, have no face, fear that others will look down on them, and appear to commit suicide. Another situation is that in order to achieve the purpose of suicide, patients with major depressive disorder consciously cover up their painful experiences and put on a happy face to avoid the attention of medical personnel and family and friends, so as to create conditions for suicide. A sudden “improvement” in mood and “brightening up” of a major depressive patient may be a dangerous sign and should be highly alert to prevent suicide. If there are frequent and recurrent early awakenings, along with depressed mood, low spirits, decreased interest, emptiness and boredom, pessimism and depression, inattentiveness, indecision, loss of passion, easily irritated and other symptoms, you should consider that you may have entered a depressive state or suffer from depression. These “smiling” depressed patients will fall into deeper loneliness, isolation and extreme depression after the “smile”. Friends and relatives of patients should strive for early detection, so that they can seek early medical treatment, and get active and reasonable treatment as soon as possible, and understand the relevant scientific knowledge, not to be confused by the surface “smile”, so as not to cause irreparable damage.