High-functioning depression is heartbreakingly common. In fact, regular depression often hides in plain sight as well. On the other hand, there are cases where it is visible and obvious.
There is no “normal” really, even though society or the DSM-5 may tell us so. Every single person and every single case of depression (or any mental health struggle) is unique. There are of course some themes and commonalities. But high-functioning depression is harder to recognize and notice. It refers to a type of depression where the person still functions relatively well; everything on the outside seems fine. And some of these folks are even overachievers, high performers, or empaths who succeed greatly by societal or morality standards. For more detail about empath fatigue, read this blog here.
Underneath that, however, is low mood, feelings of sadness, or any other number of depression or anxiety symptoms. In this post, we will go over what the main symptoms are to be aware of for yourself and your friends and family, as well as how to deal with it and feel better.
High-functioning depression is easy to miss or overlook. It is, by definition, being hidden by the person, either consciously or unconsciously. They may not want to trouble others, or they perceive that no one is available as a safe space. This is either true, where they don’t have trusted confidantes to share with; or they do have loved ones around but choose not to discuss it.
Even though we’ve made great strides in mental health awareness in recent years, the truth is that difficult emotions still make people uncomfortable. Thus, those with high-functioning depression may push through without addressing how they feel. This can make the experience more and more isolating over time, and lead to further deterioration in wellbeing. Understanding the signs is a good first step toward meaningful change and positive shifts in mood and energy.
High-functioning depression is a form of ongoing depression where a person is still able to manage daily responsibilities while experiencing persistent sadness, emotional distress, low energy, or detachment/dissociation.
People with high-functioning depression often maintain routines that make their struggles less visible. The symptoms are more subtle and consistent rather than severe and disruptive.
A related and overlapping condition is called persistent depressive disorder (PDD) or dysthymia. Symptoms of depression that is high functioning or PDD tend to be milder than major depression, but longer term and more chronic.
Absolutely. Many people with high-functioning depression maintain careers, relationships, and routines. Productivity does not equal mental wellbeing! This is a sad and scary truth. We’ve all heard stories of people who seemed fine or even great but later went to rehab, had a breakdown, or tragically took their own life. Our goal is to catch signs and symptoms long before anything of that sort occurs.
Ironically but understandably, high achievers are often more likely to mask symptoms. The message from culture, family, religion, organization, workplace, and/or school may be to compartmentalize, soldier on, or focus on appearances. “C’mon, don’t cry” or subtle shaming for distress is common and yet very damaging. True feelings may be perceived as messy, inconvenient, or inappropriate.
Here are some of the symptoms of depression that is high functioning:
The first step is to identify the signs and stop shaming yourself for them. You are human, and we all struggle. If you grew up with strict rules or rigid models for behavior, or a lack of emotionally available caregivers, you may have a higher risk of this type of depression.
Especially in prior generations, emotions like sadness, grief, and rage were not allowed or encouraged. Most of the time, your parents or caregivers were just repeating their own conditioning from their families. It’s not intentionally harmful. In other cases, there is outright abuse or malicious intent (more likely with narcissists or dark triad traits).
Here are five steps to start to address and heal from high-functioning depression.
Recognize that functioning does not equal thriving. Just because you or someone else CAN maintain an appearance of normalcy does not mean you SHOULD or that you are fine. Take some quiet time to connect with yourself and notice what feelings or thoughts are there.
Good old basic self-care and a routine can take you surprisingly far when it comes to all forms of depression. I like to call it radical self-care when you make it a priority. You are in essence making YOU a priority.
Depression and PTSD tend to make people not even realize how much they are neglecting themselves. So, start to implement some of these manageable changes into your daily life:
Depression and anxiety often have rumination as a symptom. Ruminating thoughts are those that are obsessive, repetitive, or not constructive. Read this blog here for tips on stopping rumination. You can also work with positive affirmations if that appeals to you. Here’s my blog on affirmations for self-forgiveness and my blog on affirmations for healing to get you started.
Also consider how you could reduce self-criticism. Treat yourself with the compassion you would offer a close friend. Additionally, it can be therapeutic to practice realistic expectations, both for yourself and loved ones. No one is perfect, and that’s OK.
It takes courage to ask for help, and we all need that at times. Whether it’s sharing with trusted people or looking into therapy or counseling, do it. A mental health professional can give you tailored advice as well as a clinical diagnosis and treatment plan if needed.
Take intentional downtime, without guilt. This includes naps and resting when you need it. Also learn to say no! You must come first, which is the genesis of the saying: “you can’t give from an empty cup.” Well you can, but there may be dire consequences to your wellbeing and energy levels.
Well done on investigating whether dysthymia or high-functioning depression is affecting you or the people in your life. You now have the knowledge foundation to recognize the signs and symptoms, and then get better. Hope and healing is available to you!
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