When we think about depression, we usually think of people who are sad all the time. Maybe they neglect their hygiene, or they don’t eat much, or they sleep most of the day. And although this is an accurate depiction for some, depression doesn’t always look the same. Some people living with depression look like they’ve got it all together – from the outside. They hold down steady jobs, show up for their commitments, look fresh and showered, and are often considered positive and productive members of their communities. These people have “high-functioning depression” and it can be tricky to spot.
What is high-functioning depression?
In the Diagnostic Statistical Manual (or DSM), there is no actual diagnosis of “high-functioning depression,” much like there is no diagnosis of “high-functioning anxiety.” That said, high-functioning depression is real and it can affect anyone. Those with high-functioning depression can be overlooked because their symptoms do not always present like our stereotypical ideas of depression.
Since it often goes unseen, perhaps we need to focus less on what depression looks like and instead talk about what it is like to live with depression.
There are several types of depressive disorders, but when we hear the word “depression” we’re usually thinking of major depressive disorder (MDD), or clinical depression, which is a significant mental health disorder that persists beyond two weeks. Symptoms of major depressive disorder include:
- a persistent feeling of sadness
- diminished pleasure in activities you once enjoyed,
- decrease (or increase) in weight
- insomnia (or hypersomnia)
- feelings of worthlessness
- thoughts of suicide
- fatigue.
High-functioning depression has many of the same symptoms as major depressive disorder. It typically persists for two years or more. During this time, those living with it adopt coping mechanisms to help them function at seemingly “normal” levels – even if they are experiencing severe symptoms internally. Many people with high-functioning depression often maintain jobs (and excel at them) and relationships, all the while hiding their symptoms. They may distract themselves from how they’re feeling by overachieving and/or self-medicating. They may also experience somatic symptoms, like chronic headaches, digestive issues, and muscle tension.
Why do people hide high-functioning depression?
Due to the invisible nature of high-functioning depression, many living with it will dismiss their symptoms, or ignore them altogether, because they don’t think they’re “severe enough” to warrant talking about or seeking help over. Cultural expectations can also play a role in hiding their experience; the stigma that still surrounds mental illness is very real and people may choose not to talk about their depression out of fear of being burdensome or appearing weak.
Seeking help
While others may not see the struggle, high-functioning depression can be extremely difficult to live with and deeply impair quality of life. There are multiple treatment options available and getting help is the first step to feeling better. When you’re ready, our therapists are here to give you the space and support you need.