Do You Have Mild, Low-Grade Depression?

Low-Grade or High-Functioning Depression

Do You Have Mild, Low-Grade Depression?

Say you’re living the American Dream. You have a well-paying job, a devoted partner, successful children, and a sense of purpose. You have everything you ever imagined you’d need to feel happy.

So, why can’t you shake this feeling that the other shoe is about to drop? That the world is about to fall off its axis? That you can’t feel good about all that you have, and you may never experience true happiness again?

Because you are a high-functioning member of society, you push those “self-indulgent thoughts” aside. You know that many people would dream to have just a smidgeon of what you are taking for granted. It’s time to get a grip, to stop complaining, even if it is only to yourself. It’s time to pull yourself up by your bootstraps and love your life.

Then, you listen to Michelle Obama’s new podcast and hear her say something that resonates:

“I’m waking up in the middle of the night, cause I’m worrying about something, or there’s a heaviness … There have been periods … where I just, have felt too low … I know that I am dealing with some form of low-grade depression.”

Maybe the name she gives her condition – low-grade depression – is the name for the pain and discomfort that has been plaguing you.

Is High-Functioning Depression Real?

When high-functioning people suffer depressive symptoms, they may think they are not clinically depressed.

“Indeed, the catch-22 of high-functioning depression is that sufferers often believe that since they can push through their sadness while barely missing a step, it would be indulgent to seek help. But that’s believing one’s own happy-on-the-surface social media status updates,” writes therapist Sherry Amatenstein on Psycom.

“While the stigma against seeking mental health treatment is lessening, there remain some dangerous myths. Such as that if depression isn’t severe and persistent – involving frequent bouts of uncontrollable weeping, emotional paralysis, and suicidal thoughts – then there isn’t a real problem and one should just tolerate pain with stiff-lipped silence,” Amatenstein writes. reports that “brain scans of people with persistent high-functioning depression also show that regions associated with inward thinking or rumination are hyperactive.

These regions, one of which is called the Default Mode Network, could be the basis of negative thoughts about oneself.

And studies have shown that certain pharmaceutical drugs, meditation, and psychotherapy all help to tame these overactive networks.”

Symptoms of High-Functioning Depression

Individuals who feel they have low-grad or high-functioning depression that persists for a long period of time may have dysthymia, chronic depression, or Persistent Depressive Disorder (PDD). The Mayo Clinic reports that PDD has similar, yet milder symptoms to Major Depressive Disorder (MDD).

“If you have persistent depressive disorder, you may find it hard to be upbeat even on happy occasions – you may be described as having a gloomy personality, constantly complaining or incapable of having fun,” writes the Mayo Clinic.

“You may lose interest in normal daily activities, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy.

These feelings last for years and may significantly interfere with your relationships, school, work and daily activities.”

Other symptoms of high-functioning depression may include sleeping too much or too little, poor or overstimulated appetite, inability to make decisions, feelings of guilt, and irritability.

The Mayo Clinic writes that those suffering from high-functioning depression typically experience symptoms for years and rarely go for more than two months without symptoms.

Ways to Recognize High-Functioning Depression

In the Mighty, psychotherapist Annie Wright, LMFT, points out that even if someone with dysthymia generally can handle all the “logistical adulting stuff of their life,” inwardly, “this same person may be gripped with a challenging set of symptoms invisible to those of us who love and know them.”

Some of the signs and symptoms of low-grade depression that Wright shared include:

  1. Lack of joy. When simple pleasures that used to make you happy no longer bring you joy, high-functioning depression may be present.
  2. Thinking critically of yourself and others. It can sound a chronic, never-ending critique of yourself and others around you.
  3. Decreased energy. If you don’t feel you have enough energy to make it through the day, this may be a sign of low-grade depression.
  4. “Small things feel huge things.” It can feel you cannot control irrational anger over small inconveniences or disappointments. wise, you find yourself feeling overwhelmed by an event that wouldn’t have been a big deal to you in the past.
  5. Guilt and worry. This is an unrelenting feeling of guilt and worry over your past and future.
  6. Coping strategies become the norm. “If you find yourself needing extensive zone-out time after work and on the weekends, turning towards your coping mechanisms more often than not — such as substances or behaviors using alcohol, drugs, excessive gaming, constant Netflix, etc. — all in an effort to escape your life, this could speak to underlying depression,” writes Wright.
  7. Unable to relax/unwind. Some may keep themselves busy to avoid uncomfortable thoughts and feelings.

How to Discuss High-Functioning Depression with a Healthcare Professional

Don’t let the “high-functioning” part of “high-functioning depression” mislead you. Depression – in any of its forms – is a condition that can and should be treated.

“If you think you may have dysthymia, it’s essential to seek help. Seeing a mental health professional is the first step to recovery,” according to the National Alliance on Mental Illness (NAMI).

It is important to clarify with your physician that you believe you’re suffering from low-grade depression and present reasons why.

“Most people with dysthymia are undertreated,” according the Harvard Health Newsletter. “They may only complain about physical symptoms or fail to complain at all because the disorder has become so much a part of them that they believe that is simply how life is. In older people, dysthymia may be disguised as dementia, apathy, or irritability.”

Healthcare providers may do a brief screening questionnaire and/or refer you to a mental health professional such as a psychiatrist or psychologist.

Treating High-Functioning Depression

Finding effective treatment for any type of depression can be complex. What works for each individual patient is impacted by their life experience, their temperament, and their genetics. However, in most cases, high-functioning depression may be treated effectively with a combination of psychotherapy and medications.

Numerous studies have shown that combined treatment with psychotherapy and medication was found to be notably superior to either treatment used alone, Dr. David Mintz, MD, writes in Psychiatric Times.

“Combined treatment produces not only faster and greater short-term benefits but greater long-term benefits as well,” he states.

If a healthcare provider is considering medication as part of the treatment for high-functioning depression, then the GeneSight test may help. If you are interested in the GeneSight test, discuss whether you might be a good candidate with your doctor. If your provider decides to order the test for you, they will receive your results and can review them with you during an appointment.

High-Functioning Depression Deserves Treatment

On the surface, high-functioning depression may seem it’s easier to deal with than major depression but it is not, according to the article.

“Depression is a very heterogeneous condition,” Michelle Craske, a professor of psychology and psychiatry at UCLA told Vice. “It takes a lot of different forms in terms of its severity and in terms of what it looks in the actual symptoms. We should not dismiss the mild forms because it’s still a struggle and there’s still a value to getting treatment.”

If you’d to learn more about high-functioning depression and treatment, turn to the following links:

Depression Treatment


What Is Low-Grade Depression?

Do You Have Mild, Low-Grade Depression?

Most people have an idea of what they think depression is . When they think of “depression,” the word evokes images of sad faces and general lethargy. While many cases of depression can present this way, a lot of depressed people do not display such obvious symptoms.

Sufferers of depression can seem well-adjusted people who show no clear behavioral health issues, however, they’re internally experiencing a mood disorder that can have serious repercussions for their health. = Dysthymia or low-grade depression is a form of depression where many people may not know they have it.  This is a mental health condition that is also known by several other names, including:

  • Low-level depression
  • High-functioning depression
  • Chronic low-grade depression
  • Persistent depressive disorder (PDD)

Although the descriptors “low-level,” “high-functioning,” and “low-grade” may suggest a relatively mild condition, that is misleading. This form of depression is, in fact, a serious disorder that can lead to long-term physical and psychological complications as well as a marked decline in overall quality of life.

Low-Grade Depression: The Basics

Low-grade depression is characterized by a persistently depressed mood of mild severity.

Outwardly, sufferers seem fine. Even the individual who has low-level depression often does not realize they have a medical problem. They become used to their chronic low mood, to the point where it becomes a “new normal” for them. If untreated, this type of depression can last for years.

About 3.6% of the population will experience low-level depression at some point during their lifetime. On average, low-level depression lasts for five years in adults.1

Most cases of low-grade depression have no clear cause. It is widely believed that this condition can be triggered by a combination of genetic susceptibility and environmental stressors. People with low-level depression often also have substance abuse problems, anxiety disorders, or a chronic illness.

Symptoms of Low-Grade Depression

Not all cases of low-level depression are a. Symptoms vary, with some sufferers experiencing a wide variety of recognized symptoms and others developing only a few. The most common symptoms of low-grade depression are:

  • Eating too much or too little, with accompanying weight changes
  • Sleeping too much or too little           
  • Persistent fatigue       
  • Negative thoughts and moods
  • Low self-esteem
  • Restlessness
  • Inability to enjoy activities that used to bring pleasure           
  • Feelings of hopelessness or “emptiness”      
  • Poor concentration
  • Chronic difficulties with making decisions     

Sufferers of low-grade depression tend to experience one or more of these symptoms for most of the day, with occasional episodes of relief.

To be diagnosed with low-grade depression, an individual must experience two or more of these symptoms for at least two years. For minors, only one year of symptoms is required for diagnosis.

Low-Grade vs Major Depression

Low-grade depression is considered less severe than major depressive disorder (MDD). However, MDD is generally not as long-lasting as low-grade depression. To qualify for a diagnosis of major depression, an individual needs to experience MDD symptoms for only two weeks.

The symptoms of low-grade depression are similar to those associated with major depressive disorder. The main differences between the two disorders are the severity of symptoms—MDD sufferers are more ly to experience suicidal ideation—as well as their duration.

75% of individuals with low-grade depression will experience an episode of major depression. This is one reason why it is important to seek treatment for “mild” depression, as it can easily turn into a more serious condition.2

Treatment for Low-Grade Depression

Treatment for low-grade depression often calls for the patient to take antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), as prescribed by a qualified mental health professional.

Talk therapy (psychotherapy) is another common component of depression treatment programs. Recovery from low-grade depression can involve one or both of these treatments.

Your health-care provider will help you determine a treatment plan that works for you.

Persons suffering from low-grade depression are also advised to maintain a healthy lifestyle to avoid aggravating their symptoms. Patients should attempt to eat healthily, exercise several days per week, and abstain from drugs and alcohol. Looking after your health is key to your recovery from low-level depression.

The behavioral health center at Crystal Run Healthcare is staffed by licensed clinical psychologists who have years of experience with treating depressive disorders.

We have six locations across New York State, in Middletown, Newburgh, Goshen, Haverstraw and West Nyack. To learn more, visit us online at

If you have any questions or concerns, feel free to call us at 845-703-6999.




Do You Have Mild, Low-Grade Depression?

Dysthymia is a milder, but long-lasting form of depression. It’s also called persistent depressive disorder. People with this condition may also have bouts of major depression at times.

Depression is a mood disorder that involves your body, mood, and thoughts. It affects the way you eat and sleep, think about things, and feel about yourself. It’s not the same as being unhappy or in a «blue» mood. It’s not a sign of weakness or something that can be willed or wished away. People with depression can’t «snap it» and get better. Treatment is key to recovery.

Dysthymia affects women twice as often as men. Some people may also have depression or bipolar disorder.

What causes dysthymia?

There is no clear cause for this type of depression. Mental health professionals think it’s a result of chemical imbalances in the brain. Many factors are thought to contribute to depression. These include environmental, psychological, biological, and genetic factors. Chronic stress and trauma have also been linked to this condition.

Dysthymia seems to run in families, but no genes have yet been linked to it.

What are the symptoms of dysthymia?

Dysthymia is  milder, yet more long lasting than major depression. Each person may experience symptoms differently. Symptoms may include:

  • Lasting sad, anxious, or “empty” mood
  • Less ability to concentrate, think, and/or make decisions
  • Less energy
  • Fatigue
  • Feeling hopeless
  • Weight and/or appetite changes due to over- or under-eating
  • Changes in sleep patterns, such as fitful sleep, inability to sleep, early morning awakening, or sleeping too much
  • Low self-esteem

To diagnose this condition, an adult must have a depressed mood for at least 2 years (or one year in children and adolescents), along with at least 2 of the above symptoms. The symptoms of this illness may look other mental health conditions. Always talk with a healthcare provider for a diagnosis.

How is dysthymia diagnosed?

Depression often happens with other conditions, such as heart disease, or cancer. It may also happen with substance abuse or anxiety disorders. Often, people with dysthymia grow accustomed to the mild depressive symptoms and do not seek help. But, early diagnosis and treatment is key to recovery.

A diagnosis may be made after a careful psychiatric exam and medical history done by a mental health professional.

How is dysthymia treated?

Treatment may include one or a combination of the following:

  • Medicine. Many different medicines are available to treat depression. It often takes 4 to 6 weeks for anti-depressants to have a full effect. It’s important to keep taking the medicine, even if it doesn’t seem to be working at first. It’s also important to talk to your healthcare provider before stopping. Some people have to switch medicines or add medicines to get results.
  • Therapy. This is most often cognitive behavioral or interpersonal therapy. It focuses on changing distorted views of yourself and your environment. It also works to improve relationship skills, and identify and manage stressors.

Because this condition usually last for longer than 5 years, long-term treatment may be needed.

If you have depression, there are things you can do to help yourself. Depression can make you feel exhausted, worthless, helpless, and hopeless.

Such negative thoughts and feelings may make you feel giving up. It is important to realize that these negative views are part of the depression and may not reflect reality.

Negative thinking fades as treatment begins to take effect. Meanwhile, consider the following:

  • Get help. If you think you may be depressed, see a professional as soon as possible.
  • Set realistic goals and don’t take on too much.
  • Break large tasks into small ones. Set priorities, and do what you can as you can.
  • Try to be with other people and confide in someone. It’s usually better than being alone and secretive.
  • Do things that make you feel better. Going to a movie, gardening, or taking part in religious, social, or other activities may help. Doing something nice for someone else can also help you feel better.
  • Get regular exercise.
  • Expect your mood to get better slowly, not right away. Feeling better takes time.
  • Eat healthy, well-balanced meals.
  • Stay away from alcohol and drugs. These can make depression worse.
  • It is best to postpone big decisions until the depression has lifted. Before making a big change — change jobs, get married or divorced — discuss it with others who know you well and have a more objective view of your situation.
  • Remember: People rarely «snap » a depression. But they can feel a little better day-by-day.
  • Try to be patient and focus on the positives. This may help replace the negative thinking that is part of the depression, and the negative thoughts will disappear as your depression responds to treatment.
  • Let your family and friends help you.

Key points

  • Dysthymia is a milder, yet more chronic form of major depression. People with this illness may also have major depression at times.
  • There is no clear cause of this disorder, but mental health professionals think it’s a result of chemical imbalances in the brain.

    Some types of depression seem to run in families, but no genes have yet been linked to depression.

  • In general, nearly everyone with depression has ongoing feelings of sadness, and may feel helpless, hopeless, and irritable. Without treatment, symptoms can last for many years.

  • This condition is most often treated with medicine, therapy, or a combination of both.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.


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