Is It Possible to Have Functional Depression?

High-Functioning Depression: An Invisible Illness with Unique Risks

Is It Possible to Have Functional Depression?

I had a difficult time beginning this piece because the topic hit very close to home.  I’ve suffered from depression pretty much my entire life.

I have supportive and loving friends, family, meaningful work and engaging hobbies. I have a good appetite and sleep through the night—albeit with a few pee breaks and the occasional need for melatonin gummies.

  While there are periods I exist in a miasma of sadness, more commonly my daily experience is a slight impairment of an ability to fully enjoy life. There is an ever-present emotional chalkboard scrape reminding me that to live means to co-exist with knowledge of human and animal suffering that I cannot prevent.

Which is why I won’t leave home without my daily anti-depressant. (I’ve been taking medication for more than a decade.)

Dealing with High-Functioning Depression

My situation is far from rare.  Over 6.7% of adults in the United States—16.2 million!—endure at least one major depressive episode annually.  My brand of misery—dysthymia, known as chronic low-level depression, occurs in 1.5% of adults in the United States annually.

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.

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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.

Therapists, Therapy, and Therapists in Therapy

Ashley has extensive professional and personal experience in coping with high-functioning depression. The Nashville-based therapist admits, “I started therapy as an adolescent and began taking psych meds as a young adult.” Ashley, who started her private practice 10 years ago, adds, “The meds allow me to feel normal, myself.”

The therapist has many friends, including mental health professionals who take psych meds and/or are in therapy for depression and anxiety.  She explains, “Many of my patients are high-functioning. You’d see them on the street and not know something is wrong.”

Awareness of what depression and anxiety feel helps Ashley get into the psyche of her patients. But she suffers bouts of self-stigma over what sometimes feels a clash between her professional and personal selves.  She admits, laughing, “Once I mentioned to my shrink I felt shame about being a therapist and in treatment. My therapist said, “Ashley, I’m in therapy too.”

Overcoming Mental Health Stigma

Myths and misinformation about mental illness delayed Claire’s depression diagnosis until age 20. “I had certain characteristics of depression as a teenager, such as irritability and crying jags, but my parents wouldn’t take me for help. They figured, ‘Oh, you’re a girl. You’re just emotional.’”

Now, at age 26, Claire manages to hold down a high-stress job as a legal office manager for a multimillion-dollar law firm despite battling not only a depressive disorder but also type 1 diabetes and kidney disease.

She says, “There are times when depression affects my productivity because it’s so intrusive. I’m fine, until all of a sudden I’m not. I try to stay on top of my meds as much as possible.”

Therapy has helped her identify triggers such, as “negative thought trains” and lethargy, that signal a potential oncoming depressive episode.

Another major trigger is her physical health.

“I can run a million dollar law firm but I sometimes feel as if I can’t make my body work,” Claire sighs adding,  “I might be having back pain, kidney stones, and/or unstable blood sugar.

” Summer is especially difficult for Claire:  When the weather’s nice and everyone is outdoors enjoying physical activity or socializing and I’m not well, I feel really left out.”

Combatting Depressive Episodes

Claire now has an array of coping mechanisms, such as journaling, to help forestall major emotional slides. Other helpful activities that relax and focus her include cooking and exercise.  “I’ve heard meditation is very good for depression, but I’m afraid it will turn into rumination.  That can be a slippery slope for me. I’d rather distract myself.”

Claire’s primary “distraction” is burying herself in her consuming job. “I work 11 hours a day.  For me, being productive gives me a purpose, which helps mitigate some of the depression.” (Other common forms of distraction people might resort to as a way to avoid tough emotions include hobbies, playing video games and drinking or using drugs.)

She has good days and knows how to handle the bad ones. Still: “I know I’m never going to wake up and say, ‘I don’t have depression.’”

Other  Coping Methods

*Ellen calls herself, “A high-functioning person who also has bipolar disorder.”  Seven years ago, the now 36-year-old, experienced a b mania as a reaction to an anti-depressant she was taking. Being a problem-solver, the financial executive, wife, mother and perennial volunteer leaped into action to find a way to “bail out the leaky ship.”

These days she employs “a variety of techniques” to keep herself well. “I can tell the difference when I slough off. It’s not recovery, but an ongoing journey.”

She goes to therapy (psychodynamic and occasionally EMDR, a type of therapy involving eye movements) sees her psychiatrist, exercises, gets acupuncture and allows herself to sleep more than average knowing fatigue is a side effect of the psych meds. Ellen says, “I have occasional bouts of depression but over-all I’m doing really well.”

Accepting Your Mental Health

The secret ingredient to Ellen feeling content, she says, is acceptance of her illness.  When depression bites at her, Ellen is gentle with herself. “I enjoy my fast-paced life and normally being busy helps combat the sadness, but when I need to I give myself permission to slow down, play with my daughter, take a day or two off from work…

She explains, “I can hide my depression so well that people around me have no idea what I’m dealing with unless I clue them in.

What I wish everyone realized is that allowing yourself to reach out for help is half the battle.

  The other half is continuing to help yourself because depression can always be there waiting to trick you with these awful, untrue thoughts : ‘You’re worthless,’ ‘You’re no good,’ ‘No one cares.’”

Seeing is Believing: The Challenge of an Invisible Illness

For people with high-functioning depression, the “invisible illness” aspect of the mental state can feel particularly searing. A few years ago, after shoulder surgery, my arm was in a sling. People fell over themselves to cluck with sympathy at my pain—socially sanctioned pain.  It felt good to be the object of so much caring.

But on the days when listening to the sorrows of others exacerbates my own and I feel spent, I typically stay silent, not wanting to advertise my own vulnerability. Why is it so much easier to let others in on pain when it’s physical?

It was difficult to begin this article, but writing it has helped free me from a shame-shackle:  My name is Sherry and I’ve suffered from depression pretty much my entire life. And I’m okay with that. My mental struggles have made me a more insightful, caring person and a better therapist than I would have been with fewer cracks beneath my emotional veneer.

*Name and identifying details changed


7 Signs You’re Dealing with High-Functioning Depression

Is It Possible to Have Functional Depression?

Most people are familiar with the idea of clinical depression. People who receive that diagnosis often exhibit symptoms you can quickly pick up on as part of the disease. However, you can appear outwardly fine to friends and family yet still feel unhappy with yourself.

Maybe you find yourself feeling tired all the time, even if you’re able to smile your way through social situations. While high-functioning depression isn’t a clinical diagnosis, it’s often used to describe people living with less debilitating symptoms of depression.

If you’re battling an addiction due to or that is causing depression, please reach out to our men’s depression treatment center today at 866.457.7590.

What Is High-Functioning Depression?

People with high-function depression are typically diagnosed with having persistent depressive disorder (PDD). Common symptoms of PDD include a lack of energy or constant fatigue. Those with PDD or high-functioning depression experience the symptoms for at least two years.

Recognizing that someone may be living with high-functioning depression can be difficult. The effects can creep in gradually until it finally gets to a point where a person realizes there is a problem. Sometimes a stressful life event can make things more complicated.

People with the illness tend to have the kind of personality where they push through their feelings. Others may see them as perfectionists, which can add to their determination to live up to a specific image. Those with the disorder may have trouble admitting they need help, which can lead to a build-up of emotion that spills over at a critical point.

What Are the Signs of High-Functioning Depression?

Those who feel they may be suffering from the effects of any form of depression, including high-functioning depression, should seek help from a mental health professional. They can make an accurate diagnosis of whether a person is genuinely suffering from PDD or other mental illnesses. Some of the common signs of PDD or high-functioning depression include:

  • Bouts of insomnia or sleeping too much
  • Feelings of hopelessness
  • Lack of self-esteem
  • Always feeling that you have no energy
  • Difficulty making firm decisions

A psychiatrist or mental health professional will look for signs that the mental health condition disrupts your ability to function normally. They can rule out other issues that could cause your symptoms and assess whether you suffer from a more severe form of depression.

Signs You May Be Dealing with High-Functioning Depression

While there are clinical clues that professionals look for in diagnosing PDD, you may have different experiences than others. Here are some signs that you may be dealing with a form of high-functioning depression.

  1. People tend to describe you as gloomy or a downer. It may be hard for you to see the bright side of any situation.
  2. Some may describe you as lazy because you find it difficult to muster the energy to accomplish basic tasks.
  3. It’s hard for you to feel good about yourself, even when given a compliment. You may continuously look for ways to criticize yourself, either internally or outwardly to others.
  4. Your weight fluctuates without you being on a diet plan because your appetite grows or recedes depending on your mood.
  5. You may find yourself crying or experiencing feelings of hopelessness for seemingly no reason.
  6. Your performance may seem fine at school or work, but you’re struggling to appear normal to peers.
  7. You find yourself tempted to use substances drugs or alcohol to make yourself feel better.

How to Manage High-Functioning Depression

In some cases, it may seem depression is an insurmountable obstacle. Many people fall into the trap of believing that nothing can help them now or that any relief they get will be temporary. Sadly, this maladaptive thought pattern can keep you in the cycle of doing nothing.
There are certain steps people can take to deal with their high-functioning depression, such as:

  • Take steps to get active: Though it may be difficult to do so, it’s vital to get at least thirty minutes of physical activity every day. For instance, you may choose to go for a jog, do yoga, or even simply go for a walk. If this action doesn’t seem feasible at first, try starting with a five or ten-minute walk at first and add a few more minutes each day.
  • Watch your diet: It can be tempting to ignore your diet but make sure you are eating healthy, well-balanced meals.
  • Get some rest: Get enough rest each day, but be careful not to oversleep. Doing so can improve your mental well-being.
  • Step into the sun: Taking time to be outside in the sunlight has been shown to significantly improve a person’s mental health.

If none of these strategies help, you may require a mental health treatment program, such as the one at Red Oak Recovery.

Get Help at Red Oak Recovery

You should seek treatment if you believe you are experiencing some form of depression. Red Oak Recovery has programs available to help you manage the symptoms of your illness. We also offer a variety of programs to address another issue you may be experiencing, including:

  • Holistic healing
  • Individual counseling
  • Family therapy program
  • Dual diagnosis treatment
  • Addiction therapy services

Learn more about how Red Oak Recovery can help with high-functioning depression by calling 866.457.7590.


High Functioning Depression: Signs and Symptoms

Is It Possible to Have Functional Depression?

It’s common for someone, after revealing that they struggle with depression, to hear a reaction akin to, “I had no idea you were depressed!” Oftentimes, it’s because the person has high functioning depression.

Just because you are typically able to get bed and present as “normal” to the world around you doesn’t mean that you’re not suffering.

People with high functioning depression suffer greatly. They live for years with depression symptoms. Knowing the signs and symptoms can help you figure out what to do if you or a loved one are coping with this challenging mental health issue.

What is High Functioning Depression?

Many people have heard of high functioning anxiety, referring to people who struggle with anxiety but are able to present “okay” in public. Fewer people have heard of “high functioning depression.” But it is similar. It’s the idea that you can have the symptoms and struggles of a mental health issue and yet your challenge is mostly invisible to the outside world.

High functioning depression (HFD) is a chronic type of depression. It is also called Persistent Depressive Disorder (and was previously known as dysthymia). This is in contrast to Major Depressive Disorder which is more acute.

Make no mistake, HFD is just as hard to cope with as any other forms of depression

In fact, it has its own unique challenges. People with an acute episode of major depression have a baseline of “normal” or “good” feelings that erodes away when they’re in depression. In contrast, people with high functioning depression typically feel depressed most of the time for years on end. They may not even remember what it felt to feel good.

Why High Functioning Depression Often Gets Overlooked

People often have a mental picture in their heads about what depression looks . They think it looks a total inability to function. They picture the worst moments that people with acute depression do sometimes deal with.

Many people, asked to imagine a depressed person, picture clouds of sadness, constant tears, staying in bed for days on end, bingeing on comfort food, lack of attention to hygiene, and suicidal thoughts.

While those things can certainly be present in depression, they aren’t present for everyone and not all of the time. People with functioning depression may hold down a steady, successful job, always look well put-together in public, and “not seem sad.” Because they don’t fit that image of “the depressed person” their condition may get overlooked.

High Functioning Depression interferes with relationships, work, school, health, and finances

The degree of the impact may be subtle enough that someone on the outside doesn’t see it. But the individual feels the impact. “Functioning “simply isn’t the same as fully functioning. People who know that they struggle with HFD often feel they have to “prove” their illness to others because they don’t fit that mental picture of the depressed person.

When diagnosing mental health conditions, professionals look at the impact that the condition has on a person’s ability to function. When a condition several interferes with a person’s ability to perform in school or at work, worsens their health, or impacts their finances or relationships, it’s ly to rise to a level of diagnosis.

Recognizing the Signs and Symptoms of High Functioning Depression

Generally, the symptoms of with functioning depression match those in other forms of depression. For one thing, they have a loss of interest in daily activities, which is one of the primary criteria for a depression diagnosis.

Other depression symptoms present in HFD include:

  • Changes in eating and/or sleeping
  • Desire to withdraw from social situations even if you force yourself to attend
  • Difficulty concentrating
  • Fatigue
  • Feeling lazy but also feeling incapable of doing more than you’re already doing
  • Feelings of guilt
  • Hopeless
  • Imposter syndrome, feeling you’re “faking it” when you accomplish things
  • Indecision
  • Irritability
  • Low self-esteem
  • Sadness
  • Tired all of the time even if you sleep
  • Worthlessness

If you know the symptoms of depression, then you know the symptoms of HFD. In HFD, they may not be as intense as in major depressive episode but they are persistent over a much longer period of time.

People with high functioning depression often try to “self-medicate” their depression. Therefore, you also want to look for signs of using substance abuse, alcohol misuse, or excessive gaming to cope as well as signs of workaholism and perfectionism.

Coping with HFD

High functioning depression can feel a misnomer when you’re living it. Sure, you’re functioning fine in the world, more or less. But you don’t feel engaged with the world or excited by it. You’re barely coping.

Trying to get through your daily tasks feels draining. You might avoid making plans with people because you’re simply too exhausted all of the time. And on the inside, you’re beating yourself up.

The good news is that there are treatment solutions

Just with other forms of depression, you can benefit from any or all of the following things, in a dose and combination that you work out with a doctor or therapist:

  • Anti-depressants or other medications
  • Exercise including yoga and low-impact cardio
  • Nutrition changes especially limiting sugar, caffeine, and alcohol
  • Reducing screen time and limiting media
  • Therapy including cognitive behavioral therapy and talk therapy

Oftentimes people with high functioning depression feel they’re getting by “well enough” and therefore that they “don’t need” therapy. However, therapy can help in every stage of life. Moreover, HFD is a serious condition, and treating it can vastly improve your quality of life.

Contact us today to find out about how a mental health professional can help you understand and work through your high functioning depression.


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