“But you don’t seem depressed …”
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 out of 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 like to feel good.
Why High Functioning Depression Often Gets Overlooked
People often have a mental picture in their heads about what depression looks like. They think it looks like 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 like 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 likely 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 like 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 like 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 like 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 like 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.
