High-Functioning Depression: What Are the Signs?
By Kendall Ruth
Anybody we meet could be living with high-functioning depression. It could be the successful entrepreneur, the top server at our favorite restaurant or the straight-A student. They seem to have it together, but they all share depression and a set of coping mechanisms that make it look as though everything is fine.
People living with high-functioning depression are working harder than their peers to keep up with the world around them. Most of us don’t realize how hard that is.
What is high-functioning depression?
While high-functioning depression isn’t found in clinical diagnosis books such as the DSM-5, it is a very real form of depression. The term “high-functioning” tends to be associated with being able to get by in spite of a challenge. “He has [fill in the blank with an ailment or disorder] but he’s high-functioning” is how we might hear the term used.
What tends to get lost in the mix is that one of the symptoms of depression is its severity -- the degree to which depression keeps one from engaging in day-to-day life. The “high-functioning” part means a person appears to be just fine because they are going about life in the ways our society considers “normal.” But the amount of emotional and psychological energy required to maintain this “normal” state is enormous.
There is an oft-used allegory about how ducks and swans look like they are coasting gracefully across the water, but underneath the surface their legs are kicking furiously to create the illusion of ease. Only add into the mix that while all the ducks and swans are pulling off the same illusion, they are using every bit of energy they have just to keep afloat. That’s what it’s like to live with high-functioning depression.
High-functioning depression symptoms
It can be hard to recognize high-functioning depression in others or ourselves. Wondering what symptoms to watch for? Consider the following:
- Is it difficult to make decisions, even about seemingly simple, day-to-day things?
- Do you still spend time with your friends, but feel less connected?
- Is your sleep the same, yet you are more tired during the day?
- Do you still have an appetite, but aren’t enjoying food like you used to?
- Are you still rolling with the highs and lows of your work or family life, but not enjoying the wins?
There’s no scoring here but if you felt resonance with a lot of the above questions, pay attention to that. People with high-functioning depression may also face the following challenges on a regular basis:
- Checking off daily tasks takes enormous effort.
- Hiding true feelings from loved ones shows up as headaches and stomach pains.
- Self-medicating with substances like alcohol.
- And here’s the high-functioning part: Despite persistent sadness and symptoms of depression, you can still knock out work and maintain your relationships -- but it takes a lot out of you.
High-functioning depression and anxiety
When it comes to high-functioning depression and anxiety, it is still depression and it is still anxiety. All the symptoms of both depression and anxiety are present, but the individual’s ability to cope and carry on clouds their impact.
In high-functioning anxiety, as with high-functioning depression, it takes more energy to maintain “normal,” no matter how together the individual appears to be. The source of the need to out-perform, work harder and keep going may be the anxiety itself.
A symptom of anxiety is living with a sense of impending danger or doom. Instead of feeling paralyzed by this anxiety, an individual might try to do whatever feels necessary to keep the danger at bay. The outward appearance of this energy looks like high performance but the fuel is coming from fear rather than peace or happiness.
Do I have high-functioning depression?
High-functioning depression more than likely isn’t going to show itself as obviously as it might with some cataclysmic event. By definition, this depression isn’t limiting your functioning but it is wearing you down. It’s like driving with the parking brake on. It’s subtle, and thus trickier to see clearly.
Think of it like the character Pig-Pen in the Charlie Brown comics and cartoons. Wherever he goes a cloud of dust follows no matter his mood. It stands out because everyone else doesn’t have that cloud fluttering about themselves. He carries on participating in all the activities that Charlie Brown and the other kids are engaged with but the cloud never leaves him. That is how it can feel living with high-functioning depression – the cloud being depression instead of dust, and everyone is accustomed to it, functioning as if nothing is taking place.
The best way to learn if you might have high-functioning depression is to consult with a licensed mental health professional.
Treatment for high-functioning depression
It is critically important for anyone who feels like they have high-functioning depression to get the help they need. Pathlight At Home is the leading virtual intensive outpatient program (IOP) for mood and anxiety disorders, offering hope for anyone with high-functioning depression.
“Functioning with untreated depression is exhausting and unsustainable,” explains Casey N. Tallent, PhD, director of telehealth development at Pathlight Mood & Anxiety Center. “We know that treatment for depression works. The sooner someone gets treatment, the less likely the depression will come back again.”
You can continue your daily routines, engaged at work and with family, while seamlessly getting help for high-functioning depression or anxiety from the comfort of your home. We’ve worked with stay-at-home parents who attend programming while their kids are in school because they felt their depression kept them from being the parent they wanted to be. We’ve worked with professionals who attend programs in the evening because they are performing fine at work but their depression keeps them from functioning in other areas of their lives.
“We designed Pathlight At Home to make intensive, evidence-based care more accessible,” shares Dr. Tallent. “You can expect to see significant improvement in your depression while making meaningful connections with your peers and compassionate care team.”
Pathlight At Home was named Best Online Therapy Service of 2022 and 2023 by top publications, including “People,” “Parents” and “VeryWell Family.” You will find programs for individual and group therapy, family therapy and education, and plenty of alumni resources. Participants have experienced more than a 40% improvement in anxiety and depression.
If you are wondering whether you’ve been living with high-functioning depression or if you simply want to explore a different method of getting help, let’s chat. Get started today.
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