We think we know what depression looks like – teary, sad, grey, emotional, unable to function. For major depressive disorders, this is this case, but it isn’t what all depression looks like. Tired, fatigued, behaving almost normally, smiling even, these too can be the outward signs of depression. But how? Depression has many forms, and for those who live with high-functioning depression, life on the outside may not reflect what’s hidden on the inside.

This is precisely what makes it so difficult to detect and even harder to treat. If you have high functioning depression, you might find it difficult to believe something is wrong at all. You may be able to complete your work, your personal life isn’t completely in shambles, but something feels off.

Businessmen, teachers, lawyers, office workers, doctors, nurses, plumbers, electricians, these are just some of the faces behind the disorder, there are many more, it occurs in all walks of life and affects all kinds of people.

The high functioning depression definition classifies it as a persistent depressive disorder or dysthymia; it’s a chronic (long-term) form of depression that lasts for years. Depression affects over 300 million people worldwide, while persistent depressive disorder affects around 1.5% of the US population (or approximately 4,908,000 people) throughout their lifetime.

The high-functioning depressive person

anxious woman

If you have this type of mood disorder, you are not alone, nonetheless it can be a challenge to recognize the symptoms in ourselves – we make excuses that “it’s just a bad day” or “it’s always been like this” instead of accepting what’s really going on – or especially in others where it’s hidden away behind a mask of normality.

The symptoms of high-functioning depression might not be immediately apparent, a person with this disorder might:

  • Appear happy and functional on the outside
  • Be good at their job and never miss deadlines
  • Have an outwardly stably life, work and family situation
  • Seem to be normal and responsive
  • Be a friend, colleague, or family member

However, on the inside, a whole lot of invisible suffering is going on, you may notice some of the following:

  • Eating too much or too little. You might feel like comfort eating at the end of the day or quite the opposite, you might not feel like eating at all.
  • Problems sleeping. Trouble hitting the hay and getting a little sleep eye, tossing and turning all night, or even sleeping way too much? This is an indicator that something isn’t quite right.
  • No energy at all. Even if you had a full night’s sleep you feel tired and lethargic, you might take no interest in tasks you should normally enjoy.
  • Low self-esteem. You may always feel you’re not quite good enough or even suffer from imposter syndrome.
  • Low concentration and indecisiveness. Decisions don’t come easy to you, not because they are difficult but because of the effort of deciding, or perhaps you fail to see the difference between one choice and another.
  • Loss of hope. You no longer believe things are going to get better and this is now “how it’s going to be.”

Many of these symptoms are also present in a major depressive disorder, and it’s not uncommon for a person to experience both at one time or another, but what sets high-functioning depression apart is the longevity of the disorder, its long-lasting impact, and that those suffering are more reluctant to seek treatment.

Someone with the disorder might believe that nothing is majorly amiss, so help isn’t needed, they’ll cope just fine. Below are a few indicative phrases, read through them. Do they sound familiar to you?

  • “I don’t need help; it’s a sign of weakness.”
  • “I don’t want to burden anyone. I’ll get over it.”
  • “I’m fine, I don’t need help.”
  • “My life is ok. Why should I complain about something?”
  • “I’m not interested in my usual hobbies.”
  • “I don’t take any pleasure in my work.”
  • “I’m not particularly sad, I just feel empty.”

If this sounds like you, it may be likely that you have depression, even if you don’t believe you do, and that means it’s time to do something about it (No. Lying in bed is not the answer).

High functioning depression is a chronic depression that lasts over two years. Sufferers are less likely to seek treatment as their symptoms are not as intense as major depression, and they are usually able to continue to live more or less normal lives on the outside.

What causes it?

Like many psychiatric disorders, high functioning depression has a variety of potential causes, depending on which may influence your treatment. They include:

  • Life events and circumstances. Those dealing with prolonged stress, complicated situations, depression, or a traumatic event may find themselves more prone to developing the condition.
  • If someone in your family, generally a direct relative, has the disorder, you might be more likely to become depressed.
  • Biology and brain chemistry. Some people might simply be predisposed to depression due to physical differences in their brains or how their neurotransmitters work and produce chemicals.

5 tips for dealing with high-functioning depression

in therapy

No, you can’t just “get over it,” depression isn’t a dose of the cold, and you can’t lie in bed hoping it will go away. If left untreated, it can continue to affect you throughout your lifetime, here’s what you can do about it:

Accept it

Depression isn’t something to be ashamed off; it’s just like any other illness. You wouldn’t be too bothered saying you had a cold, would you? You’re not superman/superwoman, no one is, so it’s time to accept that something is not quite right and that there is something you can do about it.

Seek help

You are not alone; support is out there. While we do advise you to talk to your healthcare provider as the first point of call, we also understand how scary that can be – what if they don’t believe me? What if they say it’s not that serious? It is, and you have a right to be listened to. If this seems like too big a step to take right away, talk to a friend or trusted family member and bring them with you to your appointment to be your support and, if needed, advocate. Don’t suffer alone.

Healthy behaviors

Yes, we’re talking about that old diet and exercise thing. Treating depression isn’t just popping a pill and it’ll go away trick (although medication does prove helpful in many cases). Often, you’ll need to focus on your diet and lifestyle and make some changes, healthy eating, exercise, and routine have been proven to boost mood, health, and lower the likelihood of depression.

Avoid unhealthy ones

If you have high functioning depression, you may have picked up some rather unhealthy traits – comfort eating, a drink or two after work, or becoming a workaholic (or something else). It’s time to kick the habit, everything in moderation is ok, but return to healthy behaviors and try to keep the bad out of your system. They are not helping your pain they are masking it.

Keep/get in touch with society

Don’t isolate yourself as tempting as it might be. Staying in touch with people for a quick chat or a gossip can boost your mood and ensure you don’t feel quite as isolated. We know it’s hard to get geared up for a night on the town, but sometimes that’s just what the doctor ordered. But, at the same time, don’t suffer burnout, there’s no need to head out every night of the week (see the point above), if you feel you need a duvet night – take one, and don’t you dare feel guilty about it.

Acceptance, seeking help, focusing on healthy habits while ignoring the bad ones, and staying in touch with others will help you maintain a healthier, happier life. Don’t be afraid to take the first step.

Need help? Here’s where to turn

Sometimes sitting back and waiting for a problem to go away on its own, as tempting as may be, isn’t the right solution. If you have depression, it might be time to get some professional assistance to deal with your problem.

The first step is talking to your primary healthcare provider; they will listen to the symptoms you are experiencing before referring you further to the appropriate next step to meet your needs. Don’t be afraid; it might take courage to let someone in on how you’re feeling but, afterward, you’ll feel like a weight has been lifted.

Remember, if you are having suicidal thoughts or feelings, it’s vital you reach out immediately to get the help you need.

If you are in the US, you can contact:

  • Tell them you are at risk and you will receive help.
  • The Samaritans. Call (877) 870-4673 or get in touch online here.
  • The National Suicide Prevention Lifeline. Get in touch at 1-800-273-TALK (8255).

If you are located in the UK or Ireland, here’s who you can contact:

  • Your local A&E department. Head directly to accident and emergency.
  • 999 or 112. Give them a call and they will send help to your location.
  • The Samaritans. Contact them via 116 123 (UK) or 116 123 (Ireland), send an email to jo@samaritans.org and jo@samaritans.ie or reach out via their website.
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Written by Maria Isabella Neverovich
Maria is an Irish writer, Health Editor at Verv, lover of forests, mountains and all things nature. She enjoys discovering new vegetarian dishes, creating...
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