Society pushes the mindset of hard work and busy schedules. When we fail to complete such tasks, we start to feel lazy. Even though we know that we deserve rest and also strive to balance self care with responsibilities, we can become critical of our chosen method of time management. When I think about this societal trend, I often look at it from a mental health lense. For individuals who struggle with various mental health issues, the constant notion to push yourself and continually achieve is tiring. It is easy to label someone when they do not accomplish what society deems as success.
What about the people who are able to ‘function’ by society’s standards but still struggle with depression?
Help for Major Depression
The word depression is commonly used and studied. There is a typical understanding of sadness that does not seem to go away for some. There are also other moments where people will cry nonstop and feel hopeless or lose interest in their hobbies. Clinical diagnoses of depression are often addressed but like other mental health conditions, stigma and shame may arise once this happens.
The clinical diagnosis for major depressive disorder (MDD) as outlined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes the following:
Five of more of the following A Criteria-
- Depressed mood
- Loss of interest or pleasure in almost all activities
- Significant unintentional weight loss/gain or decrease/increase in appetite
- Sleep disturbance
- Psychomotor changes severe enough to be observable by others
- Tiredness, fatigue, or low energy, or decreased efficiency
- A sense of worthlessness or excessive, inappropriate, or delusional guilt
- Impaired ability to think, concentrate, or make decisions
- Recurrent thoughts of death, suicidal ideation, or suicide attempts
Additionally, such symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning (American Psychiatric Association, 2013).
However, there are symptoms similar to the major depressive disorder that are of longer duration or less intense. There also are periods of the opposite in ability to complete tasks and responsibilities. The term “high functioning depression” or persistent depressive disorder (dysthymia) is just that.
What Is High Functioning Depression?
Even though High Functioning Depression isn’t a clinical diagnosis, it’s still important to discuss because it looks different on the outside and can easily go undiagnosed. As Healthline mentions, high functioning person can suffer from high functioning depression but it looks invisible to outsiders.
High Functioning depression is a term used for someone who is suffering from depression but is still able to keep up with everyday needs: such as getting out of bed, attending work or school, showing up to social events, being a high achiever, etc. The difference is that they still feel depressed even though on the outside it looks like they have it all together.
People often think of depression as someone who cannot get out of bed because they are so depressed, when often this is not what depression looks like for high achievers until they hit a breaking point.
Now it can be easy to assume that an individual struggling with high-functioning depression is able to function normally but that is not the case. Depression still consists of feelings of sadness however demonstrated by less impairment on daily living.
You may be asking: how do I know if I am experiencing this type of depression? The easy answer is to see a mental health provider to determine a clinical diagnosis. However, you can also ask yourself questions related to the duration of the last two years. The duration piece of this diagnosis is key in understanding low mood, sadness, the list goes on.
The other important aspect of this diagnosis is the labeling process. Should an individual feel bad for being able to function in some capacity while also experiencing sadness? Are my friends and family who expect me to always bounce back going to look at me differently if this illness is labeled?
An article by Bridges to Recovery highlights key points to help us understand what it is like to live with high-functioning depression:
- You may feel down most of the time. Other people may notice this and refer to you as gloomy or a downer.
- You may feel tired all the time, even if you get enough or too much sleep.
- It may seem like you are lazy, but you just can’t summon the energy to do more than is necessary to function at a normal level.
- You do everything you’re supposed to do, like go to school, or keep the house clean, but it always seems like a monumental effort.
- You do well enough at work or school, but it is a challenge and focusing on tasks is difficult.
- You have to force yourself to engage in social activities, when you would rather withdraw.
- You may find yourself going back and forth between high achiever anxiety and high functioning depression.
Remember, many mental health disorders will need input from professionals. However, if you do experience some of the symptoms or thought processes mentioned, it may be beneficial to seek assistance and support.
Women and High Functioning Depression
For women in particular, the standards of “having everything figured out” and balancing many roles can be difficult. Thinking about your achievements and ability to get out of bed while also feeling a sense of hopelessness or sadness is challenging and exhausting.
Women face an array of pressure in society today that can lead to high functioning depression such as:
- Pressures around body image and maintaining or changing their body’s shape or size.
- Pressures around being a mom or taking on more of a caregiving role outside of career responsibilities.
- Diet culture’s pressure and presence that leads to feelings of guilt around food, binge eating and other eating disorders.
Due to the amount of responsibilities women are given both at work and in the home, they may feel even more pressure to maintain their high achieving appearance while feeling depressed.
The conversation around high-functioning depression is starting to make its way. There is more research and understanding needed in order to allow empathy and understanding. The best advice one can give is to be patient, cut yourself slack, and do your best to make it through each day in the best way you can. Seek out support, because there are other people that struggle with this as well and help is available.
Citations & Resources
The Dilemma of High-Functioning Depression (2020, Feb 24) Sherry Amatenstein, LCSW
Bridges To Recovery (2021). Retrieved from https://www.bridgestorecovery.com
American Psychiatric Association. (2013). Major depressive disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).
Example of High Functioning Depression on Very Well’s site on what High Functioning Depression looks like.
Written by Maya Jefferson, LMSW.
Maya is a therapist who is passionate about helping college students and millennial overcome high functioning depression and high achieving anxiety. She has a special interested in disordered eating, body image and working with women of color who are seeking mental health treatment. She approaches therapy with a down-to-earth feel that is both compassionate and actionable. In her free time you can find her playing guitar, singing and reading.
If you’re interested in setting up an appointment with Maya, Contact her today.
Disclaimer: This is in no way a replacement for a therapeutic relationship or mental health services. This is for educational purposes only and should be in used only in conjunction in working with a licensed mental health professional. Reading this blog or responding to it does not constitute a provider-patient relationship If you are looking for a local mental health professional feel free to use the contact tab to request an appointment or search Psychology Today for local therapists in your area. If this is a mental health emergency and you need immediate assistance please call 911 or your county’s crisis line to speak to a mental health professional.