What is High-Functioning Depression?
Do you feel depressed constantly, but you're not going through a depressive episode, and nobody can tell if you're acting differently? There is a high chance that you have high-functioning depression.
By: Eunice Ahn
There are many different terms that people use to refer to this complicated feeling of being depressed but being able to function "normally" on the outside. A couple of common terms are "smiling depression," "high-functioning depression," and the clinical term "dysthymia" (aka persistent depressive disorder). I will explain the symptoms, practical coping skills, and the stigma surrounding "high-functioning depression."
What Does it Mean to Have "High-Functioning Depression?"
Dysthymia, persistent depressive disorder (PDD), is a milder form of depression that persists for over two years. Dysthymia is often seen as a characteristic of high-functioning depression because it is not characterized as the more severe episode that is drastically different from your normal self (aka major depressive disorder-more commonly known as "depression" in society). The non-clinical term "smiling depression" is another characteristic of high-functioning as it refers to an individual's effort to conceal their emotions/troubles from loved ones or the people around them. They do so by putting on a smile and pretending like everything is fine and functioning as usual as possible. There are many reasons one would want to hide their distress from the people surrounding them. But to name a couple, one may be trying to avoid being a burden to others, appear weak, avoid attention on themselves or their problems, and honestly don't know or believe they have a more serious underlying mental illness that must be treated.
As we are all different, PDD is not defined solely by the symptoms listed below. These are just the more commonly seen symptoms across the board used to diagnose patients.
The individual experiences a depressed mood every day for most of the day for a minimum period of two years. One must also have at least two or more of the symptoms below:
decreased appetite or overeating
insomnia or hypersomnia
lack of energy or constant fatigue
lowered self-esteem
difficulty concentrating and making decisions
feeling sad and hopeless
In addition, just because you have been diagnosed with PDD, that does not mean you could not be diagnosed with MDD (major depressive disorder). It is possible for someone to have PDD and go through a more severe episode of depression and have something called "double depression."
What Are the Issues Associated With the Term "High-Functioning Depression?"
The issue with the term "high-functioning depression" is that it can reinforce shame about depression and the stigma that successful people do not have depression. Not only that, but because the term is called "high functioning," people may believe it is a less serious form of depression, which is NOT the case. According to a mental health professional interviewed by the Washington Post, "' Depression is depression, 'Just because some people have personality traits that make them more able to function shouldn't make them less likely to be taken seriously...'" Moreover, there may also be the misinterpretation and lack of acknowledgment of the true efforts that go into functioning "normally" that the term "high-functioning" does not encompass.
What Does it Feel Like to Live with High-Functioning Depression and How Could You Cope?
A typical day with PDD may look like feeling down most of the time, and you feel as if it doesn't ever disappear, even when you're happy. You feel tired constantly, even if you got a healthy amount of sleep the night before. Others, including yourself, may view you as lazy, but you can never muster up enough energy within yourself to do more than what is expected of you, like going to school/work, doing your homework, socializing with others, and doing other daily tasks. If anything, even doing these "necessary" things require tremendous amounts of effort from oneself. Ironically, the ones who struggle with high-functioning depression are often overachievers. For example, it is a challenge to focus on tasks, but often people with PDD tend to excel or do well academically/at work.
Another example would be when one is forcing themself to attend social events. This goes with the idea of smiling depression, where the ones who smile and are the bubbliest often put up a front and silently suffer on the inside. Oftentimes, people tend to gain or lose weight without any particular reason because they overeat or undereat without realizing it. This can lead to one feeling bad about oneself, which may bleed into other aspects of one's life, and you believe you are unworthy of being happy or don't possess any qualities worth being loved.
A couple of ways to cope with high-functioning depression are to seek professional help, journal, exercise, meditate, distract oneself, maintain a healthy sleeping schedule, and accept the mental illness. Seeking professional help would be the ideal step because it can help one recognize negative thought patterns and seek to change them. Cognitive Behavioral Therapy is an evidence-based tool that can help treat PDD. We are here to help. Schedule a free consult today, and together we'll find a treatment path for you.
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