“It doesn’t get easier, you just get stronger.”
We all experience feelings of sadness or hopelessness from time to time, life does that to everyone and it is natural to experience all feelings. Some people are able to carry out their daily responsibilities, go to work, and maintain relationships while hiding what they’re going through internally. This is often described as a high-functioning mental illness.
An individual with high-functioning depression wouldn’t appear outwardly distressed and would seem to be doing well while quietly struggling beneath the surface. Let’s understand what high-functioning depression is, its symptoms and what you can do to cope with it.
What is high-functioning depression?
High-functioning depression means experiencing depressive symptoms that are persistent such as low mood, fatigue, sleep issues, etc., but still being able to maintain an outwardly “normal-seeming” functioning in work, relationships and daily life. It’s like you are struggling internally but being productive and appearing fine externally.
High-functioning depression signs and symptoms
- Persistent low mood, sadness,
- Anhedonia or lacking interest, joy or pleasure in activities
- Chronic fatigue, low energy and emotional exhaustion
- Issues in sleep and in appetite
- Negative thoughts and self-talk
- Masking distress with constant productivity or perfectionism
- Always performing even when drained or exhausted
Identifying signs and symptoms of high-functioning depression can be tricky as they’re often masked yet they are present in a subtle and persistent manner, and they span at least two years which meets the Persistent Depressive Disorder (PDD) criteria.
According to research, high levels of anhedonia, trauma, risk of substance abuse are associated with high-functioning depression.
High-functioning depression DSM-5
High-functioning depression is not a formal or official diagnosis. However, high-functioning depression is diagnosed under Persistent Depressive Disorder (PDD) or Dysthmia, a chronic low-grade depression lasting 2+ years, as per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). PDD or Dysthmia is considered a milder form of major depression, for those who do not appear overtly impaired in their areas of social or work functionality.
High-functioning vs low-functioning depression
In high-functioning depression, daily functioning is maintained with effort and often masking or appearing fine, and it can often go undiagnosed as it is hidden.
In low-functioning depression, known as major depression, daily functioning is impaired with an obvious struggle manifesting in the form of withdrawal and it is more visibly addressed and consequently, diagnosed more.
Interestingly, research indicates that high-functioning depression in men often goes unrecognized as well as untreated. Men tend to mask their depressive symptoms with overworking, substance use or withdrawal and moreover, stereotypical gender roles for men highlight emotional restraint and self-reliance over expressing their emotions and seeking help, all of which contribute to underreported and undiagnosed high-functioning depression in men.
High-functioning depression test
While there is no exclusive test for high-functioning depression, screening tools for PDD such as Patient Health Questionnaire-9 (PHQ-9), or Mental Health America (MHA) Screening for Depression can be utilized. You should consult with a mental health professional for official testing and diagnosis if you are concerned about your symptoms, as self-diagnosis is not recommended.
