Oct 21, 2024
Mental illness is not always what it seems. People can smile on the outside while struggling internally. They may look like they have their life together while feeling like they’re barely holding on.
If you are someone who, on the outside, seems to have it all together while feeling like you’re falling apart on the inside, you may be experiencing a “high functioning” mental illness.
High-functioning depression is a common mental health disorder. Although not officially distinguished from major depressive disorder in the DSM, high-functioning depression has unique traits that set it apart from other types of depression. People with high-functioning depression also experience different challenges and may benefit from different treatment methods.
This article will go over high-functioning depression: what it is, its symptoms, and treatment options.
What is High-Functioning Depression?
High-functioning depression is used to describe a subtype of depression in which the person suffering is still able to complete their responsibilities. This might mean attending and succeeding at work, maintaining relationships, and maybe even maintaining a good level of personal health and hygiene.
However, underneath this mask of success, they are still struggling with low mood, sadness, hopelessness, and emptiness. They may struggle to get out of bed in time and collapse into it as soon as they get home. They may force a convincing smile while around friends, but break down when they are by themselves.
High-functioning depression is not a “lesser” depression, although it does tend to be less severe. It can still be diagnosed as depression and is treated in similar ways.
What does “high functioning” mean?
In the world of psychology, “high functioning” is used to describe mental illnesses that do not prevent someone from accomplishing their responsibilities. For example, if someone has high-functioning anxiety, they may not let their anxiety stop them from doing things they are afraid of, but doing so does bring them significant distress.
You can still be diagnosed with depression if you have High-Functioning Depression. The DSM-5, the handbook for diagnosing and treating mental illnesses for therapists, states for nearly all mental illnesses “The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
This means, in order for a diagnosis to be given, the mental health concern must either impair your ability to function or cause significant emotional or mental distress. (It can also cause both.)
This is important for those with high-functioning depression: just because you’re “doing fine” socially, at work, and financially does not mean that you are okay. You can be depressed and successful; that’s high-functioning depression.
How to Know if You Have High-Functioning Depression
It often comes as a relief when people with high-functioning depression receive their diagnosis. You are not just “lazy” or “broken”, you’re depressed. Other people don’t have to fight through what you do just to get out of bed, and with the proper treatment, you don’t either. High-functioning depression is very treatable once it is diagnosed. The first step is becoming aware of it.
Here are ten signs you have high-functioning depression:
- Persistent feelings of sadness or emptiness: These feelings may not be easily noticeable to others. You may put on a good mask in front of others by smiling, laughing, and saying everything is okay, but once you’re alone you can’t ignore the feelings of emptiness or heavy sadness that permeates everything.
- Irritability and mood swings: Even if you’re able to work through them, you may experience irritability, anger, and mood swings. One minute you may feel okay, and then a minor inconvenience will make you feel awful again. These emotional mood swings are a sign of depression.
- Fatigue and lack of energy: It may take a lot of energy to do even basic tasks, but you get them done. The result is probably little time to spend on yourself. You may succeed in some areas of your life, but it's unlikely you have the energy to succeed in work, relationships, hobbies, exercise, and more. If you feel exhausted even after resting, you might have depression.
- Changes in sleep patterns, such as difficulty falling asleep or sleeping too much: A common symptom in all types of depression, changes in sleep patterns can affect people with high-functioning depression.
- Changes in appetite, leading to either weight loss or weight gain: You may eat to fill the emptiness you feel, or you may feel too tired and sick to eat at all. Regardless, you probably hide your eating behaviors from close friends and family.
- Difficulty concentrating or making decisions, impacting productivity in daily tasks: You may feel like it's impossible to focus and constantly beat yourself up for your productivity levels. It doesn’t seem like it's as hard for everyone else, and you wonder what’s wrong with you.
- Feelings of guilt or worthlessness despite external achievements: No matter how much you accomplish, there’s always a nagging sense of guilt and feeling like you won’t be enough.
- Engaging in activities to distract from negative thoughts or emotions: You may develop unhealthy coping mechanisms to ward off the negative thoughts and emotions. These can include drinking, video games, sex, binge-watching TV, or others that are harmful to your overall mental and physical health.
- Isolation or withdrawing from social interactions, feeling disconnected from others: You still feel alone, even when around others. That along with the constant exhaustion and fatigue makes you opt out of social events a lot.
- Persistent physical symptoms with no clear medical cause: You may suffer from headaches, muscle tensions, or stomach aches without any clear medical issue. Your doctors may not know what's wrong.
High-functioning depression can be challenging to identify, as individuals may mask their internal struggles with outward success. Seeking help from a mental health professional can provide support, guidance, and tools to manage symptoms and work towards a brighter, healthier future. Remember, recovery is possible, and you are not alone in this journey.
Treatments for High-Functioning Depression
Treating high-functioning depression is similar to treating depression. Treatments include:
- Therapy: Talk therapy is a great way to address the underlying cause of your depression, strip away the masks you hold, and heal from high-functioning depression.
- Medication: If your depression is severe enough, medication can help.
- Support system: After you are diagnosed with high-functioning depression, it can be helpful to tell your support system about it. They may have not known you were struggling, but they can help you recover if you let them.
- Lifestyle changes: Building healthy habits like a healthy sleep schedule, eating enough, work-life balance, getting exercise, and making meaningful connections are all small things you can do to help you heal from high-functioning depression.
- Healthy Coping Mechanisms: Fully healing from depression takes time, and you’ll need a way to cope with it while you are in therapy. Coping mechanisms help mitigate the distress caused by mental illness and cultivate positive emotions. For high-functioning depression coping mechanisms could be talking to a friend, going for a walk, practicing a favorite hobby, or doing some mindfulness or meditation.
If you are struggling with high-functioning depression, reach out to a mental health professional. There is no such thing as “not being bad enough for therapy”; if you are struggling, therapy can help. Whether you have high-functioning depression or crippling depression, you deserve to be free from the weight of mental illness.
Lifebulb Counseling and Therapy can help. We have depression therapists located throughout the United States and can match you with a therapist near you who accepts your insurance and fits your schedule. Reach out to our team today or browse our list of depression therapists near you.
