High-functioning depression: Depression has many faces

High-functioning depression is not easy to deal with as it is likely to go unnoticed by loved ones. But what we need to remember is that a highly functioning person suffers invisibly too. Understanding “high-functioning depression” can help raise public awareness.

General signs and symptoms of depression

Below are some of the general signs and symptoms of depression. If you experience this, kindly seek help.

  • feeling sad, anxious, or “empty”
  • feeling hopeless, worthless, and pessimistic
  • crying a lot
  • feeling bothered, annoyed, or angry
  • loss of interest in hobbies and interests you once enjoyed
  • decreased energy or fatigue
  • difficulty concentrating, remembering, or making decisions
  • moving or talking more slowly
  • Insomnia, early morning awakening, or oversleeping
  • Change in appetite appetite and weight
  • chronic physical pain with no clear cause that does not get better with treatment (headaches, aches or pains, digestive problems, cramps)
  • thoughts of death, suicide, self-harm, or suicide attempts

High-functioning depression

The diagnosis for high-functioning depression is called a persistent depressive disorder, or PDD. Many mental illnesses are severe enough to impair a person’s ability to function. Dysfunction for major depression means not being able to hold down a job, perform well in school or work, avoid social activities, or being unable to manage healthy relationships. Whereas, in high-functioning depression, a person is able to get things done and go on about their normal routines like work or school. But then depression hits harder on most days than others. Two important differences are duration and severity. PDD persists over a long period of time, two years or more, while major depression occurs in episodes that are shorter-lived but still at least two weeks long.

This type of depression is dangerous because loved ones tend to think someone is okay and no one offers or suggests help. It is difficult to detect in oneself, but especially in others. Outwardly, people suffering from high-functioning depression look okay, but they struggle internally.

High-functioning is not the same as fully functioning. With high-functioning depression, there is still some impairment. Anyone with PDD is also at risk of experiencing episodes of major depression. During an episode of major depression, the functioning will slide. They may begin to perform more poorly at school or work, become socially withdrawn, or neglect personal hygiene.

Diagnosis and signs of high functioning depression

high functioning depression

The depressed mood must include two or more of these symptoms:

  • Experiences depressed mood most days and for most of the day, for a minimum period of two years.
  • Decreased appetite or overeating
  • Insomnia or oversleeping
  • Lack of energy and fatigue
  • Lowered self-esteem
  • Difficulty concentrating and making decisions
  • Feeling sad and hopeless

In addition to these symptoms there are a few other criteria that have to be met:

  • The depression symptoms cannot be better explained by another mental illness, by a medical condition, or by substance abuse.
  • Depressed mood causing some impairment in one or more areas of normal functioning and significant distress.
  • Meet criteria for major depression.
  • Feelings of worthlessness or guilt. Leading others to refer to you as gloomy, cynical, or a downer.
  • Tiredness, lethargy, in spite of adequate 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.
  • Persistent negative thoughts
  • Feeling irritable or easily annoyed by others
  • Feeling agitated or restless
  • Thoughts of suicide
  • Frequent crying

Treatments for High-Functioning Depression

Following an evaluation by a mental health professional, it may be determined that one needs treatment. Once diagnosed, PDD can be treated with a combination of medications and therapy.

Therapy for high-functioning Depression

Therapy helps treat PDD by teaching patients ways to recognize negative patterns in thoughts and to actively change them.

  • Cognitive Behavioural Therapy (CBT) – an effective treatment that involves making changes in both the patterns of negative thoughts and the behavioural routines, which are affecting the daily life of the depressed person.
  • Person Centred Therapy – a strategy that allows and encourages clients to understand and resolve their concerns in a safe, support environment.
  • Psychodynamic Therapy – a style that investigates the role of the unconscious mind depression.
  • Solution Focused Therapy – an approach interested in solutions which can be quickly implemented with a simple first step leading to further positive consequences.
Medication for Depression

Some individuals who experience high-functioning depression warrant the use of antidepressant medications. It may also take a few tries with different types to find a medication that works best.

Basic types of antidepressants categories:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
  • Tricyclics
  • Monoamine Oxidase Inhibitors (MAOIs)
  • Atypical Antidepressants
Tips for Managing High-Functioning Depression

Listed are lifestyle changes that have been believed to help. Please note that this is not a substitution for treatment nor should be done as a distraction.

  • Add exercise of any kind (under physician’s advice) to your daily routine. This includes a jog, yoga, or even going for a walk.
  • Set daily simple goals that are easily reached, in order to boost a sense of accomplishment.
  • Improve your diet which coincide with more energy.
  • Establish a healthy sleep routine.
  • Avoid maladaptive behavior such as use of substance abuse.
  • Journaling has been said to help forestall major emotional slides.
  • Get enough rest each day, but be careful not to oversleep.
  • Reach out to family, friends, or and loved ones for emotional support.
Other Coping Methods

Accepting Your Mental Health: Acknowledging that depression is an illness like any other and is not your fault. Let go of blame and shame.

Know that you are not alone in dealing with depression. Mental illness can be isolating, just keep in mind that you are not alone in dealing with depression or anxiety.

When & How to Seek Professional Help for High-Functioning Depression

It is always advisable to seek help for a functional depression since this can easily become a chronic problem that persists for years if left untreated.

  • Ask a primary care physician for a referral to a psychotherapist
  • Ask your health insurance company for a list of in-network mental health providers near you
  • Use an online provider locator service and refine your search by insurance company, location, or other factors important to you
  • Contact the local community mental health centre. 

How to share with your employer

If possible, share with your employer and colleagues so that on days you can get the support you need and thus making things easy for you.

  • Do it in person.
  • Choose a time that is right for you. Preferably when you are relatively calm.
  • share some basic information about depression, and where you may need additional support.
  • Do not share your personal details your therapist or therapist medications
  • Keep it professional. And ensure your boss that you are still capable of doing your job
  • Keep keep the conversation relatively short.
How to Help a Loved One

If you’re trying to support someone, avoid making assumptions. Don’t, for instance, tell a person they need therapy, rather ask questions first and point out potentially concerning behavior changes.

  • Simply listening to their thoughts and feelings is often the most helpful thing you can do as a friend or partner.
  • Offer your emotional support, empathy, and encouragement
  • Take time to be involved with them in activities which they enjoy
  • Offer thoughts that are hopeful and suggest outcomes which are optimistic and manageable
  • Take seriously any statements about death or suicidal thoughts
  • Promote the benefits of professional help and offer help in finding one
  • Offer to accompany them to the appointment or to remind them to go
  • For older teens and adults, share the national hotline numbers for suicide prevention



Person Centered Therapy




Prateek Katyal pexel

Raphael Brasileiro pexel

Photo by Surface on Unsplash

Image by StockSnap from Pixabay 



Founder & Editor

My name is Queen. This blog is a back love platform showcasing African fashion, beauty, art, lifestyle, opportunities, and Mental Health. I like to call it Africa through my eyes. These as well topics around the globe.

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