Could you be experiencing high-functioning depression, and what does it entail?

Could you be experiencing high-functioning depression, and what does it entail ?

Externally, you maintain a façade of productivity and success. However, once the day concludes, you find yourself depleted internally. Perhaps you decline social invitations and opt to retreat to the couch or bed, mustering just enough energy to prepare for the next day.

This is the experience of individuals grappling with what is commonly referred to as high-functioning depression. Despite outward appearances of coping well, internally, you endure silent suffering.

Is "high-functioning depression" a legitimate disorder?

High-functioning depression isn't formally recognized as a distinct medical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the authoritative text in the mental health field. However, it's gaining traction as a term used by treatment centers and health blogs to describe individuals experiencing low mood, low energy, and anxiety, according to experts.

Dr. Johnny Williamson, a board-certified psychiatrist, suggests that while not a clinical term, "high-functioning depression" is useful because it captures individuals who don't neatly fit into conventional diagnostic categories.

Many individuals categorized as high-functioning may have dysthymia, also known as persistent depressive disorder—a milder form of depression characterized by lingering fatigue and low-grade symptoms. This condition can persist for two or more years, and those affected often present a brave face while grappling with unhappiness.

Diagnosing dysthymia can be challenging due to its gradual onset, often unnoticed until individuals reach a breaking point or a significant life event triggers a heightened emotional response.

Even individuals with major depression, characterized by severe episodes of low mood and loss of interest, may fall under the high-functioning umbrella. Despite experiencing significant symptoms, they may persist without seeking help due to their determination and willingness to endure.

Dr. Anthony Rothschild, a psychiatry professor, emphasizes that individuals with major depression, often high-functioning professionals in various fields, may not reach their full potential due to their silent suffering.

How to Determine If You Have High-Functioning Depression?

High-functioning depression cannot be diagnosed through a clinical test, but healthcare professionals utilize various screening tools to evaluate depressive symptoms and functioning. Your doctor may inquire about feelings of unhappiness, frequency of crying episodes, energy levels, and sleep patterns during assessments.

Dr. Anthony Rothschild often uses a straightforward question during initial evaluations: "What do you do for fun?" A lack of response or an uncertain reaction may signal potential depression.

Assessing an individual's engagement in various life roles—such as work, relationships, parenting, and community involvement—can provide insight into high-functioning depression. According to Dr. Michael Thase, being active in these roles can help determine functioning levels, with noticeable gaps indicating potential depression.

Negative self-image and traits like perfectionism, guilt, and self-criticism may contribute to chronic unhappiness, suggests Dr. Steven Huprich. Individuals with high-functioning depression may exhibit such traits alongside mood symptoms.

Feelings of self-doubt, anxiety, and diminished confidence may also accompany a sense of underperformance, notes Dr. Johnny Williamson. If you're experiencing these symptoms, it's essential to discuss them with a healthcare provider for further evaluation and support.

When should you seek help for high-functioning depression?

People with high-functioning depression often camouflage their struggles effectively, leading to feelings of loneliness and isolation, as highlighted by Dr. Williamson. However, it's crucial to recognize that coping on your own doesn't diminish the need for support.

Depression treatment varies widely and may involve lifestyle adjustments, counseling, and/or medication, tailored to individual needs. Initiating the process could involve reaching out to your primary care physician, utilizing an employee assistance program, or contacting a therapist.

The key message from experts is the importance of seeking help, as depression is highly treatable. According to Dr. Williamson, the specific starting point for treatment matters less than taking the initial step toward seeking support.