When you hear that someone has depression, you likely get a specific picture in your mind. You think that they probably have trouble getting out of bed in the morning. That they may sleep a lot and isolate themselves from their friends. Or that they call out sick from work all the time, and they have days when they can’t stop crying. Depression doesn’t always look like the textbook definition though. High-functioning depression, also known as persistent depressive disorder, can leave you with distressing emotions while your life looks perfect on the outside. You’re holding it all together, but are you really doing fine?
What is High-Functioning Depression?
The official diagnosis for high-functioning depression is persistent depressive disorder, or PDD. The symptoms of depression are there, but they are less severe than they are in people with major depression.
Because persistent depressive disorder doesn’t feel as intense as major depression, people who struggle with it can often take care of their responsibilities and obligations. It may be difficult for them on the inside, but they put on a good face and get things done.
Just because you’re functioning well, doesn’t mean that you’re functioning optimally. You might perform well in some areas of your life but not others. For example, the routine of going to work may help you feel balanced. You may not have trouble holding down a job, but you isolate yourself outside of work hours and avoid social functions.
High-functioning depression doesn’t look like what you picture when you think about stereotypical depression. PDD is hard to identify because it doesn’t always take everything out of you.
People with high-functioning depression go about their daily lives. Their suffering may be invisible to their friends and family. But if PDD goes untreated, it can become more severe and lead to other psychological problems, such as anxiety.
If you have major depression, you might not be able to get out of bed no matter how much you want to. Persistent depressive disorder can also impair your motivation. But high-functioning depressives push through.
You go to work even though you’re anxious. You push toward your goals even though doing so feels like pulling teeth.
You might even feel like you’re not the person doing all of the productive things. You may feel disconnected from your mind and body. You can go through the motions, but you’re empty inside. You don’t feel fulfilled, and you wonder why you can’t pull it together even though your life is pretty good.
Many people with high-functioning depression are high achievers. People with PDD may be very accomplished. They may be seen as leaders. You might not be able to tell how they feel from the outside, which makes the depression even worse.
If you’ve dealt with PDD before, you know that high-functioning depression can make you feel like a phony or an impostor. You feel alone in yourself because nobody understands what’s really going on.
Persistent depressive disorder isn’t something that you can just snap out of. It’s caused by a mix of personal, historical events in your life as well as a possible chemical imbalance. Therapy, medication, and alternative treatments that influence your brain chemicals and teach you coping mechanisms can help you heal. But above all, digging in and exploring your history and the things that you’ve suffered through, will be the strongest and most effective way to cope and surpass the ailments of PDD.
If this sounds like it could be you, it’s worth digging deeper. Persistent depressive disorder can detract from your quality of life.
The following questions can help you identify some signs of high-functioning depression:
• Do people say that you’re a gloomy person?
• When you’re happy, do you worry that it won’t last long?
• Do you feel like you’re in a low mood most of the time?
• Are you often fatigued even though you get enough sleep?
• Do you have trouble finding the energy to perform your best?
• Do you think that you don’t deserve to be well-liked or happy?
• Even though you do well at school or work, does it feel overwhelming?
• Do you cry for seemingly no reason?
If you answered yes to any of these questions, you might want to talk to a therapist. You could be dealing with persistent depressive disorder or high-functioning depression.
High-functioning depression can be difficult to identify. If someone else has it, they’re usually fairly good at making it look like everything is ok on the outside. If you have it, you might tell yourself that you’re achieving all of your obligations and don’t have a problem.
If you have high-functioning depression, you might not have the same symptoms as someone with major depression. High-functioning depression symptoms may also be similar to, but less intense than, those associated with major depression.
According to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), someone with high-functioning depression has a depressed mood for the majority of the day on more occasions than not for at least two years. In addition to that, you must have at least two of the following symptoms to be diagnosed with high-functioning depression:
• Loss of or increase in appetite
• Difficulty sleeping or sleeping too much
• Fatigue or lack of energy
• Poor self-esteem
• Difficulty concentrating or making decisions
• Feelings of hopelessness
You might also have some of these other symptoms:
• Trouble experiencing joy
• Critical negativity of yourself and others
• Pervasive self-doubt
• Small events feel like the end of the word
• Excessive anger and irritability
If you have high-functioning depression, these symptoms don’t prevent you from living your life. You might feel awful, but you post happy photos on social media and go out with your friends. You get to work on time every day and complete your projects.
While most people experience some of the symptoms on this list from time to time, someone with high-functioning depression may have them for several years.
Treatment and Support for High-Functioning Depression
Although you can get through life with high-functioning depression, it doesn’t feel good. Suffering on the inside can feel lonely. It’s hard to maintain a good quality of life if you don’t get support for what you’re going through. If it’s left untreated, high-functioning depression can turn into a more serious mental illness.
Even though high-functioning depression isn’t always debilitating, it can ebb and flow. If you suffer from high-functioning depression, you could slip into periods of major depression. You could also develop an anxiety disorder or other mood disorder.
If you think that you may have high-functioning depression, it’s important to seek treatment. You’re probably used to hiding it. You’re probably used to being an over-achiever, which makes you feel like you should be able to fix this on your own.
But depression doesn’t work that way. No amount of willpower can get you out of it. In fact, if you try to avoid the issue and push yourself out of it, you may feel more overwhelmed as your symptoms intensify.
Psychotherapy and medication have been proven to improve high-functioning depression symptoms. In many cases, therapy alone is effective.
Working with one of our therapists in Beverly Hills can help you identify what you’re going through, and it’ll give you the tools to get out of the shadow of high-functioning depression.