What Is High-Functioning Depression?

a woman looking out the window suffering from high functioning depressionWhen you suffer from high-functioning depression, it may be difficult to experience much joy, satisfaction or peace in your everyday life. You might not necessarily feel sad or worthless. If you had to describe how you feel, you might choose the word “numb.”

If you can relate to this experience, yet you don’t feel your life is necessarily going in a negative direction, this could be a sign of high-functioning depression. Signs of high-functioning depression—also referred to as persistent depressive disorder (PDD)—can include a range of both psychological and physical symptoms.

High-functioning depression differs from other types of depression that may cause major disruptions in your life. This doesn’t make it any less serious or upsetting than major depressive disorder. In fact, since high-functioning depression often goes unnoticed, it may worsen over time.

The best thing you can do is learn how to recognize PDD so that you can appropriately treat it. Let’s take a look at the key signs of high-functioning depression and compare it against some other common types of depression.

Signs of High-Functioning Depression

General depression can feel different to different people. But there are typically some common symptoms with high-functioning depression:

  • An inability to feel pleasure in activities you used to enjoy (also known as anhedonia)
  • Mental numbness
  • Persistent sadness and low self-esteem
  • Changes in sleep patterns (e.g. insomnia or oversleeping)
  • Lack of energy and fatigue
  • Difficulty concentrating and making decisions
  • Changes in diet (e.g. poor appetite or overeating)

A psychiatrist would give you a diagnosis of PDD (formerly known as dysthymia) if you have experienced a depressed mood for most days over the past two years or more. You must also have at least two of the above signs. A clear sign of high-functioning depression is the ability to carry out daily activities while experiencing these symptoms.

If a loved one or colleague doesn’t open up about their depression, there are other signs of high-functioning depression you can look out for:

  • Instances where someone is extremely critical of themselves, both physically and mentally
  • Sudden changes in work quality, performance or attitude (e.g. being even more quiet than usual in meetings or avoiding social activities)
  • Someone who seems overly concerned about productivity or wasting time; for example, work may be used to escape numb feelings, and a persistent feeling that life is just a waste of time and not worth living
  • Substance abuse or alcohol consumption, which can make depression symptoms and thoughts of suicide worse

Living Life With Depression

Many people with high-functioning depression seem to live a normal life. Friends, family and co-workers may either not realize or be shocked to learn that someone is suffering. After all, most people think that depression means you struggle just to function in life. If you have high-functioning depression you can still get work done, be successful and be sociable, yet still experience a lot of emotional pain.

Someone with high-functioning depression will fulfill their commitments and do their work while putting on an act that everything is okay. Many do not open up about their feelings because they do not want to feel vulnerable. People with high-functioning depression often have feelings of guilt and learn to pretend that “everything is fine.” Over time, pretending can even start to feel normal.

While being praised for doing well, they may feel a constant dread about failing to meet expectations. For instance, a college student might feel pressure to graduate from college in four years, even though a five-year plan would be easier for them to handle. Or a parent might have difficulty asking for help when they are having trouble juggling everything at home and work.

People with high-functioning depression are usually capable of hiding their depression around others, but in reality they are struggling with their mental health and may not know how to seek help.

High-Functioning Depression vs. Major Depression

People with major depression can experience the same symptoms as those with high-functioning depression, but major depression differs in some important ways.

Firstly, for a psychiatrist to diagnose you with major depression, you must experience at least two signs of depression every day for at least two weeks (as opposed to two years with PDD). Major depression is usually more short-lived, although a major depressive episode can sometimes last a year or longer.

Another important difference is that the symptoms of major depression are more severe. In the case of major depression, it is common for sufferers to experience:

  • Exhaustion
  • Lack of motivation
  • Hopelessness
  • Self-loathing
  • Suicidal thoughts

PDD is a milder form of depression that persists for longer than major depression. This is why it can be harder to detect. Major depression, in contrast, can be very disruptive. People with major depression may be ready to give up on their relationships, careers and even on life itself.

Another common sign of major depression is struggling to get out of bed. This is due to the severity of the symptoms. But depression doesn’t affect everyone this way.

To some, getting up with the alarm isn’t a problem; they can do it without any real mental or physical struggle. Are they happy to be getting up for another day? No. Are they energized by the thought of a work project? Not particularly. Will they be able to get their work done? Actually, yes. Are they excited about weekend plans? If the plans ended up being canceled, they wouldn’t feel a strong emotion one way or another. These people might have high-functioning depression.

High-Functioning Depression vs. Bipolar Disorder

A bipolar disorder is characterized by swings between a depressed mood and manic episodes. Mania typically involves:

  • Euphoria
  • Intense moods
  • Hyperactivity
  • Feeling invincible
  • Extreme overconfidence
  • Impulsivity
  • Reduced need for sleep
  • Talkativeness
  • Delusions
  • Racing thoughts
  • Easily distracted
  • Increased agitation

PDD, in contrast, doesn’t feature any of these symptoms. High-functioning depression doesn’t switch between highs and lows as experienced by bipolar disorder patients. Instead, there is a long-lasting and mild depressed mood.

High-Functioning Depression vs. Seasonal Affective Disorder

Seasonal affective disorder (SAD) features the common symptoms of depression, but these symptoms follow a seasonal pattern. SAD is also known as “winter depression” because symptoms tend to show up for many people during winter. This has been linked to the lack of sunlight, which may impact brain function.

High-functioning depression doesn’t come and go with the seasons. It remains constant throughout the year. Having said that, someone with PDD may notice a worsening of symptoms in winter due to reduced sunlight.

Treatments for High-Functioning Depression

There are many effective treatments for PDD that can reduce symptoms and improve your mental health overall. The most successful outcomes often include a combination of the following:

  • Antidepressant medication
  • Counseling (including family therapy)
  • Regular exercise
  • A healthy and balanced diet (including a high intake of whole grains, fruits and vegetables, and limited consumption of alcohol, caffeine, sugar and processed foods)
  • Meditation
  • Yoga

Sometimes it is hard to know when a person is living with a mental illness like depression. Think of it like this: Someone with high-functioning depression is like an iceberg; you only see the tip, but there is so much more going on under the surface. People with high-functioning depression are just good at hiding it.

If you recognize any signs of high-functioning depression in a friend or loved one—or in yourself—it’s important to understand that depression is treatable. Getting joy out of life again is certainly possible. Talk to someone you trust or visit a doctor to find out what treatment plans may be best for you.