What is High-functioning Depression?

We recently heard an analogy that describes high-functioning depression to a tee. Imagine two cars driving down the road at the same speed. They look exactly the same from where you’re standing, but in reality, one driver has to jam the pedal to the floorboard to keep pace.

That sums up high-functioning depression. People with high-functioning depression appear to be performing well, but functioning normally is actually a struggle.

Because they manage to keep up appearances, people don’t realize they’re having a hard time. This can create a dangerous barrier to treatment. Learn more about high-functioning depression, including the warning signs. If you notice these signs in yourself or someone else, treatment is a viable option.

Depressed Businessman Leaning Against Brick Wall

Types of High-functioning Depression

High-functioning depression isn’t an official diagnosis. Instead, it’s used to describe people with depression that appear functional to the outside world. They still go to work, meet deadlines, and appear fine – even though they’re struggling internally.

High-functioning depression can occur due to a major depressive episode or dysthymia. Let’s take a closer look at both.

Major Depressive Episodes and High-functioning Depression

When psychiatrists diagnose clinical depression, they consider the patient’s ability to function. However, some people meet the criteria for clinical depression even when they’re able to function.

Major depressive episodes often present as high-functioning depression in people that put a lot of pressure on themselves. They’re often perfectionists with classic “Type A” personality traits.

Also, people of color are more likely to have high-functioning depression when dealing with a major depressive episode. Unfortunately, there’s still a big stigma and reluctance to get treatment for mental health disorders in the Black community. Many see depression as a sign of weakness and do their best to prevent others from noticing.

You can see a combination of both factors in Cheslie Kryst. The former Miss USA was also a correspondent for Extra and an attorney. Unfortunately, the Black woman also had high-functioning depression – and ended up taking her own life in January 2022.

Her loved ones were shocked because she hid her symptoms so well. Unfortunately, the symptoms tore her up on the inside, as they do with many suffering from high-functioning depression.

Dysthymia and High-Functioning Depression

Some people with high-functioning depression have what’s called dysthymia, or persistent depressive disorder. You can experience many of the same symptoms as major depression, but they’re not as severe.

Even though the symptoms aren’t as acute, they can be debilitating because they last so much longer. Instead of lasting for at least two weeks, the symptoms last for two years or longer. They put such a drain on the person that they can lead to suicidal ideation or action.

It’s also worth noting that people with dysthymia can suffer a major depressive episode on top of it. Sometimes, these people are high-functioning until a major depressive episode comes on and sets them back. Then, they’re unable to meet the demands of daily life.

Signs of High-Functioning Depression

Since people with high-functioning do their best to maintain outward appearances, the condition can be hard to spot. However, we’ve come up with some signs that you or a loved one has high-functioning depression.

Some common signs include:

  • Changes in sleep (even sleep quality)
  • Feelings of powerlessness, sadness, or hopelessness
  • Dark thoughts about the future
  • Subtle changes in mood
  • Lower energy
  • Skipping social functions that they normally attend

Having these symptoms for a couple of days isn’t cause for concern. However, if they persist for two weeks or longer, it’s time to consider treatment.

Treatment for High-Functioning Depression

Psychotherapy and medication are often used to treat high-functioning depression. Let’s take a closer look at both options.

Therapy for High-Functioning Depression

If your symptoms are mild, you might only need to undergo therapy. Some options include:

  • Cognitive behavioral therapy
  • Interpersonal therapy
  • Psychodynamic therapy

Most depressed patients respond well to cognitive behavioral therapy (CBT). The therapist helps the depressed patient identify thought patterns that worsen depressive symptoms. Then, the therapist guides the patient to reshape negative thoughts.

Many patients are afraid to join therapy because they think they’ll have to stay with a therapist forever, but that’s usually not the case. In general, patients need to go to therapy for:

  • 8-12 sessions for mild depression
  • 8-16 sessions for moderate depression
  • 16 or more sessions for severe depression
  • Up to two years of sessions for chronic depression

Medication to Treat Depression

If your symptoms are mild, you might not need antidepressants. However, moderate to severe symptoms require faster relief, so your mental health provider might recommend starting on medication in combination with talk therapy.

Research shows that medication can provide faster relief than talk therapy. However, the impact of therapy is long-lasting, making it easier to avoid depressive symptoms in the future. That’s why many providers recommend that you also go to therapy if you take medication.

Getting Ready for Treatment

It’s hard to keep moving forward when you have high-functioning depression. You might feel like you’re barely hanging on, so undergoing treatment is overwhelming. However, it’s important to understand that treatment can help you overcome the symptoms and get your life back in order.

We’ve compiled some resources to make the next step as easy as possible.

First, check out our online therapy reviews. You can pour over reviews for online therapists and psychiatrists, ensuring you find the right fit for your situation. Then, you just need to set up an appointment with the provider.

We also know that the first therapy appointment can be overwhelming, and that causes some people to forgo treatment. We’ve compiled a guide on what to talk about in your first therapy session. Go over the guide so you’ll know what to expect. Then, you can start therapy with confidence.

You Don’t Have to Struggle with High-functioning Depression

You might seem fine to the outside world, but we know you’re struggling inside if you have high-functioning depression. We encourage you to review your treatment options and set up an appointment. You can overcome your symptoms and find joy in life again with the right treatment.