Depression is much more than just feeling sad. It’s a diagnosable medical condition that cannot be “snapped out of” and affects mood, sleep, work-life balance, bodily health, and relationships.

Most cases of depression are diagnosed as major depressive disorder (MDD), which usually involves a single depressive episode. But people can also suffer from persistent depressive disorder (PDD), which is more long-lasting and consistent.

While “high functioning depression” isn’t classified by the DSM-5, it’s a useful term to describe how depression symptoms may appear in some people. When we picture someone with depression, we might imagine a teary-eyed, lethargic person lying in bed with the curtains drawn to darken a messy room.

But for many of those suffering from clinical depression, this isn’t the case. Usually, those around someone with high functioning depression may not even know they’re depressed. They may be a high-powered lawyer, a busy schoolteacher, or a fast-food worker who never misses a shift.

However, just because someone with depression might outwardly be succeeding in their daily lives, that does not mean their mental illness should go untreated.

Signs and symptoms

Here’s a list of symptoms of both MDD and PDD, and can be present in those with high functioning depression:

• Feelings of guilt, worthlessness, and emptiness

• Negative thoughts that won’t go away

• Feeling irritable, restless, or agitated

• Difficulty focusing on tasks

• Loss of interest in things you once took pleasure in

• Increased need for sleep

• Feeling lethargic despite adequate rest

• Frequent crying

• Changes in appetite

• Thoughts of suicide or death

The term “high functioning” means that you could have any or all of these symptoms but are still able to complete daily tasks. You might feel like you can “push through” your exhaustion and still get up for early work meetings. Maybe you’re still involved in your child’s PTA even though you’re struggling to concentrate.

You might still be able to attend a friend’s birthday party and socialize all night despite feeling low and tearful when you’re alone. These symptoms are most likely not obvious to people close to you.

“High functioning” is still a struggle

Unfortunately, stereotypes about mental illness and who is outwardly “sick” enough to get treatment still persist. Those with high functioning depression might feel less inclined to seek treatment if the people around them haven’t commented on their symptoms.

If your boss is still praising the work you’re putting in, you might think you can put off looking for a therapist. Eventually, your work performance could suffer. As with all mental illnesses, early intervention is best.

If left untreated, even high functioning depression can evolve into a major depressive episode or lead to the development of unhealthy coping mechanisms (like substance abuse).

Steps for seeking help

If you think you may be feeling depressed, it’s best to seek treatment. Even when the signs aren’t obvious to those around you, you know internally when something isn't right. Talk first with your primary care physician to talk through your options. Consider seeking a licensed counselor who can help you manage your depression in talk therapy sessions.

You might think about doing cognitive-behavioral therapy, dialectical behavior therapy, or another therapeutic approach. It’s possible you may also need pharmacological treatment, so speaking to a psychiatrist and getting a diagnosis would be a good next step. Getting on the right antidepressant can take time and trial and error. Having a therapist you trust in that interim period can help you better tackle your depression.

If you’re interested in learning more , please reach out to see how depression therapy can help you.