What is High Functioning Depression?
High-functioning depression is not a proper medical diagnosis. You won’t find it listed in the Diagnostic and Statistical Manual of Mental Disorders, the bible of the mental health profession. But it is popping up on treatment center websites and mental health blogs to characterize individuals with low mood, low energy, and anxiety, experts say.
Some experts believe the term comes from a lack of clarity surrounding persistent depressive disorder (PDD), or dysthymia, an ongoing form of depression. PDD differs from major depressive disorder (MDD or major depression) as the symptoms tend to be less severe but longer.
People with high-functioning depression are typically diagnosed with persistent depressive disorder (PDD). Common symptoms of PDD include a lack of energy or constant fatigue. Those with PDD or high-functioning depression experience the symptoms for at least two years. If you’re battling mental health challenges, alcoholism, or chronic stress due to or that is causing depression, please reach out for support.
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What it Feels Like to Live with High-Functioning Depression?
Former Miss USA Cheslie Kryst hid her high-functioning depression from “everyone” until right before her death, her mother said. She was identified as the woman who jumped out of a New York building on January 30, 2022. People with high-functioning depression may resist acknowledging vulnerability and seeking help.
The symptoms of high-functioning depression are less severe than those of major depression. Major depressive disorder (major depression) is also called clinical depression. But they can still be very disruptive to a person’s life. People with high-functioning depression may struggle to concentrate, stay motivated, or enjoy activities that used to please them. They may also experience problems with sleep and changes in appetite.
High Functioning Depression Symptoms
Your high-functioning depression may have you and your friends and family members convinced that you are not suffering from the disorder. However, if you exhibit any of these symptoms for two weeks or more and at least one of your symptoms is depressed mood or loss of interest or pleasure, you may have a major depressive disorder. These symptoms will be a noticeable change in your previous ability to function.
Common symptoms of high functioning depression include the following:
- Persistent sadness or low mood.
- Fatigue and low energy.
- Difficulty concentrating or making decisions.
- Loss of interest or pleasure in activities.
- Irritability or mood swings.
- Changes in appetite or weight.
- A sense of emptiness or hopelessness.
- Sleep disturbances (insomnia or excessive sleep).
- Feelings of guilt or worthlessness.
- Social withdrawal or isolation.
- Physical symptoms such as headaches or digestive issues.
- Increased perfectionism or self-criticism.
Individuals with high-functioning depression may not exhibit all of these symptoms, and their ability to maintain daily responsibilities can make it challenging to recognize their internal struggles.
High Functioning Depression Causes
The exact causes of high-functioning depression are not fully understood but likely involve a combination of genetic, biological, environmental, and psychological factors. Stress, trauma, a family history of depression, and chemical imbalances in the brain may contribute to its development.
Genetics
People with a first-degree relative, such as a parent or sibling, with major depression are at increased risk for high-functioning depression. Suppose you trace your family tree back several generations and notice that almost everyone struggles with some mood disorder. In that case, exploring whether there is any genetic component to this pattern may be helpful.
Stressful Events
Incredibly stressful life events can contribute to high-functioning depression. This may include a death in the family, a job loss, or a divorce.
Chemical Imbalance
It is believed that chemical imbalances in the brain may be partially responsible for high-functioning depression. Furthermore, serotonin and norepinephrine are two neurotransmitters linked with mood disorders.
Medications
Some medications can contribute to feelings of depression. For example, steroids and some blood pressure medications have been linked with mood changes that may lead to low energy, sadness, irritability, or other symptoms associated with high-functioning depression.
Substance Abuse
People who struggle with substance abuse may be at increased risk for high-functioning depression. Drug and alcohol use can alter the way neurotransmitters function in the brain, which may increase feelings of sadness or irritability.
Diagnosing High Functional Depression
The diagnosis of high-functioning depression requires that all of the following criteria be met:
- A depressed mood most of the day, nearly every day.
- At least four of the following symptoms must be present:
- Depressed Mood: Persistently feeling sad, empty, or down most of the day, nearly every day.
- Loss of Interest or Pleasure: Markedly diminished interest or pleasure in most activities.
- Significant Weight Change: A noticeable increase or decrease in weight or a change in appetite.
- Sleep Disturbance: Insomnia or hypersomnia nearly every day.
- Psychomotor Agitation or Retardation: Observable restlessness or slowed behavior.
- Fatigue or Loss of Energy: Persistent tiredness or lack of energy.
- Feelings of Worthlessness or Guilt: Excessive or inappropriate guilt or feelings of worthlessness.
- Impaired Concentration: Difficulty concentrating or making decisions.
- Suicidal Thoughts: Recurrent thoughts of death, suicidal ideation, or a suicide attempt.
- Duration: Symptoms must be present for at least two weeks and cause significant distress or impairment in daily life.
The medical professional will also look for signs that the person can function well in most areas. This includes having a job, caring for oneself, and having supportive relationships.
High Functioning Depression Tests
Different tests can be used to determine if high-functioning depression is present. These may include the following:
- Zung Scale: This questionnaire can measure the severity of depression symptoms.
- Beck Depression Inventory (BDI): The BDI is a test that measures how depressed a person feels. It includes 21 items, such as “I feel hopeless about the future” and “I have difficulty making decisions.”
- Hamilton Rating Scale for Depression (HRSD): The HRSD measures the severity of depressive symptoms over time. It includes 17 items, such as “insomnia or hypersomnia nearly every day” and “pessimism about the future.”
If you think you may be suffering from high-functioning depression, it is crucial to seek professional help. There are many treatments available. These can help improve mood symptoms and allow you to live a fuller life.
High Function Depression and Other Forms of the Condition
Comparing high-functioning depression with other forms of depression:
High-Functioning Depression:
- Individuals maintain daily responsibilities and may appear successful externally.
- Symptoms are often concealed, making it challenging for others to recognize their struggles.
- Internal distress, persistent sadness, and emotional exhaustion are common.
- They may experience irritability, mood swings, and difficulty concentrating.
- Treatment often involves therapy, lifestyle changes, and self-care strategies.
- Functioning at work or in social situations may not reflect the internal emotional state.
Major Depressive Disorder (MDD):
- Symptoms can significantly impair daily functioning and may lead to difficulties at work or school.
- More apparent and pervasive symptoms include visible sadness, withdrawal, and loss of interest.
- Diagnosis is based on meeting specific criteria outlined in the DSM-5.
- It may involve severe symptoms such as suicidal thoughts, appetite changes, and sleep disturbances.
- Treatment often includes therapy, medication, and close monitoring by mental health professionals.
Persistent Depressive Disorder (Dysthymia):
- A long-lasting form of depression lasting at least two years in adults. It is also considered a high-functioning depression.
- Chronic low mood and feelings of hopelessness, often with less severe symptoms than MDD.
- Similar treatment approaches to MDD include therapy and medication.
- Impairs daily functioning and can lead to social and occupational difficulties.
Bipolar Disorder:
- It involves episodes of depression (low mood) and mania (elevated mood) or hypomania.
- Periods of high energy, impulsivity, and grandiosity alternate with depressive episodes.
- Diagnosis requires the presence of manic or hypomanic episodes and depressive episodes.
- Treatment may include mood stabilizers, antipsychotic medications, and therapy.
Seasonal Affective Disorder (SAD):
- Occurs seasonally, typically during the fall and winter months.
- Depressive symptoms are linked to reduced sunlight exposure.
- Treatment may involve light therapy, counseling, or medication.
- Symptoms improve in response to increased sunlight exposure in spring and summer.
While these are distinct categories, individuals with depression may experience symptoms that vary in severity and presentation, and treatment approaches can be tailored to individual needs. Consulting a mental health professional is crucial for accurate diagnosis and appropriate treatment.
Highly Functioning Depression Vs. Major Depressive Disorder Chart
Depression high functioning symptoms typically involve individuals who outwardly maintain their daily responsibilities despite persistent internal distress, often concealing their symptoms. In contrast, major depressive disorder (MDD) includes more apparent and pervasive symptoms that significantly impair daily functioning and may lead to difficulties at work or school, often requiring intensive treatment and support.
| Characteristic | High Functioning Depressive Symptoms | Major Depressive Disorder (MDD) |
|---|---|---|
| Functional Impairment | May maintain daily responsibilities and appear successful externally. | Symptoms can significantly impair daily functioning and may lead to difficulties at work or school. |
| Visibility of Symptoms | Symptoms are often concealed, making it challenging for others to recognize their struggles. | It may involve severe symptoms such as suicidal thoughts, appetite changes, and sleep disturbances. |
| Internal Distress | Internal distress, persistent sadness, and emotional exhaustion are common. | Includes internal distress, marked by deep sadness, hopelessness, and pervasive emotional pain. |
| Specific Diagnosis | It is not a formal diagnosis; it often falls under the category of atypical depression. | Diagnosed based on meeting specific criteria outlined in the DSM-5. |
| Symptom Severity | May experience milder symptoms compared to MDD, but still impactful. | May involve severe symptoms such as suicidal thoughts, appetite changes, and sleep disturbances. |
| Treatment Approach | Treatment often involves therapy, lifestyle changes, and self-care strategies. | Treatment typically includes therapy, medication, and close monitoring by mental health professionals. |
| Work and Social Functioning | Functioning at work or in social situations may not reflect the internal emotional state. | Impairments in work, school, and social functioning are common. |
Top 6 Signs of High Functioning Depression
What does high functioning depression look like? Evidence suggests that high-functioning depression can lead to chronic fatigue due to emotional exhaustion and disrupted sleep patterns, even when individuals continue to meet their obligations.
High-functioning depression can also lead to physical symptoms such as headaches, digestive issues, and muscle tension, reflecting the mind-body connection in mental health.
However, individuals with high-functioning depression may excel in their daily responsibilities while concealing their emotional turmoil. This phenomenon, “smiling depression,” is linked to a strong desire to maintain a facade of competence and resilience.
The top 6 signs of high functioning depression to watch out for include the following:
1. Sadness
This is the most common symptom of high-functioning depression and can be accompanied by feelings of emptiness, hopelessness, or worthlessness. Sadness can also take the form of grief, as people with high-functioning depression often have difficulty dealing with loss and may become depressed after losing a loved one or experiencing some other type of significant life change.
2. Lack of Energy
People with high-functioning depression often have a low energy level and feel chronically fatigued. This can make it difficult to get out of bed in the morning, complete everyday tasks, or participate in activities that used to bring joy.
3. Poor Concentration
People with this depression often have difficulty concentrating and may feel like they are “wasting their time” when they try to do anything other than relax. This can lead to feelings of frustration and self-criticism.
4. Insomnia
Many people with high-functioning depression experience problems with sleep, either insomnia (not being able to fall asleep) or excessive sleeping (sleeping for more than eight hours per night). Irregular sleep patterns can further aggravate mood symptoms.
5. Changes in Appetite
People with high-functioning depression may experience changes in appetite, either losing their appetite or overeating. Appetite changes can lead to fluctuations in weight, which may contribute to a poor self-image.
6. Low Self-Esteem
People with high-functioning depression may struggle with feelings of worthlessness, inadequacy, and guilt. This can lead to a lack of motivation.
Dealing with High-Functioning Depression
Lifestyle changes are very often helpful for people coping with any depressed mood. These lifestyle changes may include changes in diet, exercise, sleep routine, use of medications, and involvement with a social support network.
Since it is common for people with depression to have difficulty initiating new behaviors, a recommended first step is to seek the help of a mental health professional who will be supportive and help you make the changes that will be the most beneficial.
Here are seven lifestyle changes that have been shown to lessen depressive symptoms for most people:
- Contact a psychotherapist and schedule an initial meeting as soon as possible.
- Add exercise (under physician’s advice) to your daily routine. Physical activity has been strongly linked to improved mental health and mood for all ages. This is particularly true for persons with chronic mild depression, such as PDD, and for depression related to chronic anxiety.
- Set daily goals, preferably simple ones that are easily reached, to boost self-confidence and sense of accomplishment.
- Begin to make improvements in diet, which coincide with more energy, less sluggishness, and improved focus.
- Establish a routine for sleep and waking.
- Limit or omit alcohol and other drugs depending on personal health risks. Seek support for recovery from substance abuse if needed.
- Contact family, friends, or local and online community members for emotional support.
High-Functioning Depression is Treatable
High-functioning depression is treatable, and early intervention can significantly affect an individual’s well-being. Evidence-based treatments, such as various forms of psychotherapy (e.g., cognitive-behavioral or interpersonal therapy), have proven effective in helping individuals manage their symptoms and improve their mental health.
Moreover, self-care, including regular exercise, a balanced diet, adequate sleep, and stress reduction techniques, can complement therapeutic interventions.
Support from loved ones and a solid social network can also play a crucial role in the treatment and recovery process, reinforcing the message that high-functioning depression is not a battle that needs to be fought alone.
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Alcoholism can also cause depression in some circumstances. Prolonged alcohol abuse can drastically change and rewire the brain, impacting many other chemical balances in the body. This is particularly true of the brain’s neurotransmitters, which send electric and chemical impulses and control many of the body and mind’s functioning. These systemic changes can cause depression.
Connection Between Alcohol and High Functioning Depression
There is a strong connection between alcohol consumption and risk factors for high-functioning depression. Many depression sufferers, especially those not adequately diagnosed, often use alcohol to escape. Desperate to feel better or numb the pain, even for a little while, individuals with high-functioning depression often use the sedative effects of alcohol for that purpose.
Alcohol abuse is rampant among people suffering from depression. At least 30%-40% of alcoholics also experience a depressive disorder.
People are often seduced by the sedative effects of alcohol and use it to self-medicate and help distract them from persistent feelings of despair. Alcohol may appear to relieve some of the symptoms of depression temporarily. However, it ultimately worsens high-functioning depression on a long-term basis. As consequences of alcohol abuse persist, high-functioning depression worsens. This often leads to a damaging cycle of abusing alcohol to self-medicate symptoms of depression, while the high-functioning depression worsens due to the continued alcohol abuse.
Alcohol is a central nervous system depressant (CNS) that slows the body down. Studies have consistently shown that alcohol use increases the duration and the severity of depressive episodes. It also increases the likelihood, frequency, and severity of suicidal thoughts.
High Functioning Anxiety and Depression Comorbidities with Addiction
High-functioning anxiety and depression often co-occur with addiction, creating a complex web of comorbidities. Individuals with these conditions may use alcohol or drugs to self-medicate to alleviate their emotional distress or anxious thoughts.
This can lead to a dangerous cycle of substance misuse and worsened mental health symptoms. Efficient treatment approaches should address both the underlying anxiety or depression and the addiction simultaneously, typically involving therapy, support groups, and, in some cases, medication-assisted treatment to provide comprehensive care and support for recovery.
Do you have questions about high functioning depression and addiction or treatment in general? Call our helpline 24/7.
High Functioning Depression Definition
Fact Sheet
Combatting High Functioning Depression and Anxiety Attacks
Combatting high-functioning depression and anxiety attacks involves evidence-based strategies rooted in scientific research. Here are science-based approaches to manage these conditions:
- Cognitive-Behavioral Therapy (CBT): CBT is a well-established therapeutic approach that helps individuals identify and modify negative thought patterns and behaviors. Research consistently shows its effectiveness in treating both depression and anxiety.
- Mindfulness and Meditation: Mindfulness practices, such as meditation and deep breathing exercises, have been scientifically proven to reduce symptoms of anxiety and depression by promoting relaxation and increasing self-awareness.
- Medication: For some individuals, medication prescribed by a healthcare provider can be beneficial in managing symptoms. Antidepressants and anti-anxiety medications can be effective in a comprehensive treatment plan.
- Exercise: Numerous studies have demonstrated that regular physical activity can improve mood and reduce symptoms of depression and anxiety by promoting the release of endorphins and reducing inflammation.
- Diet and Nutrition: Research suggests a balanced diet rich in nutrients can positively impact mental health. Nutritional interventions and dietary changes can complement other treatment methods.
- Sleep Hygiene: Proper sleep is essential for mental health. Evidence-based sleep hygiene practices can help improve sleep quality, reducing symptoms of depression and anxiety.
- Stress Management: Stress reduction techniques, including yoga and progressive muscle relaxation, have alleviated symptoms by reducing the body’s stress response.
- Social Support: Building and maintaining a solid social support network is essential. Scientific studies consistently show the benefits of social connections in mitigating the effects of depression and anxiety.
- Professional Guidance: Seek help from mental health professionals, such as psychologists or psychiatrists, who can provide evidence-based therapy and medication management tailored to individual needs.
- Self-Care: Engaging in self-care routines, including hobbies, relaxation techniques, and setting healthy boundaries, can contribute to better mental well-being.
What works best can vary from person to person, and a combination of these approaches may be most effective. Consultation with a qualified mental health provider is crucial to creating a personalized, science-based treatment plan for managing high-functioning depression and anxiety attacks.
Often, sufficient treatment for depression involves a combination of medication with psychotherapy for the most effective treatment of high-functioning depression.
Is High Functioning Depression Real?
Yes, high-functioning depression is a recognized phenomenon within the mental health field. It refers to individuals who experience depressive symptoms but can maintain their daily responsibilities and appear outwardly successful.
This form of depression may be less apparent to others because those affected have developed coping strategies to manage their symptoms and continue functioning in their work, social, and personal lives. However, the internal emotional distress and symptoms of depression are still very much real and impactful for individuals with high-functioning depression. Acknowledging and seeking help for this condition is essential, as it can lead to significant long-term emotional and psychological challenges if left untreated.
High Functioning Depression Meaning
Despite emotional distress, individuals with high-functioning depression often excel in their work, relationships, and other obligations, making it challenging for others to recognize their internal struggles. This form of depression is characterized by the ability to “function” outwardly, masking the emotional pain and fatigue that individuals may experience internally.
What is the Best Medication for High Functioning Depression?
There is no single “best” medication for high-functioning depression, but several types of antidepressants may be considered:
- Selective Serotonin Reuptake Inhibitors (SSRIs): These are commonly prescribed as first-line treatment for depression. Examples include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro).
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These medications, such as venlafaxine (Effexor) and duloxetine (Cymbalta), affect both serotonin and norepinephrine levels in the brain and can be effective for depression and anxiety.
- Atypical Antidepressants: These include medications like bupropion (Wellbutrin), which works on different neurotransmitters than SSRIs and SNRIs and may have a different side effect profile.
- Tricyclic Antidepressants (TCAs): While less commonly used today due to side effects, TCAs like amitriptyline may be considered if other treatments are ineffective.
- Monoamine Oxidase Inhibitors (MAOIs): MAOIs like phenelzine (Nardil) are typically reserved for cases where other antidepressants haven’t worked, as they have dietary restrictions and can interact with other medications.
The choice of medication for high-functioning depression, like any form of depression, should be made in consultation with a qualified mental health professional, typically a psychiatrist.
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Hotline (877) 378-4154High Functioning Depression Statistics
Depression and addiction often co-occur, meaning that individuals with one of these conditions are at an increased risk of developing the other. This comorbidity can create a complex and challenging situation for affected individuals.
20.4 Million
In 2019, an estimated 20.4 million adults in the US had a substance use disorder related to illicit drugs.
Source: CDC
14.5 Million
About 14.5 million adults in the US had alcohol use disorder (AUD) in 2019.
Source: CDC
40%
Alcoholism is rampant among people suffering from depression. At least 30%-40% of alcoholics also experience a depressive disorder.
Source: NIMH
Do I Have High Functioning Depression Quiz
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High Functioning Depression Treatment
To determine the most effective ways to cope with high-functioning depression, it’s crucial first to get an accurate evaluation of all the symptoms. When a mental health professional has assessed the symptoms, it may be determined that another form of depression is present and needs a particular type of treatment. Very often, some combination of psychotherapy, medication, and lifestyle changes are effective for coping with functional.
Psychotherapy for Depression
Several different modalities of psychotherapy have been used in the treatment of depression, including:
- Cognitive Behavioral Therapy: CBT is an effective treatment that involves changing both the patterns of negative thoughts and the behavioral routines that are affecting the daily life of the depressed person for various types of depression.
- Person-Centered Therapy: A psychotherapy strategy that allows and motivates clients to understand and resolve their concerns in a safe, supportive setting.
- Solution Therapy: An approach interested in solutions that can be quickly implemented with a simple first step leading to further positive consequences.
Medication for Depression
Some individuals who experience high-functioning depression may have symptoms severe enough to warrant antidepressant medications. There are five basic types of antidepressants, categorized as follows:
- Selective Serotonin Reuptake Inhibitors (SSRIs).
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).
- Tricyclics.
- Monoamine Oxidase Inhibitors (MAOIs).
- Atypical Antidepressants.
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Co-occurring disorders, including depression and addiction, are often challenging to go through alone. Many people experience relapses during withdrawal in an attempt to alleviate symptoms and satisfy cravings. However, you can manage withdrawal symptoms and successfully recover with detox and rehab therapy and a robust support system at the We Level Up NJ treatment center. If you require assistance with your rehab journey, contact a We Level Up New Jersey treatment professional now. Your call is free and confidential.
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Top 4 What is High-Functioning Depression? FAQs
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Whats high functioning depression?
High-functioning depression is a term that some people use to describe a type of depression that does not interfere with their daily functioning. However, this term is not a medical diagnosis, and it may not accurately reflect the severity of the condition.
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What is low functioning depression?
“Low functioning depression” is not a recognized clinical term in mental health. However, it seems to be a term used colloquially to describe a severe and debilitating form of depression where an individual’s ability to function in daily life is significantly impaired. Depression itself is a clinical condition, and its severity can vary widely from person to person.
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What is the connection between high functioning autism and depression?
The connection between high-functioning autism and depression is a complex and essential topic. High-functioning autism (HFA) is a term that some people use to describe a type of autism spectrum disorder (ASD) that does not interfere with their daily functioning. Depression is a mental health disorder that affects how a person feels, thinks, and behaves. It can cause persistent sadness, hopelessness, guilt, and loss of interest in activities. A 2019 meta-analysis found that autistic people are four times more likely to experience depression than those who are not autistic. The reasons for this high prevalence are not fully understood, but they may involve a combination of biological, psychological, and environmental factors.
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How to cure high functioning depression?
High-functioning depression is not a clinical diagnosis but a term that some people use to describe experiencing symptoms of depression without significant impairment in their daily functioning. However, this does not mean the symptoms are less severe or deserve treatment. High-functioning depression can affect mood, energy, motivation, self-esteem, and relationships. Different treatments can help with high-functioning depression, depending on the severity and duration of your symptoms.
Therapist Tips to Cope & Combat Depressive Episodes. Depression Symptoms & Signs Recovery Strategies
High-functioning depression is a challenging battle that often goes unnoticed by others due to the individual’s ability to maintain daily responsibilities. Those dealing with it may appear outwardly successful and put-together but internally struggle with persistent sadness, hopelessness, and fatigue.
It’s crucial for individuals facing high-functioning depression to seek professional help and support from loved ones, as early intervention can significantly improve their quality of life. Remember that you don’t have to face this battle alone; help is available to navigate and overcome high-functioning depression.
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Sources
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