Face Behind The Mask: High Functioning Depression

By: Nadia Khan

Updated May 06, 2021

Medically Reviewed By: Wendy Boring-Bray, DBH, LPC

Face Behind The Mask: High Functioning Depression

Did you know that many people suffer from depression while appearing perfectly functional to the outside world? On the surface, they appear to be accomplished people who are going to work, participating in social engagements, going on dates, or being a great partner. On the inside, just getting through the day can leave those same people feeling exhausted. People with this experience of depression are able to maintain their day-to-day life without appearing to struggle.

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It is entirely possible that someone you see every day or work with closely could be struggling with high functioning depression, and you may not see many indicators. It can be difficult to understand and therefore easy to overlook. High functioning depression is not a clinical diagnosis, but rather an understanding that some people experience depressive episodes without some of the definitive symptoms. The characteristics behind “high functioning depression” can also often categorize someone experiencing Persistent Depressive Disorder (PDD). PDD is characterized by periods of low-grade depression that can last for years. PDD is often in line with high functioning depression, as it is a multi-year depressive episode of feelings of persistent sadness.

Individuals with this kind of depression appear to live and function with ease. Those closest to them often misinterpret their functioning as them powering through and overcoming their mental illness. This may not always be the case. Straight-A students, the CEO of a large corporation, a perfect mother and wife, or a timely and efficient worker may all be struggling with high functioning depression. Their outward success may be a mask they put on to maintain their life or a coping mechanism if they’ve struggled finding ways to ease their symptoms. Their ability to stay afloat may also be taking a larger amount of effort than you might expect.

What Is It Like To Live With High Functioning Depression?

Living with depression can look different on different people. Depending on who you are as a person, including your usual motivation, responsibilities, and lifestyle, your experience will naturally vary. Depression does not have to look like being unable to get out of bed, although it can look like that for some. Impairment to daily functioning is a common symptom, but less severe forms of depression can look like an overall gloominess, lack of energy, or tasks starting to feel like monumental obstacles.

Depression is often characterized by a lack of interest in things that used to interest you, negative thoughts about your life and yourself, or feelings of hopelessness. Depression can make it harder to feel motivated to do the things you used to do, whether out of obligation or choice. If you’re struggling with high functioning depression, you may find it challenging to go about your life but not impossible.

Factors like praise, favorite hobbies, loving family and friends may not bring the feelings of pride and comfort they used to. Completing tasks or succeeding in your daily life may be the only thing that gets you out of bed. Going through the daily responsibilities of your life may also give you the sense of routine that keeps you from falling apart. Feeling responsible to yourself and others can also be incredibly taxing for someone with high functioning depression.

You're seen as strong and successful, but that is not how you feel. It can be isolating for your friends, neighbors, family, and coworkers to see your ability to function without seeing your pain. At the root of depression is often a rift between how we see ourselves and how we want to be seen by ourselves and others. Maybe this is why it’s challenging to tell someone how you feel, or maybe when you do tell people, they think that the solution is to keep powering through.

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Signs To Look Out For

If you are still able to move through your life without major behavioral changes but feel consistent feelings of sadness of hopelessness, these are some questions to ask to better understand your symptoms.

  • Are you critical of yourself? Are you more critical of yourself lately?
  • Are you finding less joy in the people or activities that used to bring you joy?
  • Do you find yourself dwelling on past mistakes?
  • Is your view of yourself consistently negative?
  • Do you find it hard to concentrate?
  • Do you find it hard to make decisions?
  • Do you feel more irritable than normal?
  • Do you feel more upset by small mishaps than usual?
  • Do you feel more tired than usual? Do you notice changes in your sleep patterns? Do you have a harder time falling asleep?
  • Does it feel harder to feel or express joy?  
  • Are you noticing more of a reliance or use of drugs and alcohol?

Wondering What High-Functioning Depression Looks Like?
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If you or someone you know is experiencing these symptoms more often than not, it’s worth having an open and honest conversation and considering treatment paths.

Pursuing Help

You may also feel plagued by feelings of hopelessness, anxiety, and self-doubt but your exterior circumstances are staying intact. If you are in pain or discomfort, regardless of your exterior life, you deserve help to feel healthy again. Depression in any form is not something that can be willed away by favorable external circumstances or positive thinking. Even if you are able to move toward your goals, your struggle with high functioning depression is likely adding a lot of extra baggage.

Options like talk therapy, medication, mindfulness tasks, and other activities known to boost your mood or feeling of wellbeing can all be a part of your plan to feel better. Establishing a routine that includes time or activities that directly help alleviate your symptoms lets you move forward every day as you figure out your long-term treatment plans.

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If the answer was "yes" to any of those questions, then it is likely that you may be suffering from High Functioning Depression. This short quiz should not be used as a diagnostic tool. It is simply a starting point as you try to understand what you are going through. Make an appointment with a doctor for a medical diagnosis and for the appropriate treatment path.

Speaking to a licensed therapist is a healthy first step towards understanding your feelings and where you can go from there. If you and your doctor categorize your symptoms as depression, treatment paths including medication and/or talk therapy can be pursued.

Depressive disorders and high functioning depression are more common than you might think, and people have been exactly where you are, scouring the internet for articles and advice on ways forward. Studies have shown that the vast majority of people find online therapy to be effective, with nearly 38% of users showing clinically significant improvement in symptoms of depression within 3 months.   

If you feel apprehensive about the idea of seeing a counselor in person or you can't fit in therapy with your hectic schedule, consider seeking support from counselors at BetterHelp. If you’re feeling hesitant about taking this step forward, an online therapist can be a low-risk and low-commitment step forward until you feel more comfortable. With BetterHelp, you can access the health care you need from the comfort and privacy of your own home (or wherever you have an internet connection). Read below for some reviews of BetterHelp counselors, from people experiencing similar issues.

Counselor Reviews                                                                  

"Colleen has been an intricate part of my healing, and I know that I would not be as successful as I am without her encouragement, support, and advice. She is always there when I need her without hesitation and fully understands the goals I have and the challenges I face. She has wonderful techniques in helping me release and cope with stress and anxiety, and it has greatly reduced my depression. Colleen is an absolutely fantastic therapist, and I can't recommend her highly enough!"

“I have had chronic mild depression my whole 50 year life. Been to therapy, once long term, several other attempts where I did not connect, including a couple on BetterHelp, but made minimal progress. Laura is the first person who I felt has been able to zero in on the root problem and offer a path to recovery, and for the first time I am cautiously optimistic that with her help she can prod me and work with me to finally achieve happiness.”

Conclusion

If you are suffering from depression of any kind, you don't have to give up. If you feel you are affected by any of these symptoms, then you deserve to find ways to feel better. With some help from a license counselor, you can find balance and peace in your life again. If someone you know is suffering from depression, encourage them to investigate treatment paths. Listen to them if they need to talk, acknowledge, and empathize with what they're going through. Remind them they are not alone. With the right tools, living a truly fulfilling life is possible. Take the first step today.

If you feel like you are in a crisis and need someone to talk to immediately, there are resources. For confidential help, you can call 844-208-0633 or get 24/7 assistance from the crisis line at 1-866-996-0991.


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