The Face Behind The Mask: High-Functioning Depression

Medically reviewed by Melissa Guarnaccia, LCSW
Updated May 14, 2024by BetterHelp Editorial Team

Many people grapple with depression while maintaining a façade of unobstructed functionality to the outside world. On the exterior, someone with high-functioning depression might appear accomplished and sociable, engaging in work, social activities, and relationships. Beneath the surface, however, just getting through the day can leave them completely drained.

Signs of depression can vary depending on the person

What is high-functioning depression?

High-functioning depression is not a clinical diagnosis; it is a concept illustrating how some people experience depression or depressive episodes while continuing their everyday lives. Often diagnosed with persistent depressive disorder (PDD), these individuals can experience periods of mild to moderate depression that can last for years.

People with high-functioning depression appear adept at managing life’s demands. This outward success can mislead both those close to them and even themselves, disguising the true depth of their circumstances. This phenomenon, known as masking, stems from the disparity between external appearance and internal experience.

Given the nature of high-functioning depression, its symptoms can be easy to overlook.

A straight-A student, a corporate CEO, a devoted parent, or a diligent employee might all be living with high-functioning depression. Their achievements may consciously or unconsciously mask their symptoms as a defense mechanism against social stigma or a coping strategy to maintain their life. As a result, maintaining daily functionality might demand more effort than expected. 

What is it like to live with high-functioning depression?

Depression manifests variably based on individual factors like motivation levels and lifestyle. While some experience overt symptoms such as insatiable exhaustion and difficulty getting out of bed, others may exhibit subtler signs such as frustration and difficulty making decisions. Feelings of hopelessness, diminished interest in things that used to bring joy, and negative self-perception are other characteristic symptoms of depression, and these expressions can make it difficult for a person to find the motivation to complete daily tasks.

Impairment of daily functioning is a common symptom of depression, but this particular symptom is often not outwardly noticeable in a person experiencing high-functioning depression. In fact, the perceived need to fulfill responsibilities, maintain routines, or complete tasks may be their sole driver for getting out of bed. Instead, those with high-functioning depression might exhibit more subtle shifts, such as changes in sleep quality, energy levels, eating patterns, and mood. Despite outward stability, inner despair, anxiety, and self-doubt might persist in those with high-functioning depression.

Even sources of praise, hobbies, and loving relationships may not offer the same pride and comfort to someone living with high-functioning depression. This disorder may lead to self-isolation, an attempt to mask internal pain, making it harder for friends, family, and colleagues to recognize an internal shift or a change in behavior. In this way, masking is a taxing coping mechanism in itself.

Signs to look out for

If you are able to move through your life without major behavioral changes but experience consistent feelings of sadness or hopelessness, consider the following questions:

  • Are you critical of yourself? Have you been more critical of yourself lately?
  • Are activities that once brought you joy now less enjoyable?
  • Do past mistakes occupy your thoughts?
  • 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 relatively small mishaps upset you more than usual?
  • Are you more tired than usual? Have you noticed changes in your sleep patterns? Do you have a hard time falling asleep?
  • Do you find it harder to feel or express joy?
  • Are you drawn toward drugs or alcohol more than usual?

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

If you answered “yes” to many or most of those questions, then you may be experiencing high-functioning depression. Please note that this short quiz is not an exhaustive diagnostic tool but a starting point as you try to understand what you are going through. Consider consulting a mental health professional for a proper medical diagnosis so you may start on the appropriate treatment path.

If you or someone you know is in crisis and needs immediate assistance, text “HOME” to 741741 or click here to message a Crisis Text Line counselor for 24/7 help.

Pursuing help

Depressive disorders and high-functioning depression affect an estimated 5% of the global population. Regardless of outward appearances, your mental well-being matters, and you deserve to feel well internally, too. Even if you are progressing toward your external goals, high-functioning depression could be a significant obstacle to have to work around — and in most cases, it cannot be willed away by favorable external circumstances.

Getty/Vadym Pastukh
Signs of depression can vary depending on the person

Speaking to a licensed mental health professional could be a healthy first step toward understanding your thoughts and feelings. You might be inclined to join a support group where you can connect with others experiencing similar difficulties, or you might feel safer in one-on-one therapy. Online therapy may be a particularly helpful tool. Studies show that for treating high-functioning depression, with nearly 38% of users showing clinically significant improvement in symptoms of depression within three months.

Many people with depression are apprehensive about seeing a counselor in person, and in cases of high-functioning depression, people often have a hard time gathering the energy to leave their homes to engage in activities they deem “nonessential.” Online therapy provides a convenient and flexible way to utilize professional support from the comfort of one’s own space. For those managing the demands of daily life while concealing their internal struggles, online therapy offers a discreet avenue to open up about their emotions and receive guidance.

The licensed online therapists at BetterHelp can offer you the care you seek from anywhere you have an internet connection. You can also manage settings by having your sessions via phone call, video chat, voice chat (recordings sent back and forth), or in-app messaging — whatever works best for you.

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 to help 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, and 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.”

Takeaway

If you suspect that you are affected by any of the symptoms of high-functioning depression, you are not alone. With some help from a licensed online counselor, you can work toward finding balance and inner peace again. If someone you know is living with depression, encourage them to investigate treatment paths. Listen to them if they want to talk, acknowledge the problem, and empathize with what they are going through. With the right tools, living a fulfilling life with high-functioning depression is possible.

Depression is treatable, and you're not alone
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
You don't have to face depression aloneGet started