Symptoms And Signs Of High-Functioning Depression: Early Detection And Treatment

Though it isn’t a formally recognized psychiatric diagnosis, high-functioning depression is a common presentation of major depressive disorder and other types of depression. Someone with high-functioning depression (HFD) may be highly productive in their daily life while masking underlying symptoms like sadness, fatigue, and a sense of hopelessness. Without intervention, HFD symptoms can worsen, regardless of how “together” someone seems on the outside. This post explores the signs, symptoms, and causes of HFD and other depressive disorders. It also offers suggestions for managing depression and when to seek support from a mental health professional.

High-functioning depression can deeply impact mental health

Address depression symptoms in online therapy

Symptoms of high-functioning depression 

Symptoms of HFD may vary between individuals depending on many factors, but they often include many of the same symptoms as other depressive conditions, such as persistent depressive disorder and major depression. These might include persistent sadness or low mood, reduced interest or pleasure in activities previously enjoyed, and a sense of guilt, hopelessness, or worthlessness. Physical symptoms like changes in appetite or weight, fatigue or low energy levels, and sleep disturbances also tend to be common. People might have trouble concentrating or making decisions as well. 

What causes a depressive disorder?

Research on the causes and risk factors for depression is ongoing, but researchers believe a combination of genetic and environmental factors is responsible. Genetics is a possible cause, as depression can run in families, and people with a family history of depression are more likely to experience it themselves. Imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine may contribute to the development of depression as well. Environmental factors, such as stressful life events, trauma, and social isolation, may also play a role in depression etiology. 

The mental health impacts of untreated depression

Because of its lack of obvious symptoms, HFD might go for years or even decades without treatment. When unaddressed, mild symptoms can intensify and lead to a more severe form of depression or other mental health concerns. For example, people with untreated depression might be at greater risk of suicidal thoughts and behaviors. Depression often co-occurs with other mental health disorders. When untreated, depression can lead to or worsen conditions like anxiety disorders or increase the risk of bipolar disorder and schizophrenia.

Depression and relationships

Depression and relationships can be interconnected, with relationship quality affecting depression and depression affecting the quality of relationships. Strong, supportive relationships can act as a protective factor against depression. Good communication, emotional support, and shared activities may mitigate the impact of depressive symptoms. Relationship problems, conflict, and lack of intimacy, on the other hand, can worsen depressive symptoms. Depression can negatively impact how a person interacts in their relationships, potentially leading to intimacy problems and strained connections. 

Depression and physical health

As with relationships, depression and physical health tend to be closely interconnected. Depression can cause or worsen physical health problems, and physical health issues can contribute to or exacerbate depression. This bidirectional relationship can create a cycle where mental and physical health challenges negatively affect each other.

Self-care for depression

Caring for depression may require lifestyle changes across a variety of areas. Because the mind and body are interconnected, how we take care of our bodies can influence mental health. How we spend our time, where we choose to focus our attention, and the type of support we receive from loved ones can play a role in managing depression symptoms.  

Physical activity, nutrition, and sleep

Sometimes referred to as “the big three health behaviors," exercise, nutrition, and sleep often play key roles in mental health and well-being. Exercise regularly to care for your body, even if it's just a brief walk or another low-impact activity. Eat nutritiously and stay hydrated. Adults should try to get seven to nine hours of quality sleep each night. 

Relaxing activities

Do things that nurture and bring you joy, such as hobbies, time in nature, or engaging in a creative activity. Deep breathing exercises, guided imagery, and progressive muscle relaxation can reduce depression symptoms by calming the nervous system and reducing the body’s stress response. Even small gestures, like taking a warm bath, lighting a scented candle, or listening to music, may promote overall mental wellness. 

Mindfulness and cognitive reframing

Mindfulness and cognitive reframing can be effective for managing depression by helping individuals understand and change their negative thought patterns and emotional responses. Mindfulness activities like meditation and journaling usually involve paying attention to the present moment without judgment, allowing individuals to observe their thoughts and feelings without reacting. Cognitive reframing, a core aspect of cognitive behavioral therapy (CBT), involves challenging and altering negative or distorted thought patterns to promote a more balanced and positive perspective.

Support from loved ones

Knowing they are understood and cared for can help individuals feel less burdened and isolated, which can be common experiences during depression. Loved ones can help individuals with depression cultivate self-esteem and confidence, perhaps encouraging empowering behaviors like self-care and seeking mental health support. Finally, loved ones may offer practical assistance with daily tasks, appointments, or other needs to reduce the stress of managing depression.

Clinical treatment methods for depression 

Depression treatments can vary depending on the severity of symptoms and an individual’s unique situation. In some cases, therapists may use a combination of techniques. Cognitive behavioral therapy (CBT) is one of the most common treatments, helping individuals identify and challenge negative thought patterns and behaviors that contribute to depression symptoms. Other treatments for depression include, but aren’t limited to, the following:

• Interpersonal therapy (IPT): IPT generally focuses on improving interpersonal relationships and skills, which can be particularly helpful in addressing relationship issues that contribute to depression.
• Dialectical behavior therapy (DBT): This type of therapy can be particularly useful for individuals with depression who also experience suicidal thoughts, self-harm, or substance use disorders.
• Mindfulness-based cognitive therapy (MBCT): MBCT combines mindfulness practices with cognitive therapy to prevent relapse and manage symptoms. 
• Psychodynamic therapy: Psychoanalytic approaches typically delve into unconscious conflicts and unresolved issues that may be contributing to depression. 

Sometimes, medication is prescribed in conjunction with therapy. If you’re interested in medication options, speak to your doctor or a psychiatrist. Never start, stop, or change the way you take medication without consulting your prescribing provider.

When to seek treatment

You should consider seeing a therapist for depression if you're experiencing persistent sadness, hopelessness, or a loss of interest in activities you once enjoyed, especially if these symptoms interfere with your daily life. If you're feeling overwhelmed, have difficulty managing daily tasks, or are struggling with self-esteem, therapy can offer a safe space to work through these feelings. Additionally, you may consider therapy if you isolate yourself or turn to unhealthy coping mechanisms like substance or alcohol use. Finally, you may consider treatment if you’re struggling to maintain relationships or are having trouble coping with significant changes, like a new job, move, or relationship shift. 

Early intervention for managing symptoms of a depressive disorder

A mental health professional can help individuals manage symptoms and cope with emotional distress as it arises. People with high-functioning depression might be particularly resistant to confiding in a counselor because they may not want to acknowledge their feelings, preferring to stay busy rather than confront them. However, early intervention can play a significant role in ensuring an accurate diagnosis and successful outcomes.  

High-functioning depression can deeply impact mental health

Address depression symptoms in online therapy

Online mental health treatment for high-functioning depression 

While therapy is effective for many, some people with high-functioning depression don’t seek treatment. The potential reasons for this are many, from accessibility to affordability to stigma around mental health care. Even though they might be productive in daily life, people with high-functioning depression might have trouble finding the motivation to commute to and attend sessions. Some may have limited access to mental health care in their local area, or they might assume they can’t afford therapy. 

Online therapy can be an excellent alternative to traditional, in-person treatment, and it may eliminate many of these barriers. With virtual therapy, users can attend sessions from home on a schedule that fits their needs. Platforms like BetterHelp give users greater access to a broader pool of mental health professionals from diverse backgrounds and specializations. Additionally, online therapy through BetterHelp is often more affordable than conventional treatment without insurance, and some users may qualify for financial assistance. 

Research repeatedly shows that online therapy can be as effective as in-person treatment for a variety of mental health conditions, including depression. For example, one 2023 review compared outcomes from 14 studies, finding that telehealth was particularly effective in treating depression and anxiety, and there appeared to be minimal differences in the quality of care between traditional and virtual sessions.