Danielle Ibelema, MD
What Is High Functioning Depression?
“High-functioning” depression isn't an official diagnosis, but it's a term used to describe depression that doesn't present in the stereotypical manner. Depression has many faces, different levels of severity, and it can present different ways. There are symptoms of depression, that you can look out for, but the full clinical picture will be unique to the individual.
When the term "high functioning depression" is used, people are usually alluding to the idea that there are individuals who externally appear to be functioning well despite suffering from depression.
If we imagine the stereotype of a depressed person, we may think of a someone who appears sad, disengaged, wearing pajamas, and tired appearing. If this was a movie, maybe the camera would give a us a glimpse of their home. Maybe we would see this individual laying in bed, having difficulty getting up, with a messy, cluttered room around them. After all, they have no energy or motivation to clean.
In contrast, a someone with high functioning depression may not show those external signs of depression. Perhaps this individual is high achiever, accomplished, and might externally appear to be doing well. They may be dressing the part, combing their hair, and putting on "real clothes". Their home may even be clean. Yet they could internally feel depressed, guilty, worthless and empty. High functioning doesn't necessarily equal high achieving. Yet, high functioning depression does seem to be a theme seen in many high achieving patients.
Shh.. It's A Secret: Hiding Depression
Beyond that high functioning individuals may work hard to hide their external depressive symptoms. There are patients that pour energy into appearing "normal" , productive or into meeting obligations. They make work hard to appear "normal" in front of others, but may be struggling behind the scenes.
They may have adopted a skill set that allows them to "talk the talk" and "walk the walk" in such a convincing way that the people around them may be clueless to their mental health struggles.
High Functioning Depression Needs Treatment
"High functioning depression" is not a term used by psychiatrists or therapists, because it's not helpful. In the mental health field, we know that there are many faces of depression, and that all depression requires treatment. Unfortunately, patients with "high functioning depression" sometimes feel guilty about their symptoms in relation to their abilities or accomplishments. This sometimes prevents someone from seeking treatment for their depression. Yet, the sooner you can start treatment the better the outcome may be.
Learn more about the available options for treatment here:
If you or anyone you know is struggling with thoughts of suicide, please contact the National Suicide Hotline by dialing 1-800-273-8255. If you need immediate assistance, dial 911 or go to the nearest hospital.