Learn / How to Spot High Functioning Depression: Signs and Treatment
High functioning depression can look like appearing okay to friends and family, while really you’re struggling on the inside. There are a lot of misconceptions about what depression looks like. But depression actually comes in many different forms and levels of intensity. Sometimes, symptoms can be hard to identify.
Seeking help can be daunting, but you are strong enough to begin healing. You can get treatment for high functioning depression to start living to your fullest potential.
High functioning depression is a subtype of depression in which individuals experience symptoms of depression but can maintain their daily functioning, such as going to work or school, socializing, and completing daily tasks. It is characterized by a relatively high level of functional status, low depression scores, and little agitation.
High functioning depression can be challenging to spot, so it’s important to recognize the symptoms you’re experiencing. This disorder usually has milder symptoms of major depression1. And it can be caused by a combination of genetic factors2 and other life experiences.
Despite feeling the opposite, putting on a happy face may seem like a good way to cope with depression at first. But ignoring the signs that you might be depressed can make it worse. High functioning looks different for everyone. Sometimes it seems like a way to protect yourself from uncomfortable feelings, and sometimes it looks like wearing a mask and pretending to be happy when you are not.
While your high functioning depression might feel manageable now, it could snowball into something more harmful. But co-occurring disorders like anxiety, major depressive disorder, and insomnia can also be an issue as a result of the depression3. And if you’ve experienced these feelings for 2+ years, you may have persistent depressive disorder (PDD), or dysthymia4.
If you think you have high functioning depression, it’s essential to talk to a licensed clinician who can diagnose you; however, here are some of the symptoms that you can identify4:
These symptoms can have damaging and long lasting effects. Sometimes, high functioning depression can cause more harm than acute major depression5. But there are resources and tools available. You can stop the cycle and step into a more fulfilling, positive lifestyle by seeking professional help for your high functioning depression.
Acknowledging that you may have high functioning depression, and facing those negative feelings, is a vital first step in your journey toward healing. Getting a diagnosis and the right care can then get you to feel like the real you again.
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOs) can help manage your symptoms. However, medications are even more effective when combined with other therapies5.
Cognitive behavioral therapy (CBT) is proven to be one of the best treatments for depression6. This therapy helps you identify unhelpful thought patterns that might contribute to your high functioning depression. Then, you’ll learn how to replace those negative thoughts with positive ones. Once you build out these new ways of thinking, your emotions will likely become more manageable. And you’ll learn habits to overcome any new challenges that arise in the future.
Cognitive behavioral analysis system of psychotherapy (CBASP) is a therapy designed specifically for persistent depression7. CBASP helps you create a clear, step-by-step action plan to tackle your issues. You’ll learn how to develop constructive, positive habits. And you’ll focus on your actions’ impact on yourself and others. This, in turn, motivates you to maintain a positive lifestyle.
Healing requires looking at the whole “you.” And healthy lifestyle changes can enhance treatment for depression5. There are a few different holistic practices that you can incorporate into your recovery to heal your mind, body, and spirit.
Yoga builds physical and mental strength, which makes it an effective treatment for depression8. Yoga can provide community and a sense of belonging, and depression-related themes can be shared in classes. You’ll work through breathing exercises, learn resilience in different poses, and practice mindfulness. And you can do it from anywhere and on your schedule.
Meditation and mindfulness are another instrumental way to treat depression. In fact, data shows that mindfulness-based training is as effective as other talk therapies for depression treatment8. These practices draw your attention to the present moment and your surroundings. By incorporating mindfulness into your daily routine, you can become more aware of your emotions. And in time, you can better manage your feelings and choose to seek the positive.
If you think someone you love is experiencing high functioning depression, providing a listening ear and complete understanding can go a long way. While you can be a support system for the person you love, encouraging them to get professional treatment is the best way to help them heal. You can be their rock, guide them through the process, and be patient as experts help your loved one work through their depression.
Coming face-to-face with your depression can be scary. But by confronting what’s holding you back, you can set yourself free. Tap into your resilience by seeking help for your high functioning depression.
Change happens in small steps. Here are 6 things you can start doing today to live fearlessly:
Apa psycnet. (n.d.). Retrieved May 22, 2023, from https://psycnet.apa.org/doiLanding?doi=10.1037%2Famp0000904
Schramm, E., Klein, D. N., Elsaesser, M., Furukawa, T. A., & Domschke, K. (2020). Review of dysthymia and persistent depressive disorder: History, correlates, and clinical implications. The Lancet Psychiatry, 7(9), 801–812. https://doi.org/10.1016/S2215-0366(20)30099-7
Lustberg, L., & Reynolds, C. F. (2000). Depression and insomnia: Questions of cause and effect. Sleep Medicine Reviews, 4(3), 253–262. https://doi.org/10.1053/smrv.1999.0075
American Psychiatric Association. (2013). Desk reference to the diagnostic criteria from DSM-5 (R). American Psychiatric Association Publishing.
Melrose, S. (2019). Persistent depressive disorder or dysthymia: An overview of assessment and treatment approaches. https://pressbooks.pub/sherrimelrosepublications/chapter/persistent-depressive-disorder-or-dysthymia-an-overview-of-assessment-and-treatment-approaches/
Bogucki, O. E., Craner, J. R., Berg, S. L., Miller, S. J., Wolsey, M. K., Smyth, K. T., Sedivy, S. J., Mack, J. D., Johnson, M. W., Burke, L. M., Williams, M. W., Katzelnick, D. J., & Sawchuk, C. N. (2021). Cognitive behavioral therapy for depressive disorders: Outcomes from a multi-state, multi-site primary care practice. Journal of Affective Disorders, 294, 745–752. https://doi.org/10.1016/j.jad.2021.07.061
McCullough, Jr., Schramm, E., & Penberthy, J. K. (2014). Cbasp as a distinctive treatment for persistent depressive disorder: Distinctive features (0 ed.). Routledge. https://doi.org/10.4324/9781315743196
Saeed, S. A., Cunningham, K., & Bloch, R. M. (2019). Depression and anxiety disorders: Benefits of exercise, yoga, and meditation. American Family Physician, 99(10), 620–627. https://www.aafp.org/pubs/afp/issues/2019/0515/p620.html
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