High-functioning depression is a condition where people experience symptoms similar to major depression but to a lesser extent. These symptoms can include changes in eating and sleeping patterns, low self-esteem, tiredness, a sense of hopelessness, and difficulty focusing. While individuals with high-functioning depression may appear fine on the outside, they often struggle internally. The condition can be treated through medications and therapy.

The World Health Organization reports that over 264 million people worldwide, of all ages, suffer from depression. High-functioning depression is a genuine issue with significant consequences if left untreated. Officially, it’s diagnosed as persistent depressive disorder (PDD).

A mental health expert can assess whether your symptoms match the criteria for depressive and other psychiatric conditions outlined in the “Diagnostic and Statistical Manual of Mental Disorders,” a guide published by the American Psychiatric Association.

Even if you have symptoms of these depressive disorders, you might still be going about your daily life as if everything is okay, but it might not be. When you can conceal it or continue to excel in various aspects of life, it could be described as ‘high-functioning’ depression, as explained by Dr. Daramus.

However, it’s important to note that many mental health professionals do not recognize the concept of high-functioning depression, finding it misleading. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), doesn’t classify it as a distinct clinical disorder.

10 Warning Signs Of High-Functioning Depression:

• Decreased appetite or overeating
• Insomnia or oversleeping
• Having a persistent feeling of sadness or emptiness
• Lack of energy and fatigue
• Lowered self-esteem
• Difficulty concentrating and making decisions
• Loss of sex drive
• Restlessness or irritability
• Suicidal thoughts or attempts

Experiencing physical symptoms such as headaches, cramps, aches and pains, and digestive issues that don’t have a clear cause and don’t get better with treatment.

Causes of ‘High-Functioning’ Depression

• GeneticsDepression can have a genetic component, meaning if you have family members with depression, you’re at a higher risk of developing it.
• Life eventsStressful life events like a breakup, job loss, or the loss of a loved one can trigger depression.
• TraumaExperiencing trauma or ongoing stressful situations can increase the risk of mental health conditions, including depression, anxiety, and post-traumatic stress disorder.
• MedicationSome medications can lead to depression as a side effect.
• PersonalityCertain personality traits may make you more susceptible to experiencing depression.

Tips and Treatment

High-functioning depression doesn’t have a specific medical diagnosis, so there are no particular treatments for it. However, for Persistent Depressive Disorder (PDD), treatment can involve two approaches: psychotherapy (talk therapy) and medication. Doctors might prescribe different medications, like Selective Serotonin Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants (TCAs), or Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).

It might take time to figure out the right combination of therapy and medication for this type of depression because not everyone responds to drugs the same way. For example, a study from 2011 on dysthymia suggested that SSRIs might not be effective in treating apathy in older people with depression and could even make it worse.

It’s important for people to have open conversations with their healthcare provider and inform them about any side effects or reactions they experience from the medication. Sometimes, it takes a bit of trial and error to find the right medication that works best for an individual.