High-Functioning Depression: A Breakdown of Society’s Secret Sad Sickness

High-Functioning Depression: A Breakdown of Society’s Secret Sad Sickness

While many of the telltale symptoms of depression are often easy to spot, sometimes they aren’t so obvious. Whereas some sufferers are completely consumed by their demons and simply cannot function due to their illness, others manage to just get by, all the while maintaining the facade of a perfectly stable, has-their-shit-together person. Those who suffer, but maybe not quite enough to give up on everything, have high-functioning depression.

What is depression?

In order to understand high-functioning depression, it is imperative to understand major depression at its core first. Depression, or Major Depressive Disorder (MDD), is characterized by episodic feelings of negativity and impairment in important areas of functioning that last for at least two weeks to months. It is a common mood disorder that comes in many shapes and sizes, ranging from moderate to severe and in capacity of how much it can interfere with a person’s everyday life. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms of depression include:

  • Persistent feelings of sadness, hopelessness or emptiness
  • Lack of interest or motivation
  • Loss of energy or fatigue
  • Irritability/mood swings
  • Inability to concentrate
  • Trouble sleeping properly
  • Loss or change in appetite
  • Low self-esteem
  • Self-isolation
  • Suicidal thoughts

What is high-functioning depression?

High-functioning depression, or dysthymia, refers to chronic, low level depression. Otherwise known as Persistent Depressive Disorder (PDD), high-functioning depression is defined by at least two years of mild, ongoing depression.

How is high-functioning depression different from major depression?

High-functioning depression differs from “normal” depression in that symptoms are less severe and fewer in number, but last considerably longer. A person with high-functioning depression may experience some or all of the symptoms of major depression, but to the outside world, appear perfectly fine. They are often able to complete the tasks someone with major depressive disorder may have a lot more difficulty completing – going to work, maintaining relationships, accomplishing activities of daily living and other tasks. But, that does not mean it is not as emotionally and physically draining, or that it does not require an immense deal of energy and effort.

Symptoms of high-functioning depression manifest more quietly, creepily, and below the surface compared to those of major depression. Whereas a major depression diagnosis happens typically after two weeks and when symptoms are severe, high-functioning depression takes years to mold and has a subtler, albeit prolonged toll on the body and mind. Symptoms can become so ingrained in a person’s daily life that after a while, sufferers get used to functioning with them.

Living with high-functioning depression

If you have high-functioning depression, you may have difficulty experiencing joy and excitement in capacities you yearn to and may have even forgotten you had. You may go to work daily, but feel as though you aren’t able to work to your full potential, or not appreciated for trying. You may have a solid support system from your friends and family, but a lot of anxieties that accompany these relationships. You may be able to get out of bed and dress yourself everyday, but struggle to maintain that momentum and confidence. With high-functioning depression, you go through all the motions of daily life, but are often screaming on the inside.

Because its symptoms are less obvious, high-functioning depression is often imperceptible. This is why high-functioning depression can be so difficult to understand and detect, even for those suffering from it. If you have high-functioning depression, you may feel as though others may not believe that you are suffering or comprehend the magnitude of your illness. Others may not view you as being sick at all. 

These perceptions from others can be dangerous, as they may cause you to begin to question the validity of your own feelings and illness. On the contrary, if you have dealt with depression for a long period of time and have successfully made the strenuous transition from low to high-functioning, through probably years of therapy and practicing coping strategies, you might even feel insulted by others’ lack of ability to understand your struggle. Either way, asking for help can feel challenging when you feel the need to “prove” you are depressed, only because you are able to get out of bed in the morning and do what you need to do.

Bottom line

Despite what others see, high-functioning depression is very real and requires a great deal of tenacity to live with. It is imperative to provide those suffering from it with comfort, empathy, and accessible, tangible resources to help deal with symptoms effectively. If you or someone you love is showing signs of high-functioning depression, a good way to begin exploring treatment plans would be to schedule an appointment with a local therapist or mental health professional as soon as possible. 

If you are already well versed in the world of seeking help and are looking for new, helpful coping mechanisms, check out: 

  • Treatment Options for Depression
  • Treating Depression with Cannabis 
  • How to Use Mindfulness with Cannabis for Mental Health

Do understand that if you suffer from high-functioning depression, there are treatment options available. You will find a mental health professional that will take you seriously and understand what it takes to help you – realize that the mental health community sees you and recognizes that you are doing the best you can, despite your depression telling you otherwise.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.



Melrose, S. (2017). Persistent Depressive Disorder or Dysthymia: An Overview of Assessment and Treatment Approaches. Open Journal of Depression, 6, 1-13. https://doi.org/10.4236/ojd.2017.61001



Huprich, S.K., Porcerelli, J., Binienda, J. and Karana, D. (2005), Functional health status and its relationship to depressive personality disorder, dysthymia, and major depression: preliminary findings. Depress. Anxiety, 22: 168-176. doi:10.1002/da.20116

Caroline Platzman

Caroline Platzman is a Behavioral Health Counselor working with adults diagnosed with schizophrenia. She is passionate about mental health, journalism, nonprofit advocacy, and public relations. Caroline is also a dedicated guitarist and artist in her free time.


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High Functioning Depression

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