Hello, high-functioning depression
Many people are familiar with the stereotypical hallmark symptoms of depression: difficulty with daily tasks, neglect of personal hygiene, a sense of hopelessness, social isolation… Many, however, are less familiar with the symptoms and signs of high-functioning depression.
High-functioning depression (HFD) is not a clinical diagnosis, but rather a descriptor for people who experience significant depressive symptoms while still maintaining their external responsibilities and image—like holding a job, attending school, or maintaining relationships. The expression of HFD in individuals is often internal, and therefore almost imperceptible and frequently overlooked. Individuals who appear outwardly together can be battling profound internal distress. The term “high-functioning” can be misleading as it implies that a person who can socialize, work, or parent does not, and cannot, experience severe depression. In reality, these individuals expend enormous amounts of energy to maintain appearances, often at the expense of their mental and physical well-being.
People who experience HFD often show minimal or no major disruptions to their life and appear to handle stressors with ease. The low energy, sadness, feelings of inadequacy is effortfully repudiated by the hustle, grind, and achievement. They may smile, socialize, have perfectionistic tendencies and appear to have everything together. This is a form of masking behavior that is protective in nature.
The consequences of untreated high-functioning depression can be serious. Chronic emotional distress can impair relationships, reduce quality of life, and increase the risk for substance use or suicidal ideation. According to the National Institute of Mental Health (2022), even mild but persistent depression significantly affects daily functioning and overall well-being.
Moreover, the effort to maintain a "normal" facade can lead to burnout, physical health problems, and deepening self-criticism. People often describe feeling like they are "wearing a mask" or "running on empty," which can contribute to feelings of isolation and hopelessness. Individuals mask depression for a myriad of reasons like culture, personal stigma, lack of support. The reasons people mask are varied and nuanced.
High-functioning depression can be more insidious because it is harder to identify. The person (and those around them) may not realize they are struggling. It is often subtle and lasts longer, while low-functioning depression is more debilitating and acute, prompting faster recognition and treatment.
The difference between high-functioning and low-functioning depression lies mainly in how the depression impacts daily functioning, visibility of symptoms, and external productivity; it is not necessarily indicative of the severity of the emotional pain.
Something important to note: High-functioning depression and high-functioning anxiety often look eerily similar on the outside—people seem capable, productive, and composed. But internally, these are two very distinct experiences, with different emotional cores, thought patterns, and physiological symptoms.
High-functioning anxiety and depression can co-occur. Many people with high-functioning anxiety also develop depressive symptoms, especially if chronic anxiety leads to burnout or feelings of helplessness. Let this be a reminder to check in with yourself, and to connect with your friends and loved ones. In the hustle of life it can be easy to overlook those silently struggling with depression– especially when they appear to have it all together.
We encourage anyone navigating this quiet struggle to remember this: functioning is not the same as flourishing. And, help is available.
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