High-functioning depression defies the archetype that most expect when people think of depression.
Depression can be hard to spot at the best of times. While depression is typically characterised by social withdrawal and changes to mood, there is no “typical” case of depression.
Many people with depression can behave and function in a way that makes it almost impossible to detect what’s going on behind the scenes. Someone with depression can very well be present socially, hold down a steady job, and – for all intents and purposes – look like a contented individual to their family, friends, and co-workers.
What is high functioning depression?
High-functioning depression is a term that is used to describe an individual who suffers from depression whilst keeping a seemingly “together” facade to those around them.
High-functioning depression is not a specific medical diagnosis.
Instead, it is a social or colloquial term that has been adopted to describe individuals who suffer from depression whilst masking many of the outward signs and symptoms that are typically associated with depression.
An individual with high-functioning depression can look completely fine to those around them. The ability to mask depressive symptoms does not detract from the inner turmoil that that person may be feeling. A person with high-functioning depression can be just as affected as a depressed individual who exhibits more typical symptoms of depression.
What are the signs of high-functioning depression?
The key sign of high-functioning depression is that many of the typical signs and symptoms of depression can go entirely unnoticed. Which, in itself, makes it hard to offer help to those who are suffering.
Common signs & symptoms
- Low mood and constant fatigue
- Feelings of dread and helplessness
- Trouble concentrating and finishing tasks
- Inability to form and stick to routines
- Constant background anciety
- Changes to appetite
- Trouble sleeping or settling at night
- Physical symptoms like aches, headaches, pains
- Masking any or all of the above symptoms to those around you
- Deflection when people ask if you’re ok
Because high-functioning depression can go almost entirely unnoticed, the signs and symptoms listed above will be more relevant to those suffering themselves, rather than to friends or family hoping to spot the signs from the outside.
How we can support high-functioning depression
Perhaps one of the most confusing aspects of high-functioning depression is that someone suffering can have an entirely enviable existence.
They could be the person out to dinner, socialising, on overseas trips, and hitting life milestones. All the while, they may be suffering in plain sight.
Advocating for better mental health starts with creating a safe space for those around you. Whilst high-functioning depression can often go unnoticed, there are things that you can do to make sure that you are helping to spot those that may be suffering in silence:
- Check in with your friends and family
- Listen without trying to fix – sometimes people just need to be heard
- If you notice a change, don’t be afraid to reach out
- Never judge – make sure you create a safe space
- Encourage people to seek professional help when needed
Lastly, and perhaps most importantly – normalise this type of conversation and try to keep things informal. Those suffering with depression whilst masking it to those around them are likely those that don’t want to “create a fuss”. There’s no need to hold a formal intervention or make it a formal ‘check-in’ process. Keeping things informal helps to reduce the stigma of mental health and create spaces where people can talk openly.
Treatment for high-functioning depression
Even though the outward signs of high-functioning depression may be masked, the treatment and approach is no different to anyone seeking treatment for depression. Treatment for high-functioning depressions can typically include:
Therapy: Therapy, such as cognitive behavioural therapy (CBT) as well as specialised depression counselling enable a structured approach to processing thoughts, patterns, and behaviours that may have caused or exacerbated feelings of depression. Therapy for high-functioning depression helps to develop practical coping strategies that enable an individual to identify thoughts and behavioural patterns.
Medication: As with all forms of depression, medication may sometimes be prescribed to help an individual to moderate the symptoms of depression. Medications are intended to balance the neurotransmitters in the brain that control moods. Medication for depression is typically prescribed by a psychiatrist who works to create a treatment plan that involves a combination of therapy, medication, and lifestyle changes.
Lifestyle & support: Changes to lifestyle and encouraging support networks is a key piece to the puzzle – particularly for those suffering in silence. Support groups, in particular, aim to create a space where those suffering in silence don’t feel marginalised and can find common ground and comfort. Similarly, changes to lifestyle may include promoting exercise, avoiding triggers (including drugs and alcohol), and other lifestyle changes that recognise the link between community, physical, and mental wellbeing.
Final thoughts
Depression has no archetype. The signs and symptoms of depression can look different and even be completely invisible.
Understanding depression means knowing that it has no “normal”.
Initiatives like “RUOK Day” in Australia are one of the public health campaigns that are designed to close that gap and create a space that encourages people to talk. Treatment starts with a conversation. If you notice a change – however subtle that may be – in a friend, coworker, or family member – make sure to check-in with them.
