High-Functioning Depression: How Depression Impacts Those Who Appear Like They Are Functioning

In 2022, 19.9% of adults in Delaware had been told by a doctor they had depression. However, this doesn’t take into account the people who have depression but have not seen a doctor about it. People with high-functioning depression might hide their symptoms from other people. Even if treatment is required for them to feel better, they might resist discussing it with their doctor.

At SUN Behavioral Health Delaware, we are dedicated to educating the community on all types of mental health disorders, including different types of depression. Today, we are going to focus on high-functioning depression. 

High-functioning depression, like high-functioning anxiety, is not a clinical term, and it misleadingly describes someone’s experience. It is sometimes referred to as “smiling depression.” Someone experiencing high-functioning depression is not necessarily experiencing depression that is not severe or debilitating. All it means is that they appear to function day-to-day despite meeting the criteria for a depressive disorder. High-functioning depression can exist in anyone, from a waitperson in a restaurant to the CEO of a company. 

There is a stigma attached to depression. A popular belief is that people can’t function or be successful and have this condition. This couldn’t be further from the truth. When many people think of the term “high-functioning depression,” they interpret it as being less severe or nonexistent because what they see doesn’t fit into the stereotyped image of the disorder. Instead, someone with high-functioning depression often has to use a lot of energy and effort to maintain a performance of health.

Depression manifests in different stages along a spectrum. For some people, it might look like not being able to get out of bed, eat a meal, or brush their teeth in the morning. They might seem down and disassociated with their surroundings. For others, they appear to be functioning well, going to work or school, and accomplishing tasks associated with being mentally healthy. For the latter, they appear on the outside to be healthy and happy. Still, on the inside or behind closed doors, they are experiencing intense symptoms of mental distress. Just because someone appears happy and healthy doesn’t mean they are. 

It is also crucial to note that while people with “high-functioning depression” can function and others can’t, it doesn’t make either experience less valid. Both people may be experiencing severe intensities of depression. Just because one person with depression can go to work and take care of their kids and another person can’t, it doesn’t invalidate their experience or indicate laziness for either person. Depression is different for everyone, and there is no “right” way to experience or respond to the disorder. 

Major depression is a spectrum. For many people with this condition, it means having a difficult time attending to their responsibilities while experiencing intense psychological symptoms. However, it may also fall on the other end and be labeled “high-functioning.” With high-functioning depression, people with this condition will appear to be happy. In reality, they barely manage to keep themselves together. 

On the surface, someone with high-functioning depression is a functioning member of society. They are maintaining their well-being, paying their bills, socializing with friends, engaging in activities, and doing everything that indicates to the rest of the world that they are healthy and doing well in life. It may be challenging for an onlooker to notice clear signs of depression in that person. Below the surface, it feels like they have nothing put together, and their whole world is falling apart at the seams. They often end their days exhausted and drained of energy because it has all been spent maintaining the mask of “well.”

Those who have high-functioning depression will still have symptoms. However, it might not seem evident to themselves or other people. Some of these symptoms include:

People with depression may also have thoughts of suicide or self-harm. For those with high-functioning depression, these thoughts and actions may come as a surprise to others. If you have any thoughts of suicide, please go to a 24/7 crisis care facility as soon as possible. You don’t have to try and function independently with these thoughts. A team of professionals will help you find a sense of stabilization and safety.

Depression also comes with physical symptoms alongside the psychological ones listed above. These include abdominal cramps, aches and pains, digestive concerns, and headaches. For some, these symptoms do not get better with over-the-counter treatment methods and require depression to be treated and managed to improve.

Unless you are with someone with high-functioning depression every second of every day, it might be challenging to know what they are going through. You may never know who is experiencing depression and might need your help solely through observation. With that said, there are some things you can do to discover who might need assistance with a mental health concern. 

First and foremost, check in with your loved ones without judgment. People with high-functioning depression will not often come to you themselves. They will try to hide it because they don’t want to burden you with that information. However, coming to them, even with a simple “Are you doing okay?” can let them know that they are not alone, they have your support, and it might ease some of the emotional pain they are feeling. Remember, they might not talk to you in that instance, and more than one check-in may be necessary before they are ready to speak on the topic. 

You can also open up about your own story with mental health, personal challenges, and fears. Depression makes people feel and believe that they are alone and that they are the only ones who have ever felt this way. When you talk about your own experiences, it helps others know they are not alone. 

If someone does open up to you about having depression, you must listen to them without judgment and with empathy. Asking them what you can do to help them is helpful, but sometimes, they might not want that. In this case, try sitting in silence with them, talking, or hugging them. Just being present with them can be enormously helpful. 

If they are a danger to themselves or others due to their depression, take them to a crisis care center as soon as possible. Attending treatment helps them find peace and rediscover their inner strength. 

The best way for you to manage high-functioning depression is through treatment for depression. During treatment, you will be exposed to tools and therapies that will make managing depression easier. High-functioning depression is a terrifying and exhausting situation for many people, and you are not alone if you have been feeling that way. The good news is you will regain control and live a happier and healthier life through treatment. 

SUN Behavioral Health Delaware solves unmet needs in Georgetown. Some people with high-functioning depression might not realize how depression has been impacting their life. Our online depression survey, while not a diagnosing tool, helps people know if seeking treatment is right for them. To learn more about high-functioning depression or treatment, call us at 302-604-5600.