High functioning depression: signs, symptoms and management

People with high functioning depression (or highly functioning depression) tend to experience many of the same symptoms as those with clinical depression, except their symptoms tend to be less debilitating. Those with high functioning depression are able to go about their day-to-day lives relatively well, even though they’re struggling internally.

Here, we explore what high functioning depression is, as well as the signs and symptoms to look out for. We also provide tips on how to cope with high functioning depression.

What is high functioning depression?

To the outside world, people with high functioning depression may seem to be happy, successful, hardworking and look like they’re leading a perfectly ‘normal’ life. However, the reality for someone who is struggling with high functioning depression is often very different.

This form of depression can cause many of the same symptoms of depression, except these tend to be less severe. This means that people are generally able to go about their daily lives, instead of being completely incapacitated by their depression. They are able to perform well at work or school, socialise normally, and keep on top of their responsibilities.

However, high functioning depression can be a chronic and enduring illness. Although its symptoms are less severe than other types of depression, this doesn’t mean it’s insignificant to those that struggle with it.

Because high functioning depression is less ‘obvious’ than other types of depression, it might be overlooked or dismissed by both healthcare professionals and even the individuals themselves. However, it can have a negative impact on quality of life, which is why it’s so important that people with high functioning depression are able to get the help they need.

High functioning depression is also sometimes known as ‘dysthymia’ or ‘persistent depressive disorder (PDD)’.

Signs you might have high functioning depression

The signs of high functioning depression can be subtle. In your day-to-day life, you might:

• Feel ‘down’ most of the time. Whenever you do feel happy, this is often short-lived
• Have a generally pessimistic view of the world
• Feel tired all the time, even if you think you’re getting enough sleep
• Cry or become emotional for no clear reason
• Fulfil all of your responsibilities, such as childcare, work and household chores, but these feel like a huge effort
• Feel unworthy or as though you’re an ‘imposter’ going through life. You might also believe that you don’t deserve to be happy
• Be very self-critical and find it hard to receive a compliment
• Attend social activities, but feel as though you’re forcing yourself to go
• Drink alcohol or use drugs to try and make yourself feel better

Your ever-present low mood and ‘mild’ symptoms can mean that your high functioning depression is normalised and simply put down to your personality. Other people might view you as being miserable, gloomy, lazy and unable to have fun or just ‘loosen up’, as opposed to having an enduring mental health condition that needs treatment. This is why high functioning depression can be difficult to spot.

Also, instead of appearing suddenly or following a particular trigger or stressful event, the signs of high functioning depression can emerge gradually, with limited or no triggers.

High functioning depression symptoms

High functioning depression symptoms tend to be the same as the core symptoms of depression. However, the main difference is that these tend to be less severe and don’t significantly impair your ability to function. The symptoms of high functioning depression include:

• Having a low mood all day, most days
• Feelings of hopelessness and emptiness
• Feeling guilty
• Low self-esteem
• Anger, frustration and irritability
• Having difficulty making decisions
• Finding it hard to concentrate
• Becoming less interested in hobbies and social activities that you may have previously enjoyed
• Sleep disturbances (sleeping too much or not enough)
• Changes in appetite (overeating or decreased appetite), leading to weight fluctuations
• Lack of energy

Coping with high functioning depression

Living with high functioning depression can be incredibly draining. However, there are a number of things you can do to help you cope a bit better on a daily basis.

Look after yourself physically

When you’re feeling low, it can be easy to neglect your physical health and wellbeing. However, looking after yourself physically can help you to feel better mentally.

Try to do some exercise every day, even if this is just a 10-minute walk outside in the fresh air. Exercise boosts the ‘happy chemicals’ in our brain, which can help to make us feel more positive. Find out more about how exercise benefits mental health and the link between nature and mental health.

It’s also important to make sure you eat a balanced diet, drink plenty of water and try to get enough sleep at night. If you’re feeling physically well, this can help to bolster your mood and mental health.

Try to challenge your negative thoughts

One of the symptoms of high functioning depression is experiencing negative thoughts and feelings of hopelessness. That’s why it’s important to try to challenge these negative thoughts when they arise.

If you find yourself thinking in a pessimistic and negative way, ask yourself:

• What evidence is there for what I’m thinking?
• Is there another way I can look at this situation?
• What would I say to a loved one if they were thinking this way?

Challenging your thought processes can help you to view things in a more balanced, positive and healthy way, which can improve your mood.

Stay connected to others

While you might want to bottle things up and hide away from other people, it’s really important to try and maintain a support network with people that you trust. Just having someone who can listen to how you’re feeling, without judgement, and be there for you during tough times can be really helpful and reassuring. Here are some tips on how to talk to someone about your depression.

You could also consider joining a depression support group, where you’ll be able to talk to people going through the same issues as you. Find a depression support group near you.

Do things that make you happy

Feelings of happiness may be fleeting for someone who has high functioning depression. That’s why it’s so important to try and incorporate things that make you happy into your daily life.

Find things that you enjoy and try to do them as often as you can. These might be things like:

• Listening to your favourite music
• Spending time with a pet
• Watching your favourite film
• Reading a book
• Cooking new meals

Actively searching for happiness amidst the sadness can help you to view life more positively.

Find out more about how to cope with depression, as well as the importance of self-care for mental health.

Treatment for high functioning depression

While the above tips can help, if high functioning depression has become an ever-present issue in your life, it’s important to get professional support.

At Priory, our depression treatment experts will be able to design a treatment programme that fits your needs. Treatment for high functioning depression might include a combination of talking therapy, such as cognitive behavioural therapy (CBT), and medication. We can help you to identify any negative thoughts that may be fuelling your persistent low mood, and teach you skills to manage them more effectively. We also offer an innovative treatment method for depression, known as repetitive transcranial magnetic stimulation (rTMS), which is available at Priory Wellbeing Centre Harley Street.

You don’t have to live with high functioning depression. It’s possible for you to take steps towards recovery, and achieve the happy and healthy life you deserve.