What Is High-Functioning Depression? Signs, Symptoms, and Treatment

You’re able to stay on top of your coursework or job responsibilities. You show up on time to your obligations, stay organized, and look totally put together. There’s no way you could be depressed, right?

Not true. High-functioning depression is a condition in which a depressed person is able to mask their symptoms and handle everyday tasks. They’re keeping up appearances and meeting daily demands at work or at home, but inside they’re struggling with symptoms like apathy, hopelessness, indecision, low self-esteem, and low energy.

In some cases, high-functioning depression is an indicator of persistent depressive disorder (PDD). PDD is characterized by chronic symptoms of depression over a period of at least two years. The symptoms of both conditions are typically milder than those of major depression, but they still impact a person’s ability to thrive in life, relationships, and creative, academic, or career pursuits.

What You’ll Learn

• What is high-functioning depression?
• Is high-functioning depression the same as persistent depressive disorder?
• What’s the difference between high-functioning depression and major depression?  
• What therapy is best for depression?

What Is High-Functioning Depression?

High-functioning depression, or persistent depressive disorder (formerly known as dysthymia), is a mental health condition that causes mild depression symptoms that continue over a long period of time. While they may not cause intense distress or lead to life-disrupting consequences, the symptoms are always present under the surface, diminishing a person’s experience of life.

To family, friends, and coworkers, people with high-functioning depression may seem like themselves, able to handle regular tasks and interact as usual. In fact, their depression symptoms may even be hard for them to recognize. However, they are typically experiencing ongoing sadness, hopelessness, lack of motivation, and disinterest in things they once cared about. Their energy and sense of self may be depleted. They may feel adrift, careless, tired, and unable to tap into a sense of joy or connection.

Signs and Symptoms of High-Functioning Depression

What does high-functioning depression look like? What are some signs that you or your loved one might have persistent depressive disorder? Symptoms of high-functioning depression can include the following:

• Persistent, inexplicable feelings of hopelessness or sadness
• Loss of energy and/or motivation
• Loss of interest in previously enjoyed activities
• Low self-esteem
• Feeling numb or disengaged
• Difficulty with decision-making
• Fatigue or exhaustion
• Insomnia

People with high-functioning or persistent depression may experience major depressive episodes (MDEs), but most of the time, their symptoms are milder. They may also have trouble recognizing or identifying these symptoms, given that they are still able to operate normally in your daily activities. In fact, they may give the appearance of having everything under control and still feel, privately, like they’re hanging on for dear life.

High-Functioning Depression vs. Major Depression

The difference between high-functioning depression and major depressive disorder is the severity and longevity of the symptoms. Major depressive disorder consists of recurrent major depressive episodes (MDEs), in which symptoms impair life functioning and last for at least two weeks at a time.

Signs of major depression include:

• Feelings of deep sadness, despair, and hopelessness
• Apathy and loss of interested in previously enjoyed activities
• Severe fatigue and exhaustion
• Restlessness and/or inability to feel rested
• Changes in appetite, including over-eating or no interest in eating
• Inability to function normally or complete daily tasks
• Increased distress
• Low self-esteem
• Withdrawal from social or close relationships
• Isolation and loneliness
• Thoughts of suicide
• Symptoms of high-functioning anxiety, which often goes hand in hand with high-functioning depression

According to the National Survey on Drug Use and Health, 8.5 percent of people over the age of 18 experience a major depressive episode over the course of a year. Major depression is characterized by the recurrence of these episodes, impairing a person’s ability to maintain relationships, work obligations, family responsibilities, and even personal hygiene.

Other Types of Depression

There are several other types of depressive disorders that may correspond with certain conditions or stages of life. They include:

• Disruptive mood dysregulation disorder, which affects children and adolescents in the form of frequent, intense outbursts and irritability
• Premenstrual dysmorphic disorder, a more severe form of premenstrual syndrome (PMS)
• Medication or substance-induced depression, in which depression results from the use of prescribed medication or substances such as alcohol, marijuana, or other drugs
• Seasonal affective disorder, where major depression symptoms correspond with the absence of sunlight in fall and winter
• Bipolar depression, which is accompanied by manic or hypomanic episodes as part of bipolar disorder

Additionally, some depression symptoms can be caused by medical conditions. Hence, testing and evaluation at a primary care clinic can help you discover whether your depression is a sign of a medical issue, such as hypothyroidism or chronic fatigue syndrome.

If you’ve been experiencing symptoms of depression, whether chronic and mild or severe and life disrupting, it’s important to talk to a treatment professional. They’ll ask about your symptoms, life experiences, family history, and medications, so they can make a proper diagnosis and support you on the path to healing.

Treatment Options for High-Functioning Depression

How is high-functioning depression treated? There are a variety of therapeutic approaches that can help people manage their symptoms and recover from depression. Depression treatment options include:

• Individual talk therapy: This traditional form of therapy involves one-on-one conversations with a licensed therapist. A therapist can help you discover the root causes of your depression, process your feelings, and refer you to a psychiatrist if medication is necessary.
• Group therapy: People with depression may benefit from group therapy sessions led by a licensed therapist. Receiving empathy and understanding from others in a supportive environment can be very healing and help you feel less isolated.
• Cognitive Behavioral Therapy (CBT): CBT is a form of therapy in which a therapist works with you to develop frameworks for evaluating and reversing negative thinking patterns. It can be very effective for depression.
• Trauma treatment: Trauma is often a contributor to mental health issues, especially depression. Trauma resolution treatments range from EMDR to psychotherapy, somatic approaches, and Trauma-Informed CBT. Resolving trauma can be a major factor in resolving depression symptoms.
• Medication-assisted therapy: In addition to sessions with a therapist, people with depression can find relief through depression medications designed to rebalance brain chemicals. It may take time to find the right medication. If symptoms worsen with medication or you experience suicidal thoughts, contact your doctor right away.

You or your loved one don’t have to live with ongoing symptoms of depression, even mild ones that don’t prevent daily functioning. You can find support, manage symptoms, and start thriving in life again—you just need to take that first step and reach out for professional support.

Compassionate Treatment for Depression

At Newport Institute, we provide caring, evidence-based treatment for adults with mental health conditions such as high-functioning depression, major depressive disorder, or persistent depressive disorder.

Through our research-backed program, we can help you resolve trauma, understand and manage your symptoms, develop a support network, and regain your love for life. Contact us today to learn more.

Frequently Asked Questions