“Every man has his secret sorrows which the world knows not, and often times we call a man cold when he is only sad.” ― Henry Wadsworth Longfellow
High-functioning depression is more common than one might think. A person may seem to have it all together—without any of the typical signs or symptoms associated with depression on the outside, while on the inside it’s quite another story. People who suffer from this form of depression often times have the ability to excel in their careers, maintain close relationships, and frequently attend social gatherings. The downside is that during their downtime and when no one else notices, they have a real struggle coping with life. This is a common scenario for many successful people across the globe.
High-functioning depression isn’t the official term for this disorder according to the DSM-5, the diagnostic manual used by mental health professionals. The official diagnosis is PDD (persistent depressive disorder). PDD is diagnosed in 1-3% of the Canadian population a year. While these statistics may seem low, the true statistics surrounding the disorder are unknown, as many people who have it end up suffering without seeking treatment or being diagnosed. In Canada, nearly 5% of the population has been diagnosed with major depression. That’s a significant percentage when you think about the individuals who do not seek treatment and live their lives under the radar.
How High-Functioning Depression Can Impact a Person’s Life
Living with high-functioning depression is much more difficult than it may seem. Those who suffer from it are internally plagued by a negative, self-critical dialogue that makes them feel incompetent, insecure, and unworthy. They may find that they’re able to do what needs to be done each day, but truly enjoying life is a challenge. A typical good day for a person with high-functioning depression looks like being able to focus and get their job done, just as someone without this disorder does on a normal day. This means that on bad days it can take all day to accomplish a few small tasks, anxiety and self-doubt may creep in, and it can be difficult to focus. There may also be an internal struggle to get out of bed and do the things that need to be done each morning on bad days. Sadly, the bad days tend to outweigh the good ones.
Dangers of High-Functioning Depression
Suffering from high-functioning depression can cause a person to heavily rely on their coping strategies in order to survive the day. For some, this may be eating. For others, it could mean drinking alcohol, binge-watching television, or using recreational drugs. In fact, alcoholism, drug addiction, and eating disorders are common in those with PDD. Because a person who suffers from this disorder is able to get out of bed (sometimes forcefully so), go to work, and maintain social relationships while appearing to have it all together, it’s difficult for others around them to notice there is a problem. In fact, the person suffering oftentimes has no idea that his/her fatigue or struggles with eating, substances, mood, and self-esteem have anything to do with depression.
In order to be diagnosed with depression, a person must have an inability to function in life. This is why so many with PDD go undiagnosed. They appear to be functioning, but once they finish all that must be done for the day, they may find themselves going into hibernation mode at home. While the functioning inabilities are not as intense for a person with PDD as they are for someone with major depression, the symptoms can last for years. In addition, research shows that the symptoms of high-functioning depression are linked with increased risks for suicide, hospitalization, and social conflict. It’s even possible for someone with PDD to develop more severe symptoms that result in episodes of major depression when their symptoms are left untreated. This is why it’s important to seek treatment if you suspect that you or someone in your life may be suffering.
Signs and Symptoms of High-Functioning Depression
If you think that you or someone you know may have a persistent depressive disorder, it’s important to know the signs, symptoms, and treatment options available. Since depression presents differently in everyone, not all of the symptoms will look the same for each person. Some of the more common signs and symptoms of high-functioning depression include:
Difficulty concentrating and making decisions
Criticism toward self and others
Difficulty finding joy in life
Anger or irritability
Overreacting, as small things can feel like major issues
Excessive guilt and worry about the past, present, and future
Increased use of coping strategies
Persistent gloomy, cynical mood
Guilt surrounding times of rest and relaxation
Insomnia or oversleeping
Overeating or a lack of appetite
High-Functioning Depression Treatment Options
While it’s normal to feel some of these symptoms occasionally, if several symptoms persist for months to years it’s a red flag for PDD. The good news is that this form of depression is treatable. No one should have to go through life suffering from depression, regardless of how successful things seem on the outside. Psychotherapy and medications are effective depression treatment options that work best when they are combined. The first step toward recovery is seeking the help of a licensed mental health professional. If you suspect that you or someone you love has high-functioning depression, it’s time to find out. Take the first step by booking a FREE phone consultation with Dr. Maneet Bhatia, Clinical Director and Clinical Psychologist at Bhatia Psychology Group.