Disclaimer: Human Health is not recommending any specific medical treatment for any particular symptom, nor providing any other medical advice. Always seek the advice of your doctor regarding any medical concern.

It’s estimated that at least 5% of adults worldwide experience depression. It can happen to anyone, and can lead to mood changes that significantly affect an individual’s ability to function as usual.

To explain more about what high-functioning depression is, we’ll take a look at how it compares to other types of depression and what high-functioning depression might look like.

What is depression?

Depression is a broad term for a type of mental health condition that is primarily categorized by low moods and a loss of interest or pleasure in activities or other topics that would usually bring enjoyment.

Some of the other common symptoms of depression include:

• Fatigue
• A notable decrease or increase in appetite or weight
• Feelings of worthlessness
• Excessive or inappropriate guilt
• Appearing restless, or slowed down
• Difficulty thinking, concentrating, or making decisions

The type of depression most people are familiar with is known as major depressive disorder, also known as unipolar depression or clinical depression. Typically, it involves such significant changes to mood and behavior that the individual will experience significant impairment in their ability to function.

This might mean that they find it difficult to get out of bed, complete work or school activities, engage with others, manage self-care tasks such as bathing and eating, and perform other responsibilities and tasks required for everyday living.

However, like many other mental and physical health conditions, every person’s experience is unique. Over time, it has become apparent that some people with depression present differently, and may be able to function at a high level when they are not bound by social or societal responsibilities. This type of presentation of depression is now widely referred to as ‘high-functioning’ depression.

What is high-functioning depression?

To an observer, people with high-functioning depression may not appear depressed at all – they may be socially engaged, may be completing the minimum requirements at work or school, and may not appear outwardly sad or otherwise depressed.

However, on the inside or when they’re alone, these individuals may be experiencing all the hallmarks of depression, such as fatigue, extreme sadness, and loss of pleasure. It is not uncommon that away from the watchful eyes of others, people with high-functioning depression may not keep up their ‘mask’. However, because their behavior away from others remains largely unseen, their symptoms might not appear obvious to most people in their lives.

Is high-functioning depression a clinical diagnosis?

Although it’s not an officially recognized condition, high-functioning depression as a term highlights the broad spectrum of experiences that people with depression have. Although there are diagnostic criteria for depressive disorders, it is important to note that every human is unique, and depression will not affect each person in exactly the same way.

The closest clinical diagnosis to high-functioning depression may be persistent depressive disorder, also known as dysthymia. It was newly introduced as a depressive disorder in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, a handbook which is used as a guideline for the diagnosis of psychiatric conditions.

Persistent depressive disorder is characterized by chronically depressed mood. It may also appear with low self-esteem and feelings of hopelessness, as well as some non-specific generalized symptoms including:

• Sleeping too much or not enough
• Poor concentration or indecisiveness
• Low or increased appetite

Notably, in the criteria for persistent depressive disorder, a clinically significant change in functioning is also required. However, this does not mean that people with this condition, or any depressive condition, may appear to be functionally impaired to an observer. As previously mentioned, people with high-functioning depression may be able to mask or hide their symptoms, either knowingly or unknowingly.

Think you might have high-functioning depression?

If you or someone you love are experiencing symptoms of depression, reach out to a trusted healthcare professional for support. It might help to keep a record of how you’re feeling, so that you can provide your doctor with an accurate picture of how your symptoms are affecting you.

Human Health is a free app that you can use to track your symptoms, such as fatigue and difficulty sleeping, and shows you how they are changing over time. You can also keep on-top of any interventions you might be using to manage your symptoms, with reminder notifications sent when you’re due for your next treatment.

Click here to download Human Health.

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Resources

1. World Health Organization (WHO). Depressive disorder (depression). Available at: https://www.who.int/news-room/fact-sheets/detail/depression
2. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Major Depressive Disorder.
3. Rottenberg, Jonathan & Devendorf, Andrew & Kashdan, Todd & Disabato, David. (2018). The Curious Neglect of High Functioning After Psychopathology: The Case of Depression. Perspectives on Psychological Science, Vol. 13(5), 549–566. Available at: https://www.researchgate.net/publication/326546659
4. Margot Harris for National Alliance on Mental Illness. The Reality of “High Functioning” Depression (2023). Available at: https://www.nami.org/depression-disorders/the-reality-of-high-functioning-depression/
5. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Persistent Depressive Disorder.

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