Upon first glance, very few people would attach the words “high-functioning” to any conversation about depression. After all, major depressive disorder (MDD) is a mood disorder that typically causes people to exhibit difficulty with even the most basic of daily functions. However, some folks display what is euphemistically called “smiling depression.” To put it simply, for now, the person in question is able to mask classic MDD symptoms.
Part of this masking involves the depressed person powering through day-to-day life. To most outside observers, they are indeed high-functioning. They have a diagnosable condition called persistent depressive disorder (PDD) and even though they look fine, they very much need help.
What Is High-Functioning Depression?
We touched on the basics above, but here are some more crucial components of PDD:
- It presents fewer and less severe symptoms than MDD and is thus not diagnosed until after two years of such signs (for MDD, that time frame is only two weeks). This, of course, makes it tricky to accurately diagnose.
- Input from close friends and family members is essential for high-functioning depression to be recognized.
- Perhaps the primary obstacle to identifying PDD is the person with high-functioning depression. They push through problems and rarely ask for help. Their fear of looking weak or foolish causes them to actively disguise what they’re feeling.
Why Do Some People Hide Signs of Depression?
As with any mental health condition, reasons will vary. Even so, it often comes down to a fear of embarrassment or failure. People with PDD might dread:
- Making a fuss about something that others might see as minor
- Having too much attention focused on them
- Being a burden on the people in their life
- Looking too needy or sensitive
Factors like this — combined with a two-year diagnosis period — run the risk of things getting much worse before treatment arrives.
What Does High-Functioning Depression Look Like?
- Being the Reliable One: Paradoxically, someone with PDD may go to such lengths to hide their distress that become viewed as a go-to person. No matter how hard it is, they get stuff done. Not surprisingly, PDD is more common among women.
- Unexplained Physical Symptoms: A lot of work goes into suppressing overt symptoms and can thus manifest in signs like sleep disturbances, digestive problems, weight gain or loss, muscle aches and tension, low libido, and more.
- Self-Medication: Since they are eschewing treatments or interventions, a person with high-functioning depression may look toward substance abuse and other ways to numb the pain.
- Lack of Resilience: As time passes, it can get harder and harder to bounce back from physical or emotional energy expenditures.
- Going Through the Motions: Sure, you’re getting things done, but that doesn’t mean you can get any satisfaction or pleasure out of it.
- Standard Depression Symptoms: All depressive disorders can manifest in feelings of worthlessness, profound sadness, pessimism, shame, and guilt.
In the name of not worrying or burdening anyone else, you put so much more pressure on yourself. This is where self-harm and suicidal ideation can become a genuine concern.
Self-Help Steps to Take
You will need professional support, but that does not preclude the value of self-care, for example:
- The first step is to identify and accept what’s happening
- Take a big step by confiding in someone you trust about how you feel
- Actively seek out joy in your life
- Reject the counterproductive need to be “perfect”
Most of all, connect with a depression therapist who understands the struggle. There is no need to suffer in silence. Your weekly sessions can be a safe space in which you open up and find new ways to approach depression. Let’s talk soon.
