What Is High-Functioning Depression? Signs and Symptoms

You may know what depression looks like. Or feels like.

That can’t-get-out-of-bed feeling. That overwhelming cloud of hopelessness that never lets up. That hard-to-shake belief that the world would be better off without you.

Often, people with depression can’t always keep up with the demands of day-to-day life. Like holding a steady job, having meaningful friendships and relationships or keeping their house organized. Their depression can make every chore a Herculean effort. And things start to slide.

But that’s not always the case.

Some people can experience depression in a way that doesn't appear debilitating from the outside, but still causes them a wave of turmoil inside.

“Depression isn’t always something you can see in others or pinpoint easily in yourself,” says psychologist Dawn Potter, PsyD. “For some people, depression lives under the surface. It can be extremely challenging to go about your day-to-day, but to the rest of the world, you seem to be doing reasonably well.”

Some people refer to that as “high-functioning depression.” As in, you’re living with depression but still keeping up with the demands of your life.

So, what does high-functioning depression look like? And why is it important to seek treatment? Dr. Potter shares some insight.

What is high-functioning depression?

High-functioning depression isn’t a formal medical diagnosis. But it can be a helpful way to describe how some people live with symptoms of depression while managing to keep up a relatively stable life.

A person with high-functioning depression may have similar symptoms as a person with clinical depression or major depressive disorder. That includes symptoms like:

• Feeling sad, helpless or hopeless.
• Becoming disinterested in things that used to bring them joy.
• Changes in eating habits, like eating too much or too little.
• Trouble sleeping or sleeping too much.
• Difficulty concentrating.
• Negative thoughts about yourself and others.

Major depression vs. high-functioning depression

The difference between major depression and high-functioning depression is that it’s common for people with major depression to have trouble taking care of the things in life that need their attention. But high-functioning depression describes people who may live with similar feelings as people with major depression, while managing to keep up with their responsibilities.

“The difference lies in the ‘functioning,’” Dr. Potter clarifies. “A person living with high-functioning depression may appear as if nothing is amiss, but in reality, they may feel as if they’re hanging on by a thread.”

You can think of high-functioning depression like a duck gliding on a pond. On the surface, it seems they’re getting around gracefully and easily. But below the surface, their feet are flailing to keep up, and they’re just trying to stay afloat.

A person living with high-functioning depression may hold a steady job, parent responsibly, keep up their home and pay their bills on time — tasks that may prove challenging for people with clinical depression or major depressive disorder.

But the toll can be enormous.

“If it takes a person without depression 5% of their energy to do their laundry, it may cause a person with depression 10 times that. A person with high-functioning depression will probably get the laundry done. But the expense is huge,” Dr. Potter illustrates.

Why it happens

Depression can be caused by several things.

Some people are genetically susceptible to depression. Hormone imbalances can lead to depression in others. And for some people, depression can be triggered by stressful or traumatic life experiences.

But what causes some people to experience debilitating depression while others are higher functioning? It depends.

Severity of symptoms

Dr. Potter explains that depression has several subtypes that range in severity.

For example, people living with persistent depressive disorder (PDD) have milder symptoms than people diagnosed with clinical depression.

It may be that people with high-functioning depression have less severe symptoms than people with more severe forms of depression.

Masking

People with high-functioning depression may feel an enormous amount of depressive symptoms. But it could be that they’re able to “mask” or hide their depression from people around them.

“Some people can really compensate for negative emotion, particularly if they have a larger support network,” Dr. Potter shares. “That can help create an illusion that everything’s fine when it, in fact, is not.”

Hidden dysfunction

Some people with depression may not be as high functioning as they appear. While they may seem to be excelling from your vantage point, it could be that depression is keeping them from functioning in other areas of their lives — domains that are hidden from you.

That’s to say, the signs of depression are there, just not from your viewpoint.

Your co-worker, for example, may be excelling at work. But what you don’t know is that they barely get out of bed each weekend. Or your friend’s social media feed is brimming with happy, smiling photos. But inside, they feel empty but don’t show it.

Treating high-functioning depression

Let’s be very clear: Even if you or a loved one appear to be high functioning, all depression deserves treatment. You don’t have to hit rock bottom before looking for a way up.

The trouble is that high-functioning depression can be hard to spot — even in yourself.

“People can often disbelieve their own emotional experience,” Dr. Potter says. “If you’re pushing through and managing to live a productive life with depression bearing down on you, it can be tough to recognize it yourself.”

And if you’re keeping up with your commitments to work, friends and family, it’s less likely that people around you will urge you to seek treatment. They can’t help what they don’t see.

So, what happens? You continue to try to keep it up. But every task demands more and more of your dwindling energy reserves. And eventually, you can burn out.

“Without treatment, depression can get worse. So, even if you’re keeping up now, that doesn’t mean you’ll necessarily continue to,” Dr. Potter adds.

And even if your depression doesn’t progress, you’re worthy of a life where covering your basic necessities isn’t thoroughly exhausting.

Talk with a healthcare provider if you think you or a loved one are living with high-functioning depression. It merits your attention. Because you deserve to not just muddle through, but to live well.