What is it Like Living With a High-Functioning Mental Illness?

By | May 15th, 2023

All over the world, people get up in the morning, get dressed, and go about their day. And nobody knows they’re struggling. On the outside, they look as if everything is normal, but on the inside, there is a battle going on.

What is a High-Functioning Mental Illness?

high functioning mental illnessHigh-functioning mental illness is used to describe people living with a mental illness that most people don’t detect. The person might have a job, be attending classes, dress well, or even have what seems to be the “perfect” family life. High-functioning mental illness means going through most days as if there isn’t a battle going on in your head or panic running through your body. Like any mental illness, high-functioning mental illness is tiring, overpowering, and hard to cope with.

They might appear normal to people around them, but they are fighting a mental illness. You may not have heard the term, “high-functioning mental illness” before, but it is very real for many people. These  are some common high-functioning mental disorders:

Are There Symptoms of High-Functioning Mental Illness?

There is no specific look to mental illness. An unkempt appearance isn’t a symptom of depression. Still, people seem to expect that people who struggle with their mental health will have a hard time functioning in society. Assumptions like this hurt people who have high-functioning depression or any other mental illness.

Stuck in the Middle

Individuals with high-functioning mental illness can feel trapped between two groups. They struggle too much to fit in with those who don’t have mental health issues, but they don’t have the same struggles as those with low-functioning mental illnesses. This makes it difficult for them to seek help because the people around them don’t take their illness seriously in many cases.

One misunderstanding is that people with mental health challenges aren’t able to function in society. This is just not true. It is possible for a person to carry on a socially acceptable lifestyle while experiencing anxiety or having suicidal thoughts. This behavior is an attempt to be a member of society while still having mental health challenges. A person can be very successful and struggle with depression at the same time.


No Obvious Symptoms

It’s important to realize that appearance isn’t always a symptom, even with physical disorders like eating disorders. Someone struggling with an eating disorder isn’t necessarily going to have a skeletal appearance, but they are still doing harm to their bodies with some of their behaviors. Likewise, an individual with anxiety isn’t always going to bite their nails or hyperventilate.

They might appear perfectly calm, but that doesn’t mean they don’t have anxiety. Mental illnesses don’t discriminate by how prosperous someone is. A smile can hide a lot of internal turmoil.

Challenges of High-Functioning Mental Illness

Part of having a high-functioning mental illness also means feeling a lot of guilt when struggling. Many people feel like their problems aren’t major issues and they have no right to complain because there are people worse off than them. Most of the time they suffer in silence until they are at the breaking point.

What do they do? For many, a large part of conquering their illness is accepting that they have one. Just because they are one definition of “functioning,” doesn’t make them any less sick. You may be a people-pleasing high-achiever, but you might also be feeling anxiety–not high-functioning anxiety, but actual anxiety. If depression or anxiety are distressing you, it’s time to talk to a professional rather than coping with it just because you can.

Stigma and Prejudice Against People with Mental Illness

More than 50% of people with mental illness don’t get help for their disorders. Frequently, people delay or avoid seeking treatment because of worries about being treated differently or being afraid of losing their jobs. That’s because stigma, prejudice, and discrimination against individuals with mental illness are still an issue.

It may be subtle, or it may be obvious, but discrimination against people with mental illness can cause harm, no matter how bad or mild it is. Individuals with mental disorders are discriminated against in many ways, but understanding what that looks like and how to eliminate it can help.

The Facts on Stigma, Prejudice, and Discrimination

An examination of studies on stigma shows that although the public accepts the medical or genetic nature of mental health disorders and the need for treatment, a lot of people still have a negative view of people with mental illness.

Different Types of Stigma

Public Stigma

involves the negative or discriminatory attitudes that other people have concerning mental illness. For example: “People with mental illness are incompetent, dangerous, the cause of their disorder, or unpredictable.”

Self Stigma

refers to the negative attitudes (including internalized shame) that individuals with mental illness have about their own condition. For example: “I am incompetent, dangerous, and to blame for my condition.”

Institutional Stigma

is more ingrained, involving government policies and private organizations that unintentionally or intentionally limit opportunities for people with mental disorders. For example:  Fewer mental health services compared to other health care; lower funding for mental illness research, and stereotypes contained in laws and other institutions.

Stigma not only affects people with mental conditions directly but also the loved ones who support them. This often includes their family members.


Harmful Effects of Stigma and Discrimination

Discrimination and stigma can add to making symptoms worse and a decreased likelihood of getting treatment. Recent research found that self-stigma leads to negative effects on recovery among people diagnosed with severe mental illness. These effects may include:

  • Lower self-esteem
  • Diminished hope
  • Increase in psychiatric symptoms
  • Problems with social relationships
  • Lower likelihood of seeking treatment and less likely to stick with treatment
  • More problems at work or school
  • Social isolation
  • Lack of understanding by friends, family, coworkers, etc.
  • Bullying, harassment, or physical violence
  • Lower opportunities for work, school, or social activities
  • Medical insurance that doesn’t cover treatment adequately
  • A belief that they’ll never succeed or improve their situation

Stigma in the Workplace

A national poll by the American Psychiatric Association (APA) in 2019 discovered that stigma is still a major problem in the workplace. Nearly half of workers were worried about discussing mental health issues at their jobs. More than 30% were concerned about retaliation or being let go if they went for mental health care. Only about 20% were completely at ease talking about mental health issues. The poll also found that millennials were almost two times as likely as baby boomers to be comfortable talking about their mental health. (62% vs. 32%)

What Not to Say

Here are just a few samples of the hurtful comments people hear when struggling with their mental illness. The number of myths regarding mental health that are still around today is both surprising and startling. If someone tells you they’re struggling with a mental issue, don’t say these things:

  • “But you look fine.” “You don’t look like you have a problem.”
  • “If you’re depressed, there must be something terribly wrong in your life.”
  • “What do you have to be depressed about?”
  • “Wow. You don’t look like you have an eating disorder.”
  • “Can’t you forget about it and just move on?”

It’s OK to Say “No”–8 Tips For Setting Boundaries

Boundaries are clearly described rules or limits that a person establishes to protect their well-being and security around others. We define and express how others can behave around us so that we feel safe. They are an important way to help us feel secure in our environment and with other people. Here are 8 tips for setting boundaries:

  1. Allow yourself to focus on yourself and prioritize your comfort and safety. Boundaries contribute to healthy relationships with other people and boost self-respect and self-love.
  2. Practice self-awareness. Listen to your intuition. Part of creating boundaries is making your comfort a priority so you can feel safe and present with others. To do that, you need to recognize your feelings and honor them.
  3. Name your limits. Identify what you need emotionally, physically, and mentally to define your limits and communicate them to others better. A method for this is the boundary circle. Draw a circle on a piece of paper and inside the circle, write everything you need so you feel seen, supported, heard, and safe. Anything that conflicts or distracts from that, write on the outside of the circle. These are your boundaries.
  4. Be consistent with your boundaries. You can’t expect other people to know how you’re feeling all the time, so you have to clearly communicate with others if they cross the boundaries.
  5. If you don’t know how to start, use “I statements.” “I statements” keep the focus on expressing your thoughts, opinions, and feelings without worrying about what others are thinking. Describe your reaction to an unwanted situation and the response you have. Then spell out what you need to feel secure. “I feel…” “I need…”
  6. Be clear, direct, and simple. When you set and enforce boundaries, say what you need as clearly and calmly as you can. There is no need to justify, defend, or apologize for your boundaries.
  7. If you are uncomfortable with setting boundaries, start small. You absolutely deserve to be able to say no without feeling guilty, but it may take practice. Start with setting a small boundary that seems more manageable and work your way up. You may offer an alternative if it makes you more comfortable.
  8. Get support if you feel you need backup. Defining and enforcing boundaries is tricky when you have a mental health issue, especially if you share a living space with someone else. It’s important to check in routinely to make sure that everyone is satisfied that their needs are being met and that boundaries are being respected.

Evolve Wellness Telehealth

high functioning mental illnessAt Evolve Wellness we know that the struggles of everyone with mental illness, even high-functioning mental illness, are genuine. And everyone deserves help. So, if you are high-functioning but struggling, maybe it’s time to ask for help. Ask for support because your life should be about more than just surviving–it should be about thriving.

Because we provide telemental health treatment services, you can access our experienced mental health professionals from any location. Our trained clinicians are qualified in several therapeutic approaches including:

Evolve Wellness Telehealth is just a phone call away and we are ready and willing to answer your questions). Contact us today. You deserve to thrive.

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