Signs You’re Dealing with High-Functioning Depression

By | June 5th, 2023

High-functioning depression, or dysthymia, is a type of depression where someone experiences persistent feelings of sadness or low mood for two years or more. “Smiling depression” is another term often used to describe high-functioning depression. This refers to one’s effort to conceal their depression from friends and family by “hiding behind a smile.”

Although people with high-functioning depression can continue with their daily routines and responsibilities, they still feel the effects of depression on their overall quality of life. It can be difficult for them to find joy in activities that they once enjoyed because of persistent feelings of low self-esteem and trouble concentrating. They may want to hide their feelings

  • To prevent adding to others’ stress
  • To avoid appearing vulnerable or feeble
  • To refrain from attracting focus toward their difficulties
  • They genuinely believe that their mental health is not a problem

Also known as persistent depressive disorder (PDD), high-functioning depression is not always easy to detect. It can develop gradually without a person realizing that something is wrong until it reaches a tipping point. Stressful events in life can trigger or worsen the symptoms of PDD.

People with high-functioning depression tend to be tenacious in dealing with their emotions and may come across as perfectionists. This characteristic can heighten their drive to meet specific expectations. Admitting to needing help can be challenging for individuals with this condition, leading to an accumulation of emotions that may boil over at any time.

Causes of High-Functioning Depression

The causes of high-functioning depression are not entirely clear, but it is believed to be a combination of genetic, biological, and environmental factors.

Biological differences

It’s possible that people with high-functioning depression may experience physical changes in their brains. The exact impact of these changes on the disorder is not fully understood, but they could potentially provide clues about its underlying causes. Scientists continue to research this area better to understand the relationship between brain structure and depression.

Brain chemistry

Neurotransmitters are natural chemicals found in the brain that help nerve cells communicate with each other. There is evidence to suggest that changes in these neurotransmitters may contribute significantly to depression and its treatment. For example, some medications used to treat depression work by increasing the levels of certain neurotransmitters, such as serotonin and norepinephrine, in the brain.

Inherited Traits

Studies suggest that individuals with a family history of persistent depressive disorder may have a higher likelihood of developing the condition themselves. Researchers are currently investigating genetic factors that may contribute to depression. While the exact genes involved in depression are still unclear, researchers have identified several gene variations that may be associated with an increased risk of developing the condition.

Life Events

Just like with major depression, people with PDD may experience an onset of symptoms following a traumatic event, such as the loss of a loved one, financial difficulties, or high levels of stress. These events can trigger a chemical imbalance in the brain, leading to symptoms of depression.

However, it’s important to note that not everyone who experiences these types of events will develop high-functioning depression. Some individuals may be more resilient and able to cope with these stressors more effectively. On the other hand, those with a history of depression or other mental health conditions may be at a higher risk of developing the disorder following a traumatic event.

Risk Factors for High-Functioning Depression

The risk factors for developing high-functioning depression include:

  1. Family history of depression: People with a first-degree relative (parent or sibling) with depression or other mood disorders are more likely to develop high-functioning depression.
  2. Traumatic or stressful life events: Significant life events, such as the death of a loved one, financial difficulties, or relationship problems, can trigger high-functioning depression in some individuals.
  3. Negative personality traits: Individuals with negative traits such as low self-esteem, self-criticism, and pessimism are more susceptible to developing high-functioning depression.
  4. History of other mental health disorders: People who have a history of anxiety, personality, or substance abuse disorders have a higher risk of developing high-functioning depression.

It is important to note that while these factors may increase the risk of developing high-functioning depression, it does not necessarily mean that someone will develop the disorder. The onset of depression is complex, and there may be other contributing factors beyond those mentioned above.

Symptoms and Diagnosis of High-Functioning Depression

High-functioning depression can be difficult to identify because people may appear to be doing well in their daily lives. Some common signs and symptoms of this condition include:

  • Feeling sad, empty, or hopeless most of the time
  • Losing interest or pleasure in activities that were once enjoyable
  • Feeling tired or lacking energy most days
  • Difficulty concentrating or making decisions
  • Feeling restless or irritable
  • Struggling to do things timely and well
  • Changes in appetite or weight
  • Sleeping too little or too much
  • Low self-esteem and feelings of worthlessness
  • Feeling guilty or excessively self-critical
  • Recurring thoughts of death or suicide

Not everyone experiences depression in the same way, and symptoms can vary from person to person. If you or someone you know is experiencing any of these symptoms, it is important to seek help from a mental health professional.


high-functioning depression treatment

If you’re experiencing symptoms of high-functioning depression, it’s important to know that you’re not alone and that help is available. High-functioning depression can be difficult to diagnose because the symptoms may not always be apparent. To evaluate whether you meet the criteria for PDD, healthcare professionals may use tools like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Additionally, a thorough medical and psychological evaluation can help to rule out any underlying medical conditions or medications that may be causing the symptoms. It’s important to seek the help of a qualified healthcare professional, such as a psychiatrist or psychologist, to receive an accurate diagnosis.

A comprehensive assessment of symptoms and medical history can help with an accurate diagnosis, which can lead to access to effective outpatient telehealth program and support. It’s recommended that people should seek professional help if they have persistent feelings of sadness, hopelessness, or other symptoms of depression that interfere with their daily life.

Living with High-Functioning Depression

Living with high-functioning depression can be challenging and will affect one’s overall quality of life. On the outside, someone may appear to be functioning well, often excelling in work or personal pursuits, but internally you may be struggling with a range of symptoms. People with this condition may often feel like they are wearing a mask or hiding behind a facade of happiness while struggling with negative thoughts and emotions. They may feel overwhelmed and stressed, even if they appear to be handling everything well on the surface.

Living with high-functioning depression can be isolating, and individuals may struggle to communicate their experiences to others. They often struggle to maintain healthy relationships and often find themselves in conflict with family and loved ones. They may feel like they are putting on a facade or hiding their true emotions, which can make it difficult to connect with others on a deeper level. They may find it difficult to focus on tasks and may experience a lack of motivation or enthusiasm.

People experiencing high-functioning depression should seek support from a mental health professional, who can provide an accurate diagnosis and outpatient depression treatment options. With the right treatment and support, it is possible to manage the symptoms of high-functioning depression and lead a fulfilling life.

Signs of a Major Depressive Episode

A severe major depressive episode may have symptoms that are more deeply intense and persistent than those of a milder episode. Some signs that someone may be experiencing a severe episode of major depression include:

  1. Suicidal or self-harm thoughts or behaviors: this is a medical emergency and requires immediate attention.
  2. Severe loss of appetite and weight loss: this can lead to malnourishment and other health problems.
  3. Extreme fatigue or lack of energy: this can make it difficult to perform daily activities, and may cause feelings of hopelessness and worthlessness.
  4. Insomnia or hypersomnia: changes in sleep patterns can be a sign of a major depressive episode.
  5. Difficulty concentrating or making decisions: this can impact work or school performance and can make it difficult to complete everyday tasks.
  6. Persistent feelings of sadness, hopelessness, and emptiness: these feelings may persist for most of the day, every day, for two weeks or more.
  7. Significant changes in appetite: rapid weight increase or decrease.
  8. Fatigue or loss of energy: persistent tiredness even after rest.
  9. Physical symptoms: headaches, stomachaches, or muscle pain.
  10. Poor memory: difficulty concentrating, making decisions, or remembering things.

It’s important to note that not all individuals with major depression will experience all of these symptoms, and the severity of symptoms can vary from person to person. If you or someone you know is experiencing any of these symptoms, it’s important to seek help from a qualified healthcare professional.

Co-Occurrence of High-Functioning Depression with Substance Abuse

High-functioning depression and substance abuse can be a dangerous combination. Individuals with high-functioning depression may use substances such as drugs or alcohol to cope with their symptoms, which can lead to a range of negative consequences.

Studies have shown that individuals with high-functioning depression are more likely to develop substance use disorders than those without the condition. This can be attributed to a variety of factors, including increased stress, difficulties with emotional regulation, and attempts to self-medicate symptoms.

When high-functioning depression co-occurs with substance abuse, the symptoms of both conditions can worsen and become more severe. For example, substance abuse can exacerbate feelings of sadness, hopelessness, and anxiety, while also contributing to physical health problems. In turn, depression can amplify the negative effects of substance abuse, making it harder for individuals to quit using substances.

Treatment options may include telehealth therapy, medication, support groups, and substance abuse treatment programs. Seeking help can improve an individual’s chances of recovery and reduce the risk of negative consequences associated with these conditions.

How to Manage High-Functioning Depression

Managing high-functioning depression can feel like an overwhelming task, but there are several strategies that have been proven effective in reducing symptoms and improving the quality of life. Here are some evidence-based ways to manage high-functioning depression:

  1. Seek professional help: seek help from a qualified mental health professional who can provide an accurate diagnosis and help develop a treatment plan that works for you.
  2. Practice self-care: self-care can help you manage the symptoms of depression and improve your overall well-being. This includes getting enough sleep, eating a healthy diet, engaging in regular exercise, and finding ways to relax and manage stress.
  3. Cognitive-behavioral therapy (CBT): CBT is a type of talk therapy that has been shown to be effective in treating depression. CBT focuses on identifying negative thought patterns and replacing them with more positive ones.
  4. Medication: Antidepressant medications can be effective in treating depression, particularly when combined with therapy.
  5. Support groups: Joining a support group can provide a sense of community and support, and can help you feel less alone in your struggle with depression.
  6. Mindfulness and meditation: Practicing mindfulness and meditation can help you become more aware of your thoughts and emotions, and can help you develop skills to manage them more effectively.

Managing high-functioning depression is an ongoing process, and what works for one person may not work for another. Be patient with yourself and stay committed to finding the treatment strategies that work best for you.

How Evolve Wellness Inc Can Help

treatment for high-functioning depression

Evolve Wellness Inc offers a range of services to support individuals struggling with various mental health issues, including high-functioning depression. We have licensed and experienced mental health professionals who work with clients to develop personalized treatment plans that address their unique needs and challenges.

The team at Evolve Wellness Inc offers evidence-based treatments that are proven to be effective for treating depression, such as cognitive-behavioral therapy (CBT), which helps clients identify negative thought patterns and develop coping strategies to manage their symptoms. We also offer various forms of therapy, including individual, group, and family therapy. Our telehealth treatment program provides a supportive and safe space for clients to explore their thoughts and emotions.

Additionally, we provide medication management services for clients who may benefit from medication to manage their symptoms. Our team of psychiatric providers works with clients to determine if medication is an appropriate and helpful option. Our holistic services, such as yoga and mindfulness, can be helpful in promoting relaxation, improving mood, and reducing stress levels.

Evolve Wellness Inc provides a comprehensive approach to treating high-functioning depression, and our team is committed to helping clients improve their mental health and overall well-being. If you or someone you know is struggling with high-functioning depression, contact Evolve Wellness Inc to get help today.


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