If asked to picture and describe a depressed person, what would you envision?
Someone having trouble getting out of bed every day? Someone who's calling into work sick because they can't leave the house? Someone who's isolated from friends and possibly sleeping 10 or 12 hours a day? Someone who can't stop crying and who's feeling hopeless?
Or would you envision a popular, college-educated professional living it up in the big city with a great job, a good group of friends and a long list of accolades to her name, but who wakes up each morning with a grip1ping sense of anxiety and an internalized pressure to continue to be “perfect” and “keep it all together?”
Would you picture a successful Millennial startup employee who you admire for his discipline and drive but who inwardly is devastatingly self-critical and relentlessly demanding on himself and who, after work, copes with his life with a drink or two and several hours of gaming?
And would you picture that smiling, competent, friendly coworker of yours who always seems to be getting All The Things done but who secretly, inwardly feels like she's a complete failure and fears time is flying by and she's wasting it every day?
Let's face it: you're probably not going to picture these folks. And yet each of them could be a perfect example of someone dealing with what's come to be known as “high-functioning depression.”
While high-functioning depression doesn't look like the stereotype of depression most of us hold in our heads, this diagnosis nevertheless carries significant risks if left untreated.
But the uniquely tricky thing about high-functioning depression is that it's hard to spot precisely because the people dealing with it look, from the outside, like they're holding it all together.
This can lead to a lack of ability to self-identify (or have those around you identify you) as depressed and, moreover, a possible resistance to seeking treatment because of the stigma surrounding more “typical” depression. And this is a big problem.
So today we discover what high-functioning depression really is, walk you through 11 signs of high-functioning depression and how this may show up, explain the unique risks associated with high-functioning depression, and share more about how you or your loved ones can get the help you need if identified with high-functioning depression.
What is High-Functioning Depression?
High-functioning depression is a pop psychology term for what's clinically known as dysthymia.
Dysthymia, according to the “Diagnostic And Statistical Manual of Mental Disorders 5th Edition” (DSM 5), is a mental health disorder characterized by:
“Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years,” and includes the presence of two or more of the following symptoms, “Poor appetite or overeating; insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; feelings of hopelessness.”
And yet, while these symptoms may look diagnostically similar to the symptoms we think of when we envision major depressive disorder (MDD), individuals dealing with dysthymia may not have the same severe levels of impaired biological and mental functioning that can make major depression easier and more obvious to spot.
In other words, someone struggling with dysthymia may still be able to get up and go to their demanding, prestigious job, be in a romantic relationship, post the believable smiley photos on Instagram, regularly get together with their girlfriends for happy hour and generally handle all the logistical adult stuff of their life — passing for someone who doesn't “look depressed.”
But inwardly, this same person may be gripped with a challenging set of symptoms invisible to those of us who love and know them.
Symptoms that may greatly diminish their overall quality of life, their career, their relationships, and bloom into more challenging mental health concerns if left untreated.