High-functioning depression: Symptoms & treatments

Key Takeaways

High-functioning depression is a non-clinical term used to describe an experience of low-level depression that does not prevent a person from completing their daily tasks.

A person with high-functioning depression may not show visible signs of impairment. But they may struggle with internal distress that negatively affects their mental health.

While not an official condition, people with high-functioning depression may still benefit from working with a mental health professional. Remember, you don’t need a formal diagnosis to ask for help.

High-functioning depression is not a recognized mental health condition or diagnosis. It’s also a label that some mental health professionals think we should avoid. And yet, it’s become increasingly popular in public conversation because it points to an experience many people can relate to.

Unlike major depressive disorder (MDD) or other forms of clinical depression, high-functioning depression does not cause a significant impact on a person’s ability to live their life. It causes periods of lower mood and a temporary loss of motivation, but it doesn’t necessarily prevent people from completing their daily tasks.

But unlike what the “high-functioning” label might suggest, this form of depression can still cause internal distress. By learning more about the signs and symptoms of high-functioning depression, you’ll be better equipped to know when it might be time to reach out for help.

What is high-functioning depression?

Imagine having a broken arm and wearing a cast. Chances are, a person wouldn’t toss you a basketball and expect you to catch it with both hands. This is because physical injuries or ailments are often observable. In this example, you could reasonably expect someone to notice your cast. They would then adjust their expectations accordingly and without judgment. But one of the most challenging things about depression and other mental health conditions is that they’re often far less visible to an outside observer.

Of course, some clinical mental health conditions, like major depressive disorder and dysthymia, may cause a visible loss of functioning. These conditions can cause mood changes that can make even the simplest daily tasks, like attending to hygiene or showing up for work on time, very difficult.

But this is not the case for high-functioning depression. A person living with high-functioning depression will not necessarily meet the diagnostic criteria for a clinical mental health condition. Instead, they exist in a gray area between having an acute mental health condition and experiencing the occasional episodes of sadness that are a normal part of life.

Most of the time, people with high-functioning depression can continue to attend to their responsibilities despite feeling distressed. They may seem “fine” to their friends, family, and colleagues because they continue to function as usual. But just because someone can continue to meet expectations at home, work, or school does not mean they don’t need support. They may be concealing a painful internal struggle that is taking a toll on their well-being.

Do you have high-functioning depression? Take our quiz to learn more

If you’re concerned about your mental health, the best thing you can do is talk to a mental health professional. A therapist can provide an evaluation and diagnosis to ensure that you get the right support for your needs.

But if you’re just curious about whether you might have high-functioning depression, check out our quiz. While not a substitute for a professional evaluation, it may give you some helpful insight into your experience.

Signs and symptoms of high-functioning depression

High-functioning depression isn’t a formal diagnosis. But it can negatively affect your life. You can experience any of the following symptoms of depression while still being considered “high functioning:”

Feeling sad or empty
Feeling hopeless about the future
Feeling worthless
Feeling guilty
Feeling irritable or anxious
No longer being interested in things you used to enjoy
Experiencing social isolation or withdrawal from loved ones
Having chronic fatigue and low energy
Moving or talking slower than usual
Struggling with concentration, focus, memory, or making decisions
Having sleep or appetite problems
Having changes in weight (that cannot be otherwise explained)
Having frequent thoughts of self-harm, death, or suicide
Experiencing physical symptoms like headaches, digestive issues, or body pain that don’t have an apparent cause

Causes of depressive disorders

Depressive disorders have a few known causes. So it’s possible that some of these factors may make a person more likely to experience high-functioning depression even if they don’t meet the diagnostic criteria for a clinical mental health condition. These include:

Brain structure and chemistry: People with depression may have physical differences in certain areas of their brains. There may also be differences in the ways their neurotransmitters (naturally occurring brain chemicals) regulate their mood.
Hormonal health: Hormonal fluctuations can occur for many reasons, like puberty or pregnancy. These changes may cause mood changes similar to those caused by depression.
Genetics: Having a first-degree relative (like a parent or sibling) who also has depression may increase your risk. More research is needed to understand the genetic component of depression.
Environment: Experiencing traumatic events like abuse, neglect, or the unexpected loss of a loved one may contribute to the onset of depression.

Effective treatment options for depression

If your high-functioning depression escalates to a depressive disorder, know that effective treatment is available. This typically involves a combination of therapy, medication, and lifestyle changes.

Therapy: One of the most common forms of therapy for treating depression is cognitive-behavioral therapy (CBT). But there are many other types of therapy that may help you, so what’s most important is finding the right treatment for your unique needs.
Lifestyle changes: Your mind and body are connected, and caring for your physical well-being can help support your mental health. Depression can impact your sleep, appetite, and motivation to exercise, so do your best to prioritize self-care. Start small, have patience with yourself, and surround yourself with support.
Medication: There are a variety of antidepressant prescription medications available. The most common are selective serotonin reuptake inhibitors (SSRIs). There’s some research to show that a combination of therapy and medication works best for treating depression. Your doctor or psychiatrist can help you decide if medication is a fit for your treatment plan.

Myths about high-functioning depression

Many people have taken to social media to talk about their experiences with high-functioning depression. Many say they identify with the uncomfortable experience of “masking” their mental health challenges while continuing to perform as expected. Masking involves hiding your symptoms so you appear functional to other people, even if you’re struggling internally.

But some experts caution that the increased use of the term could have unintended consequences. They express concern that labeling depressive symptoms as “high functioning” could perpetuate some harmful myths, like:

If you have high-functioning depression, you’ll always be considered “high functioning,” and this won’t change.
Depression can’t interfere with daily life if it’s considered “high functioning.”
People with high-functioning depression don’t need help.
If you have high-functioning depression, you have a version of depression that’s “not that bad,” so you don’t need support.
People with high-functioning depression are better off than people with clinical depression.

The truth is that depression affects different people in different ways. You don’t have to meet the diagnostic criteria for a mental health condition to benefit from professional help. If you’re struggling internally despite keeping up with your daily tasks, talking to a therapist can help.

Find care with Rula

No matter the form of depression you’re living with, you deserve mental healthcare that meets your unique needs. At Rula, we partner with an extensive network of providers to deliver timely, accessible treatment for a wide range of mental health concerns.

In just a few minutes, you can use our therapist-matching platform to connect with a therapist who takes your insurance and who you can meet with from the comfort of home as early as this week. And if you think you might need medication, we’ve got you covered. Our network also includes psychiatric providers who, if needed, can prescribe medications and monitor your progress over time.