What is “High-Functioning Depression”? Debunking Common Myths

Unlike major depression, high-functioning depression is not a clinical diagnosis. However, regardless of how it presents, depression can be a serious mental health condition. 

This guide explores what’s sometimes referred to as “high-functioning depression” and breaks down some of the common misbeliefs surrounding the concept.

What is high-functioning depression?

High-functioning depression is a non-medical term that sometimes is used to describe experiences that may or may not meet the criteria for a clinical diagnosis of depression. However, those experiencing these feelings may still be highly functioning in their day to day life — which makes it hard for others to see that they may be struggling with these feelings.

Diagnosable clinical depressive disorders range from major depressive disorder (MDD) to milder forms like minor depressive disorder. Mental health experts assess the severity of a depressive disorder based on the frequency and duration of distress, the number of symptoms and their intensity, and overall functional impairment.

While “high-functioning” depression isn’t a clinical diagnosis, it’s become a popular term in non-clinical settings. More clinically appropriate terms to describe these experiences include the nine types of depressive disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

High-functioning depression vs. clinical depression

Clinical depression is an umbrella term used to describe the nine depressive disorders listed by the DSM-5. These depressive disorders are characterized by prolonged sadness, fatigue, loss of interest in activities once enjoyed, and difficulty concentrating or making decisions. When clinically depressed, you may need medication, therapy, or both to help manage your symptoms.

The DSM-5 doesn’t classify high-functioning depression so there is no standardized way to describe it. However what most people are likely referring to are symptoms similar to depressive disorders, but still able to function in their day to day lives with little outward impact.

Someone who experiences clinical depression or feelings of sadness, hopelessness and worthlessness without it impacting their daily activities may hear the term “high functioning depression” in non-clinical settings to describe their experience. They still participate in typical daily tasks and routines — but the inner struggle can be harder to see.‍

Myths and misconceptions regarding high-functioning depression

There are a lot of myths and misconceptions surrounding the term “high-functioning depression.” Below, we’ll discuss a few myths that are important to dispel:

Myth 1: High-functioning depression is a clinical diagnosis

High-functioning depression is not classified as one of the nine types of depressive disorders, and as we touched on above, it isn’t a clinical diagnosis. Instead, high-functioning depression is a term you may hear outside of clinical settings to describe someone experiencing symptoms of depression, but still able to function as usual in day-to-day life.

Myth 2: High-functioning depression is the same thing as persistent depressive disorder (PDD)

PDD is a form of long-term depression categorized by milder symptoms that tend to persist for longer periods of time, sometimes for two or more years. High functioning depression is not a clinical term and thus cannot be compared to an official diagnosis.  

Myth 3: High-functioning depression is just dysthymia

“Dysthymia” was a term used to describe mild, chronic depression. Today, this term is no longer in use, and individuals that once would have been diagnosed with dysthymia are now diagnosed with PDD.

Myth 4: High-functioning depression means you are not depressed

Just because high-functioning depression isn’t a clinical diagnosis doesn’t mean there isn't value in learning about where this term comes from. High-functioning depression is a term that you may hear used to describe an experience — and it's possible to be diagnosed with a clinical depressive disorder, and still be high functioning, which is where non-professionals might call it “high functioning” depression.‍

Common types of depressive disorders

The DSM-5 lists nine types of depressive disorders. However, some of these disorders are much more common than others. Here are three of the most common types of depressive disorders:

Major depressive disorder (MDD)

MDD is the most frequently diagnosed type of depressive disorder and is what most people think of when they think of depression. It's characterized by intense and persistent feelings of sadness, emptiness, or hopelessness, along with a range of other symptoms that can significantly impact a person’s quality of life.

Persistent depressive disorder (PDD)

Formerly known as dysthymia, PDD is a chronic form of depression typically characterized by milder symptoms that persist over a longer period of time — usually two years or more. People with PDD may experience fluctuations in their mood, but they often describe a pervasive sense of low mood that becomes a constant part of their daily lives.

Disruptive mood dysregulation disorder (DMDD)

Disruptive Mood Dysregulation Disorder is a depressive disorder primarily diagnosed in children and adolescents. This disorder is characterized by severe and frequent temper outbursts/an inability to regulate strong emotions. Along with temper outbursts, children and adolescents with DMDD will also commonly experience persistent feelings of irritability or low mood.

Signs and symptoms of depression

Depression can be difficult to recognize in yourself and for those around you. Common signs of depression include:

Persistent sadness or low mood

The most common symptom of depression is an underlying feeling of sadness or low mood that persists for long periods. It’s not just a few bad days — it’s a consistent feeling that never really goes away. It lingers, even when, outwardly, everything is seemingly fine. 

You find yourself feeling down or empty, but you can’t pinpoint the reason why. You may also feel numb or disconnected from your emotions, as if life is passing you by and nothing can make you feel truly happy.

Loss of interest in activities previously enjoyed

Going to the gym, socializing with friends, or taking up hobbies used to bring joy, but now you don’t have the same enthusiasm for them. You often make excuses or procrastinate because it feels like too much effort. Or maybe you just don’t feel as if there’s anything worth doing. Instead, you may find yourself relying on activities that give you a temporary escape, such as substance abuse, overeating, or watching TV for hours on end.

Difficulty sleeping or sleeping too much

Changes to your sleeping pattern can point to various mental health issues, including depression. People with depression may experience difficulty falling asleep (insomnia) or sleeping too much (hypersomnia). You can’t seem to get a good night’s rest no matter how hard you try, or maybe you don’t want to get out of bed because the thought of facing another day is too much.

Unusual fatigue or low energy

Without enough sleep, it’s no surprise you feel tired throughout the day. But even when you manage to rest, there’s still a lingering sense of fatigue and exhaustion. It feels like swimming upstream — no matter how hard you try, you never seem to make any progress. 

You lack the energy to focus on tasks or engage in activities, and even the simplest things can seem overwhelming. The lack of energy and motivation can be debilitating, leading to feelings of guilt or shame for not being able to “just snap out of it.”

Reduced appetite or overeating

Depression can also interfere with your appetite. Some days you don’t feel like eating, and food has no appeal. Other times, food becomes an emotional crutch. You binge eat to fill the emptiness inside or numb the pain. And no matter how much you eat, you can’t seem to satisfy your hunger. 

Overeating can lead to obesity, which can exacerbate other medical conditions and add to feelings of low self-esteem, ultimately affecting your overall quality of life.

Difficulty concentrating

The mental fog caused by mental illnesses affects brain functioning, making it difficult to focus on tasks and complete assignments. It feels like you’re trying to think through a thick haze, constantly forgetting things or being unable to think clearly. You may find yourself zoning out in the middle of conversations or staring blankly at your computer screen, unable to process what you need to do. This can cause problems at work or school, leading to feelings of guilt and frustration.

Feelings of hopelessness or worthlessness

Depression can lead to a distorted view of yourself. You may constantly question your worth and abilities, thinking that nothing you do is good enough. You may feel like a burden to your family or friends, believing that no one understands you or cares about your feelings. 

There is also a persistent fear that things will never improve, leading to a sense of hopelessness. You can find yourself in a vicious cycle of negative thoughts and emotions that can be hard to break out of.

Therapeutic treatment for depressive disorders

Depressive disorders can be treated and managed. Based on the assessment, your healthcare provider will likely recommend a combination of psychotherapy, medication (antidepressants), and lifestyle changes. Below are effective treatment options your health provider can recommend:

Cognitive behavioral therapy (CBT)

CBT is a goal-based form of psychotherapy that involves looking at how your thoughts, feelings, and behavior are linked. It focuses on identifying and changing unhelpful thinking and behavior patterns to help improve mood and functioning. 

CBT can help you challenge negative thoughts, develop healthier coping skills, and increase your self-esteem and sense of worth.

Dialectical behavior therapy (DBT)

DBT is a form of talk therapy that focuses on emotional regulation and mindfulness. It teaches skills like mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness to help you manage difficult emotions and address underlying issues without resorting to destructive behaviors. 

People with depressive disorders can benefit from DBT by learning how to accept and validate their emotions rather than trying to deny or suppress them.

Interpersonal therapy (IPT)

IPT is designed to improve the quality of interpersonal relationships, social functioning, and subjective well-being. It’s a time-limited (12-16 weeks) and evidence-based form of psychotherapy used to treat mood disorders.

IPT helps you focus on developing better communication skills, addressing unresolved conflicts, and improving relationships with family members and friends. You’ll be guided to recognize and express feelings constructively, learn how to set boundaries and practice more effective ways of relating to others.

Mindfulness-based cognitive therapy (MBCT)

MBCT combines cognitive behavioral therapy and mindfulness meditation to help people with depression cope with thoughts, feelings, and behavior. It helps you become more aware of your thoughts and feelings, so you can observe them without judgment.

As a result, you can become less reactive to difficult emotions and develop healthier ways to process and respond. MBCT helps people with depression recognize their sense of being, disconnect from negative thoughts, and develop ways to cope with difficult thoughts and feelings.‍

Tips for managing depression

Feelings of high-functioning depression (which are actually symptoms of depressive disorders) can become chronic and debilitating if left untreated. Managing depression is a journey of self-discovery and self-care. Even though it can be challenging, there are ways to make progress and lead a more fulfilling life.

1. Seek professional help 

If you think you or someone you know may be suffering from depression, the first step should be to seek professional help. A mental health professional can provide a proper diagnosis and guide you toward the right treatment plan.

2. Maintain a healthy diet

You’re what you eat, so it’s important to fuel your body with healthy and nutritious food. A balanced diet can help improve energy levels, boost mood, and provide essential nutrients for overall well-being. Avoid processed foods, sugars, and refined carbs as much as possible and instead opt for lean proteins, fresh fruits, veggies, and whole grains.

3. Adequate sleep

Poor sleep can exacerbate depression by causing fatigue, cognitive impairment, and negative mood. Aim to get at least seven hours of sleep each night and practice good sleep hygiene by establishing a regular sleep schedule, creating a calming bedtime routine, and avoiding electronic devices 30 minutes before bed. Limit caffeine intake after lunchtime and avoid alcohol to ensure better sleep quality.

4. Mindfulness and relaxation techniques

Mindfulness and relaxation techniques like yoga, meditation, deep breathing, and progressive muscle relaxation can help you become more aware of your thoughts and feelings, so you can observe and accept them without judgment. This can help reduce stress, anxiety, and rumination and improve overall well-being.

5. Stay connected with a support network

Support groups, family members, and friends can provide a sense of connection and validation. Sharing your feelings can be a great way to release any built-up emotions and gain valuable perspectives from those closest to you. Reach out to your loved ones and let them know what you’re going through. Remember, isolation can make depression worse, so try to stay connected with your support network.

6. Limit alcohol and avoid drugs

Alcohol and drugs provide temporary relief from negative thoughts and feelings but can have severe consequences in the long run. Substance use can increase feelings of depression and anxiety, worsen mental health symptoms, lead to addiction, and interfere with the effectiveness of antidepressant medications. 

If you’re struggling with substance abuse, seek professional help and consider joining a support group or an addiction program.

7. Practice self-care 

Self-care is essential for physical and mental health. Create time for activities that bring you joy, such as reading, listening to music, spending time outdoors, or engaging in creative activities like cooking, painting, or photography. Take time to treat yourself and practice self-compassion. Even small steps like taking a hot bath, getting enough sleep, or going for a walk can make a world of difference.

8. Establish routines for sleep, exercise, and practicing self-care daily

A routine provides structure and can help you stay organized and motivated to take action. Establishing healthy routines for sleep, exercise, and self-care activities can help you take care of yourself better and build resilience against depression. 

Get the help you need with SonderMind 

Depression can be overwhelming and isolating. The intense feelings of sadness, worthlessness, and disengagement can affect your quality of life and make it difficult to function — even if it doesn’t look like it from the outside.

But it’s important to know that you don’t have to face it alone. SonderMind provides comprehensive mental health services, including psychotherapy and psychiatry. Our community of qualified and licensed healthcare professionals can help you identify your symptoms, develop healthy coping skills, and manage your condition. 

Get connected with a therapist today and take the first step toward a healthier you.