High-Functioning Depression | Understanding the Symptoms

Written by: Angela Derrick, Ph.D. & Susan McClanahan, Ph.D.

Date Posted: August 27, 2024 4:39 am

High-Functioning Depression | Understanding the Symptoms

High-Functioning Depression Symptoms and Their Relationship to Burnout & Perfectionism.

High-functioning depression, while not an official diagnosis, is a form of depression that is long-lasting and generally not as severe as major depressive disorder (MDD), though no less worthy or needful of treatment. Its persistence can lead to severe burnout or worsening depression symptoms over time.

What is High Functioning Depression?

The term high-functioning depression refers to individuals who are able to accomplish their daily tasks and keep up with their responsibilities. Yet, they struggle with their mental health and are reasonably well able to hide this fact, projecting an image that they are doing well. They often conceal their symptoms in an attempt to keep loved ones or co-workers from worrying or getting involved. The sufferer may also genuinely believe there is nothing truly wrong, or it is all in their head, and they may double down on efforts to hide or deny symptoms.

Unlike MDD, which can be noticeably debilitating, high-functioning depression impacts an individual through persistent low moods, fatigue, and depressive symptoms that the sufferer actively masks, making it challenging, if not impossible, to spot. Individuals with high-functioning depression appear to operate normally in their daily lives, maintaining jobs, relationships, and social activities while privately experiencing a continuous, underlying sense of hopelessness, sadness, or emptiness.

Because individuals with this condition may not outwardly exhibit the more visible signs of severe depression, this disorder often goes underrecognized and, therefore, untreated. Individuals with high-functioning depression may appear to be managing their lives effectively and are frequently overachievers even while struggling internally. The appearance of manageability can make it challenging for them to recognize their own symptoms and, likewise, for others to notice their existence.

The appearance of normalcy belies the fact that quality of life is negatively impacted and that the lack of symptom recognition from the outside means a delay in receiving much-needed help. Individuals who live with this daily struggle may not even remember what it was like to feel good, but with treatment and the proper support, recovery is possible.

Symptoms

• Persistent sadness–feeling helpless or hopeless
• Fatigue or low-energy
• Difficulty concentrating
• Changes in appetite and eating habits–eating too little, overeating, binging on junk food
• Trouble sleeping or sleeping too much– still feeling tired even after sleeping
• Low self-esteem
• Negative thoughts about yourself and others
• Spending lots of time scrolling on social media, playing games, or binge-watching shows to distract from feelings of emptiness
• Self-medicating with substances
• Imposter syndrome
• Irritability
• Reduced interest in activities once enjoyed
• Tremendous amount of effort needed to complete daily tasks and stay on top of responsibilities

Causes

The causes of high-functioning depression, as with clinical depression, are multifaceted and can vary from person to person but likely include the following:

Biological Factors

There is a hereditary component to depression. Individuals with a family history of depression are more likely to develop the condition themselves. There is also evidence that brain structure and neurochemistry can play a role as these affect how the brain processes emotions and stress.

Psychological Factors

Certain personality traits, such as perfectionism, impatience,  high self-criticism, insecurities, and a tendency toward pessimistic thought patterns, may increase the risk of developing high-functioning depression. In addition, these individuals often have persistent negative thoughts and beliefs about themselves and their abilities. These cognitive distortions can lead to a chronic sense of inadequacy and low self-esteem.

Environmental Factors

Long-term exposure to stressors, such as work pressures, a toxic work environment, financial difficulties, family responsibilities, or relationship issues, are contributing factors. Chronic stress can deplete an individual’s emotional and physical resources, leading to persistent low mood. Traumatic or significant life events, such as the loss of a loved one, divorce, or a serious illness, can also trigger depressive symptoms. Even moving to a new city or starting a new job, events that we perceive as positive can still be stressful and potentially contribute to depression.

Social and Cultural Factors

Lack of strong social connections and support can increase the risk of depression. People with high-functioning depression may isolate themselves, further exacerbating their symptoms. Societal pressures and cultural expectations can also influence how individuals perceive themselves. For example, the stigma surrounding mental health can prevent people from seeking help, leading to prolonged suffering.

Who is Affected?

High-functioning depression can affect anyone, regardless of age, gender, or background. However, it is often seen in individuals who:

• Have a family history of depression or other mental health disorders
• Experience chronic stress or have high-stress jobs
• Have perfectionistic or high-achieving personality traits
• Were parentified as children
• Are dealing with significant life changes or trauma

Relationship to Burnout

Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, traditionally occurring in the workplace.

While burnout and high-functioning depression are distinct conditions, they can be related, and there is an overlap in symptoms. Both conditions can cause fatigue, lack of motivation, and difficulty concentrating. Chronic stress from burnout can contribute to the development of depression. Conversely, individuals with depression may be more susceptible to burnout due to their ongoing emotional struggles.

Occupational Burnout Symptoms

Occupational burnout is a psychological condition characterized by untreated, chronic workplace stress. It’s important to note that burnout is not only relegated to the workplace; it also impacts those working from home or raising a family. The symptoms of burnout encompass three main categories: emotional exhaustion, depersonalization, and reduced personal accomplishment.

Emotional exhaustion manifests as feeling drained and overwhelmed by work demands, leading to a lack of energy and motivation. Individuals may feel fatigued even after adequate rest, and the idea of facing another workday becomes daunting.

Depersonalization involves a sense of detachment or cynicism towards one’s job, colleagues, or clients, resulting in an impersonal, cold, or distant attitude. This attitude can lead to strained relationships at work or within the family and a diminished sense of empathy or care.

In addition to these emotional and attitudinal changes, occupational burnout also affects personal accomplishment. Individuals experiencing burnout may feel ineffective, unproductive, and incapable of achieving their goals. This reduced sense of efficacy can further erode confidence and job satisfaction, creating a vicious cycle that perpetuates burnout.

Physical symptoms often accompany these psychological changes, including headaches, insomnia, digestive issues, and an increased susceptibility to illness due to a weakened immune system. If left unaddressed, occupational burnout can significantly impair both professional performance and overall well-being, highlighting the importance of early recognition and intervention.

Relationship to Perfectionism

Perfectionism is often a feature of high-functioning depression due to the following reasons:

High Standards and Self-Criticism

• Unrealistic Expectations: Individuals with high-functioning depression often set exceedingly high standards for themselves. They may feel a constant need to achieve and excel in all areas of their life, including work, relationships, and personal goals.
• Self-Criticism: When these high standards are not met, they tend to engage in severe self-criticism, blaming themselves for perceived failures and shortcomings. This can lead to feelings of inadequacy and a persistent low mood.

Fear of Failure and Overcompensation

• Fear of Failure: The fear of failure can be overwhelming for perfectionists. They may push themselves to work harder and longer hours to avoid making mistakes or falling short of their expectations.
• Overcompensation: In an attempt to cope with their depressive symptoms, individuals with high-functioning depression may overcompensate by striving for perfection in their tasks. This behavior can temporarily relieve their feelings of worthlessness but often leads to burnout.

External Validation and Self-Worth

• Dependence on External Validation: Perfectionists often seek external validation and approval to feel worthy and competent. They may rely on praise and recognition from others to boost their self-esteem.
• Conditional Self-Worth: Their sense of self-worth is often conditional, depending on their achievements and successes. When they fall short, their self-esteem plummets, worsening their depressive symptoms.

Avoidance of Vulnerability

• Avoiding Vulnerability: Perfectionists may avoid showing vulnerability or asking for help, believing it to be a sign of weakness. They may put on a facade of competence and control, hiding their struggles and emotional pain from others.
• Isolation: Avoiding vulnerability can lead to social isolation, as they may distance themselves from others to avoid judgment or criticism. The lack of emotional support and connection can make their depression worse.

Rigid Thinking Patterns

• All-or-Nothing Thinking: Perfectionists often engage in all-or-nothing thinking, viewing situations as either perfect or a complete failure. This black-and-white perspective can contribute to feelings of hopelessness and frustration.
• Difficulty with Flexibility: They may struggle to adapt to changes or setbacks, feeling overwhelmed by any deviation from their plans or expectations.

How to Address Perfectionism in High-Functioning Depression

1. Cognitive-Behavioral Therapy (CBT): CBT can help individuals identify and challenge perfectionistic thoughts and behaviors, replacing them with more balanced and realistic perspectives.
2. Mindfulness Practices: Mindfulness and meditation can help individuals become more aware of their thoughts and feelings, allowing them to develop a more compassionate and accepting attitude towards themselves.
3. Self-Compassion: Learning to practice self-compassion involves treating oneself with kindness and understanding, especially in the face of perceived failures or mistakes.
4. Set Realistic Goals: Setting achievable and realistic goals can help reduce the pressure of perfectionism. Breaking tasks into smaller, manageable steps can make them feel less overwhelming.
5. Embrace Imperfection: Accepting that imperfection is a natural part of life and learning from mistakes can lead to personal growth and resilience.
6. Seek Support: Talking to a therapist, joining support groups, or confiding in trusted friends and family members can provide emotional support and reduce feelings of isolation.

High-Functioning Depression Vs. Major Depressive Disorder

The differences between high-functioning depression and major depressive disorder (MDD) are in intensity, duration, and impact on daily life. High-functioning depression is characterized by a chronic, low-level depression that lasts for at least two years. Individuals with high-functioning depression may appear to function relatively well in their daily lives, maintaining work, relationships, and social activities, but they often experience a persistent sense of sadness, fatigue, and low self-esteem. This ongoing state of low mood can be draining over time, making it difficult for the person to experience joy or fulfillment, even though they may not appear visibly distressed to others.

On the other hand, major depressive disorder is more intense and typically occurs in episodes that can last weeks or months. Severe symptoms, including profound sadness, hopelessness, loss of interest in activities, significant weight changes, sleep disturbances, and thoughts of death or suicide, characterize MDD. Unlike high-functioning depression, MDD often leads to noticeable impairments in a person’s ability to carry out daily activities. The episodes can be debilitating, making it challenging for individuals to maintain their responsibilities at work, school, or home. While both high-functioning depression and MDD are serious conditions that require attention and treatment, the main differences lie in the severity of the symptoms and the visible impact on one’s ability to function in everyday life.

High-Functioning Depression Awareness on Social Media

Popular creators in the mental health space on TikTok and other social media platforms often discuss these topics, and you can look for videos by professionals such as therapists or psychologists who share insights and tips on managing high-functioning depression. Some of the most popular hashtags when searching for this content are:

• #HighFunctioningDepression 
• #Dysthymia
• #MentalHealthAwareness
• #MentalHealthMatters
• #BurnoutRecovery

How Does Therapy Help in the Treatment of High-Functioning Depression?

Treatment for high-functioning depression can typically involve a combination of therapy, medication, and lifestyle changes. Cognitive-behavioral therapy (CBT) and other therapeutic approaches can help individuals identify and change negative thought patterns, while medications such as antidepressants can help balance brain chemistry and elevate mood. Additionally, lifestyle changes such as regular exercise like walking or practicing yoga, good nutrition, and mindfulness and stress management techniques can support overall well-being. The treatment recommendations we just explored for perfectionism can also have a profoundly positive effect on depression. Seeking professional help and support from friends and family is crucial for individuals dealing with depression.

At SpringSource Psychological Center, we are experienced in treating all forms of depression, including high-functioning depression. Our therapists are skilled in CBT and many other evidence-based therapies utilized in therapy for depression. We understand that the path to healing varies, and we focus on compassionately addressing each individual’s unique needs. We are available for in-person and virtual appointments in our downtown Chicago and Northbrook, IL offices. Call us today at 224-202-6260 to learn more and set up your free initial consultation. We would love to hear from you.