High Functioning Depression is sometimes called “Functional Depression,” but is formally known as “Persistent Depressive Disorder” and is just one type of depression affecting millions of people around the world.
Most people can identify with occasionally experiencing a bad mood or lack of contentment and joy in their life. But this mood usually passes with time.
For others, they are coping with high functioning depression and even though they’re handling their daily life, they find little to no relief from the symptoms.
Mental health issues are far more common than most people realize The World Health Organization (WHO) reports that depression is the leading cause of disability globally, affecting an estimated 264 million people worldwide.
In the United States, the Centers for Disease Control and Prevention (CDC) estimates around 5 percent of the population deals with this condition. In fact, more than 9 percent of emergency room visits in the U.S. list depression on the medical record.
Public awareness and understanding of mental health issues is at an all time high, but there is still a certain stigma associated with these disorders. What’s more, some people might not even realize that they’re suffering from a common form of depression.
What is High Functioning Depression?
What is typically referred to as high functioning depression is actually a diagnosis of Persistent Depressive Disorder (PDD).
This diagnosis is characterized by symptoms that are less severe than major depressive disorder (MDD), but tend to last much longer.
Formerly known as Dysthymia, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), known as the “bible of psychiatry,” now lists this condition as persistent depressive disorder.
With High Functioning Depression (PDD), which can last two years or longer, the symptoms of depression certainly impact a person’s health and wellbeing, though they are not necessarily debilitating.
This is very often why high functioning depression flies under the radar of both medical professionals and those suffering from it. Because a person is able to get on with their daily life, despite how they feel, PDD is often missed, or the symptoms are simply ignored altogether.
People with this mood disorder often appear normal on the outside to others, despite the inner symptoms they experience, hence the name “functional depression.”
In addition, some of the causes of high functioning depression are considered just a part of a life. While that’s true in one respect, it doesn’t mean that a person should not seek help if they need it.
What Causes High Functioning Depression?
Depression affects each person differently, both in the symptoms and the root causes.
Noticing the signs as they appear will make it easier to identify the causes and triggers.
Causes of Persistent or High Functioning Depression Can Include:
- Chronic stress at home
- Toxic anxiety at work
- Severe illness
- The loss of a loved one
- Physical or emotional trauma
- Substance abuse and dependency
- Social isolation
While these are common triggers for depression, there are many other situations and circumstances that can bring about difficult symptoms.
It’s quite common for people to self-medicate depression with drugs or alcohol, and it can help numb the symptoms temporarily.
But over time, this method will fail to provide effective results and can lead to addiction. If this happens, treating depression and addiction becomes much more complicated.
High Functioning Depression Symptoms
Whatever the cause, people living with high functioning depression do experience symptoms that make life harder.
Understanding and recognizing these symptoms is the first step in finding some relief.
Symptoms of High Functioning Depression Can Include:
- A cycle of negative thoughts and feelings, ranging from guilt and shame to hopelessness and worthlessness
- Difficulty concentrating or focusing, even on things that previously brought enjoyment
- Chronic exhaustion and fatigue
- Anhedonia
- Sleeping problems, such as insomnia or oversleeping
- Poor self-image
- Self-medicating with drugs and alcohol
Anhedonia leads to a lack of pleasure from previously enjoyable experiences. Anhedonia causes include depression, bipolar disorder, PTSD, substance use, and other mental health issues.
It’s human nature to shrug off poor mental health. But when left untreated, people with high functioning depression can suffer poor quality of life and are at serious risk of developing major depressive disorder.
High Functioning Depression Treatment
Like other mental illnesses, high functioning depression is highly treatable. When experiencing symptoms, it’s important to speak honestly with your healthcare provider or therapist about what’s going on.
1. Therapy Counseling
Treatment is generally effective with one-on-one therapy counseling or talk therapy. It’s necessary to be open an honest about everything with the therapist to see the best results.
2. Antidepressant Medications
If needed, antidepressant medications can improve mood and performance and these work even better if taken alongside regular therapy visits.
3. Therapeutic Interventions
Therapeutic interventions, such as Cognitive Behavioral Therapy (CBT), are also incredibly useful for adapting tools to cope with depressive symptoms.
Neurofeedback Therapy is an approach that works well for treating depression by analyzing brainwave activity and training the brain to manage neural activity and reduce negative thought patterns.
For those who have not had success with medication and develop major depressive disorder, TMS Therapy is an excellent option for overcoming treatment-resistant depression. TMS is also known as Transcranial Magnetic Stimulation, which is a safe and effective treatment modality that is approved by the FDA.
4. Lifestyle Changes
Perhaps the most effective and lasting treatment is maintaining a healthy lifestyle.
This means getting regular exercise, eating a nutritious and balanced diet, and avoiding chemicals, like alcohol and drugs that negatively impact the brain’s chemistry.
All of these activities increase production of dopamine, known as the happy hormone because it boosts pleasure and motivation.
These types of lifestyle changes also improve levels of serotonin to lift a person’s mood and feel happier. Learning how to increase serotonin can be as easy as eating the right foods and exercising.
High functioning depression does not have to be a way of life. Though it may be difficult to ask for help at first, the reward is a more fulfilling and happier life.
Frequently Asked Questions
Does high functioning depression really exist?
Yes, High functioning depression really exists although it’s not considered a clinical diagnosis in the DSM-5.
The term is often used to describe people who experience depression but still maintain regular responsibilities and outwardly appear to others to not struggle with depressive symptoms.
The formal clinical term for the condition is persistent depressive disorder, although some individuals call it dysthymia.
How is persistent depressive disorder different from major depression?
High functioning or persistent depressive disorder differs from major depression (MDD) in the severity, duration, and other factors related to the symptoms.
High functioning depression symptoms are usually milder and more consistent than major depression, yet they can last or persist for 2 years, whereas MDD symptoms may be shorter.
Because the symptoms are milder, many people can still maintain a regular routine with less impact on daily life. Major depression often impairs work, personal, and social aspects of daily living and makes it difficult to function normally.
Can high-functioning depression lead to major depression?
Yes, individuals with high functioning or persistent depression have a higher risk of developing major depression, and many of these people will experience at least one major depressive disorder episode in their lifetime.
The symptoms of the two conditions generally overlap and if left untreated, they may become worse over time. With that said, high functioning depression doesn’t always develop into major depression.
How can I tell if my symptoms are caused by high functioning depression or just a bad mood?
High-functioning depression symptoms last for 2 years or more. They are chronic and consistent, affect sleep and appetite, may cause physical symptoms like headaches, and can create feelings of low self-esteem.
A bad mood typically passes after a few hours or days and has acute symptoms that come and go based on negative events or circumstances.
A bad mood can make it difficult to sleep, although only for a few nights until it passes, and it isn’t usually associated with physical symptoms.
Can high functioning depression go away on its own?
It’s possible high functioning depression will go away on its own, but like with most chronic conditions, treatment is often necessary for recovery.
The longer depressive symptoms persist, the more difficult it becomes to manage and improve negative thoughts and feelings.
Focusing on self-care, regular exercise, healthy eating habits, proper sleep, and avoiding alcohol or other substances will increase the chances of recovery, either with or without professional treatment.
