Updated on 2/1/2023

Depression takes many forms and can affect people in various ways. High-functioning depression is a term used to describe someone who doesn’t show many outward symptoms of depression. When you’re living with high-functioning depression, you may appear fine on the outside, but on the inside you’re struggling with symptoms like low mood, hopelessness, lack of energy and motivation, and more.  

If you suspect you or a loved one might be dealing with this common yet treatable form of depression, help is available. Read on to learn more. We’ll look at what high-functioning depression symptoms — emotional and physical — can look like, what causes might contribute to someone developing it, and most importantly, how to deal with it.   

What Is High-Functioning Depression?

While depression can cause significant impairment, it doesn’t always inhibit a person’s ability to function daily. Depression exists on a broad spectrum, and the intensity of symptoms can vary. 

High-functioning depression isn’t a clinical term or a diagnosis. Instead, it’s a descriptor for a type of depression with particular symptoms. While some types of depression cause people to lose their ability to function in their daily life, high-functioning depression is different. People with this type of depression often keep a job, maintain relationships, and meet other obligations. High-functioning depression means it’s easier for someone to mask their mild or severe symptoms, but this form of depression still makes life (and relationships!) complex. 

Many people with high-functioning depression are diagnosed with a condition referred to as persistent depressive disorder (PDD) (also known as dysthymic disorder). This chronic form of depression has mild to moderate symptoms. People with PPD can experience major depressive episodes during which symptoms are more severe. 

Signs & Symptoms of High-Functioning Depression

Some high-functioning depression symptoms are similar to what people with other types of depression experience. Symptoms of depression can be emotional and/or physical and may vary in intensity. 

Emotional symptoms

Emotional symptoms of high-functioning depression can include: 

  • Persistent low mood
  • Feeling sad, worthless, or hopeless
  • Feelings of guilt or shame
  • Irritability 
  • Low self-esteem 
  • Anxiety 
  • Suicide ideation or thoughts of self-harm
  • Frequent crying 
  • Difficulty enjoying activities 

Physical symptoms

There are multiple common physical high-functioning depression symptoms. They may include things such as:

  • Lack of energy 
  • Changes in appetite 
  • Sleep disturbances 
  • Aches and pains 
  • Chronic fatigue 
  • Digestive issues 
  • Moving more slowly than usual 
  • Headaches

“If other people cannot recognize something is wrong, which is especially true with high-functioning depression, the individuals struggling will have less natural support in their community. This can impact the intensity and severity of symptoms, making these individuals feel that they are alone in this journey.”

Talkspace therapist Meaghan Rice PsyD., LPC

How to diagnose high-functioning depression

Considering that high-functioning depression isn’t an official diagnosis, a high-functioning person with depressive symptoms might have PDD or another type of depressive disorder. 

Often, when a person shows signs of depression, healthcare providers will run exams and tests to rule out medical conditions that could be contributing to these symptoms. 

From there, a doctor or mental health professional will ask questions to learn more about the symptoms someone’s been experiencing. They may also ask about any family history of depression or other mental health conditions. Professionals use this information to provide patients with an accurate depression diagnosis and a depression treatment plan.

What Causes High-Functioning Depression?

Experts don’t know exactly what causes depression. They also don’t understand why depression affects people in different ways. Depression can occur for many reasons, and several factors can put some people at increased risk of developing this mental health condition. 

  • Stress: Prolonged stress and challenging life events, such as an abusive relationship or the death of a loved one, can be triggers for depression
  • Trauma: Trauma that creates stressful environments can cause a host of mental health conditions, including anxiety, post-traumatic stress disorder (PTSD), and, yes, depression. 
  • Genetics: Studies also suggest that there may be a genetic component to depression. Depression often runs in families, and someone with a family history of depression is more likely to be diagnosed with depression later in life. 
  • Health: Chronic or sudden health conditions can lead to high-functioning depression, as people might go into survival mode just trying to cope with their issues.
  • Brain chemistry: Brain chemicals known as neurotransmitters regulate mood. When there’s an imbalance, depression might be the result.  
  • Substance use and abuse: Research shows that almost 20% of alcoholics are high-functioning and able to keep a job and maintain relationships. The link between addiction and depression is well-established, so it should be no surprise that addicts can live with high-functioning depression. 

Why are some people with depression able to function so well? First, there are different types of depression, and symptom severity can vary from person to person. Don’t forget, many people with depression feel tremendous pressure to hide symptoms of depression from others. This can be true even if depressive symptoms are causing distress. 

The Challenges of Living with High-Functioning Depression

Although high-functioning depression doesn’t always seem to impact a person’s ability to function, it can still be intensely challenging. Even if someone can handle their day-to-day obligations, depression often makes even mundane, simple tasks harder. 

Some people with high-functioning depression say they feel as if they must mask and conceal their symptoms. This can leave them feeling isolated, potentially making symptoms worse. Others may be afraid to talk about their struggles because their symptoms aren’t “that bad.”

“There’s a lot of societal reinforcement for those with high-functioning depression who have success, ambition, and perfectionism. Other people notice these qualities above anything else and will, sometimes without noticing, offer reinforcement. This can fuel the depression cycle, even if the side effects are terribly devastating.”

Talkspace therapist Meaghan Rice PsyD., LPC

Many people with functional depression also feel that they’re not sick enough to seek treatment. This ultimately prevents them from getting support for their issues. Since the symptoms of high-functioning depression aren’t as obvious, many people suffer in silence. Hiding symptoms can take a toll, though. Without help, many people find that their symptoms worsen over time. 

How to Deal with High-Functioning Depression

Some people with depression can indeed function in their life, but this doesn’t mean that their symptoms aren’t difficult to cope with. In addition to being weighed down by their condition, the pressure to conceal the signs can become overwhelming. Thankfully, people with high-functioning depression often benefit greatly from treatment. 

For someone with high-functioning depression to get help, the first step is getting a diagnosis from a mental health professional. From there, they can explore different forms of treatment, including therapy, medication for depression, and lifestyle changes. Treating high-functioning depression can boost mood, enhance relationships, and make it easier to function and improve overall quality of life.

Treat High-Functioning Depression with Talkspace

Depression affects millions of people across the globe. While not everyone with depression has the same level of impairment, anyone with a depressive disorder can benefit from treatment. Talkspace makes it easy to find an online therapist who can give you the support you need. 

If you or a loved one is living with high-functioning depression, reach out to Talkspace today. You can get help, and online therapy from Talkspace can be exactly where you find it. Online therapy offers a convenient, affordable approach to mental health care. Talkspace therapists are trained, qualified, and ready to help you manage your depression. Reach out today to get started with therapy for depression