Warning Signs of High-Functioning Depression & How to Cope with Symptoms

Written by Dr. Paul Kelly, PhD, C.Psych.              February 12, 2024

Are you curious about high-functioning depression? Check out this information.

• What is high-functioning depression?
• How to tell if you have it?
• What are the risks of ignoring it?
• How can friends and family support you?
• How lifestyle changes can help you overcome depression.
• How to choose the right therapy and therapist.

What is Depression?

Depression is a common but serious mood disorder. It affects how you feel, think, and handle daily activities. It can affect your sleeping, eating, or working. It’s more than just feeling sad or going through a rough patch. Sadness is temporary. Depression lasts longer. It can significantly impact your life. People with depression usually feel a deep sense of sadness. They lose interest in activities they once enjoyed. And they often struggle with feelings of worthlessness or guilt.

What Is High-Functioning Depression?

The term ‘high-functioning depression’ describes a common form of depression. It is also called dysthymia. It applies to people who are keeping up with their daily responsibilities, even though they have depressive symptoms. They can still go to work or school. They can still take care of their children. They might look successful on the outside. But on the inside, they don’t feel normal. They feel sad and discouraged. They feel worthless and hopeless.  They are really struggling.

High-functioning depression is also known as walking depression. People with this form of depression push themselves. They don’t want others to think that they can’t handle things. Sometimes, they don’t know that they have depression until it gets worse.

What Are the Warning Signs of High-Functioning Depression?

Why This Matters: If you are sad, it will pass. If you have high-functioning depression, then you probably need to do something.

Sometimes, people have high-functioning depression but don’t know. It can build slowly over time. Check the warning signs below to see if you have high-functioning depression. It would be better to know. If you know, then you can take steps to recover. You deserve to feel better.

1. Constantly Tired: Even if you get enough sleep, you feel worn out all the time, like you’re running on empty.
2. Feeling Down: You might feel sad or hopeless more days than not, even when there’s no big reason for it.
3. Losing Interest: Things you used to enjoy might not seem fun anymore. It’s like your favorite hobbies just don’t excite you.
4. Hard to Focus: You might find it tough to concentrate on homework, reading, or even watching TikTok videos.
5. Feeling Worthless: Sometimes, you might think you’re not good enough or criticize yourself more than usual.
6. Eating Changes: You might eat more or less than you used to, which can mean you’re not hungry or you’re eating when you’re not hungry.
7. Sleep Problems: You could have trouble falling asleep, staying asleep, or you might sleep too much and still feel tired.
8. Getting Irritated Easily: Little things might annoy you more than they should, like small noises or people’s habits.
9. Avoiding Friends: You might start to pull away from your friends and family, preferring to be alone even when you used to like being with them.
10. Feeling Numb: Sometimes, you might not feel much at all, like you’re just going through the motions of your day without really feeling anything.

What is the Risk of Not Recognizing High Functioning Depression?

Why This Matters: You can make wiser choices if you understand the risks of ignoring your depression symptoms.

If you have high-functioning depression, it is not a good idea to just carry on. Things can get worse if you ignore high-functioning depression. I know that it can be scary to admit a problem. But being honest is the first step to recovery. Check the list. If you worry about some of these things, talk to a friend or family member. Let them help you figure out what to do. Don’t keep it a secret. You deserve to feel better.

1. Getting Worse: Your depression might get deeper over time. Ignoring it doesn’t make it go away; it can make things harder in the long run.
2. Physical Health Problems: Stress and depression can lead to real body issues like headaches, stomach problems, and heart trouble.
3. Relationship Issues: You might start having more fights or misunderstandings with friends and family because they don’t know what you’re going through.
4. Work or School Trouble: Concentrating or caring about work or school might get harder. You could end up with lower grades or problems at your job.
5. Substance Use: Some people start using alcohol or drugs to feel better. This could lead to addiction and more problems.
6. Isolation: You might pull away from people and feel lonely. This could make your depression even harder to handle.
7. Self-Harm: You might start to hurt yourself as a way to deal with the pain.
8. Suicidal Thoughts: Ignoring depression can lead to thinking about suicide as a way out. It’s very important to get help before thoughts turn into actions.

How Can Friends and Family Help with High-Functioning Depression?

Why This Matters: Your friends and family want to help. Show them the list so they can support you.

Friends and family can play an important role in your recovery. No one recovers from depression in a vacuum. We all need some help. Sometimes people are not sure how to help. Show them the list below. Tell them which things are most important for you.

Advice for Friends and Family. What to Do:

1. Listen Without Judging: Let them know you’re there to listen, not to judge. Sometimes, just being heard can make a big difference to someone.
2. Encourage Sharing: Gently encourage them to talk about how they’re feeling. You can share your own feelings to show it’s okay to talk about these things.
3. Encourage Activities: Invite them to do things with you that could be enjoyable. Help them to start or work on something to give them a sense of accomplishment.
4. Read Lifestyle Section Below: There is a list of lifestyle advice in the next section. Read it. Can you help your loved one start some of these good habits?
5. Suggest Professional Help: Talk about how seeing a psychologist or therapist could help. Offer to help them find someone. Perhaps go with them to their first appointment.

Advice for Friends and Family. What to Avoid:

1. Don’t Overlook Their Feelings: Take their feelings seriously if they do open up. You don’t need to give advice, just show that you are with them.
2. Don’t Push Them Too Hard: If they’re not ready to talk, give them space. If they are not ready for a big step, help them with a small one.
3. Avoid Cliché Advice: Saying things like “Just cheer up” or “Look on the bright side” isn’t helpful.
4. Don’t Make Them Feel Guilty: Avoid making them feel bad for being depressed. It’s not their fault.
5. Take Care of Yourself: Supporting someone with depression can be draining. Make sure you’re looking after your own mental health, too.

Good Habits and Lifestyle to Overcome High-Functioning Depression

Why This Matters: Simple lifestyle changes can help you to prevent or overcome high-functioning depression.

These good habits and lifestyle changes can go a long way to helping you prevent or overcome high-functioning depression. Have a look at the list. What would be the easiest thing for you to start with? That would be a good choice. Ask a friend or family member to support you with the lifestyle change that you want to start with. Take it slow. Try one thing at a time. That is the best way to move forward when you have been depressed. I know. I have been there myself.

1. Regular Exercise: Doing physical activity, such as walking, running, or yoga, can significantly boost your mood. Exercise releases endorphins.
2. Healthy Eating: Eat a balanced diet of fruits, vegetables, whole grains, and lean proteins. Omega-3 fatty acids found in fish, and folic acid found in leafy greens, are particularly helpful for depression.
3. Limit Screen Time: Too much time on phones, computers, or watching TV can make you feel more down. Try to set some limits for yourself and spend more time doing things in the real world.
4. Connect with Others: Spend time with friends or family who make you feel good about yourself. Talking and sharing with people who care about you can make you feel less alone and more understood.
5. Do Things You Enjoy: Engage in activities that you enjoy and find meaningful. This will help you feel better about yourself and will boost your mood. Try something active like learning to play an instrument, paint or draw, or embroidery.

Would you like more advice? Have a look at this article.

Psychotherapy Treatment for High-Functioning Depression

Why This Matters: People can get stuck in depression because they feel hopeless. Learn how therapy can help get you unstuck.

Here is the Good News: Psychotherapy is a very effective treatment for high-functioning depression.  Have a look at the list below. Which type of therapy feels right for you? They are all safe choices. All of them can help you overcome depression. Most therapists are eclectic. They know about several types of therapy. They blend them to make a personal treatment approach for you. You can trust this way of working. Eclectic therapy can be very effective.

Here is the Hardest Part: Starting therapy is often the hardest part. People with high-functioning depression cope by keeping going. Often, they are afraid to slow down and look at things. They are afraid that they will crash. Does this feel like you? Don’t let this feeling keep you away from therapy. A good therapist can help you have an honest look at your life. And they can help you find your way out of depression. They can give you advice. They can help you feel less ashamed. They can show you how to return to yourself and your life. You deserve to feel better. A good therapist can help you get there.

A Tip About Therapists: Make sure you find a therapist who feels right for you. Who your therapist is matters more than the type of therapy. If your therapist is rigid, passive, cold, or disorganized, then you probably need a different therapist. There are some really good therapists out there. You deserve to work with one. Check my article about this for more advice.

4 Types of Psychotherapy for High-Functioning Depression

1. Acceptance and Commitment Therapy (ACT): ACT uses acceptance and mindfulness strategies. You learn to live according to your personal values, with kindness for yourself.
2. Cognitive Behavioral Therapy (CBT): This talk therapy helps you challenge negative thoughts so you can behave differently and improve your mental wellbeing.
3. Behavioral Activation (BA): BA helps you get moving and doing. When you complete more rewarding activities, you will feel more hopeful, and your mood improves. BA is simple and powerful. All by itself, it can be an effective treatment for severe depression. Here is how to get started.
4. Mindfulness-Based Cognitive Therapy (MBCT): MBCT combines cognitive therapy with mindfulness. You learn coping skills to overcome negative thinking. MBCT training also protects people from having a second bout of depression, after the first cure.

A Personal Note

I know how tough depression can be. I had high-functioning depression for a year when I was in graduate school. I finally saw a therapist when the strain became too much. Things started to get better after I had professional support. We are all human, and sometimes life throws us a big curve ball. Trust yourself, and also get advice from your family and friends. If they think you should try a therapist, be open to the idea. You deserve to feel better.

Sources

It is important to me that you find practical and trustworthy information. That is why I personally selected and reviewed all the sources for this article. My advice is also based on my decades of experience, working in hospitals, treating clients, and mentoring other therapists and psychologists.

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (fifth edition.). Arlington, VA.
• Barlow, D.H. (Editor). Clinical Handbook of Psychological Disorders: A Step-by-Step Treatment Manual, (sixth edition). The Guilford Press, 2021.
• Dozois, D. & Dobson, K. (Editors). Treatment of Psychosocial Risk Factors in Depression. American Psychological Association. Washington DC. 2023
• National Institute of Mental Health. Depression. (2024). Retrieved from: https://www.nimh.nih.gov/health/topics/depression.
• American Psychological Association (2023, March) Overcoming Depression: How Psychologists Help with Depressive Disorders. Retrieved from: https://www.apa.org/topics/depression/overcoming.
• American Psychiatric Association (October, 2020). What Is Depression? Retrieved from: https://www.psychiatry.org/patients-families/depression/what-is-depression.