High functioning depression is often swept under the rug.
The stigma clinging to depression (and other mental illnesses) is as insidious as it is pervasive, operating in discreet ways that often go unrecognised. Stigma lingers even in spaces where depression is openly discussed, limiting the popular perception of who a person with depression might be and how the illness might manifest. In fact, there are sometimes signs you have high functioning depression that even someone clued up on mental health might miss.
Too often, people with depression are depicted as exclusively white, cis, straight women, while the disease itself is presented as an all-consuming, incapacitating misery that binds its victims to their beds. Such a narrow scope excludes the experiences of millions of PoC and LGBTQIA+ people with depression. What’s more, it ignores the existence of high-functioning depression, denying people the chance to recognise their illness and seek the help they deserve.
High functioning depression — referred to alternately as persistent depressive disorder (PDD) or, less recently, dysthymia — is a form of chronic depression, as the Mayo Clinic explains. Though people with high functioning depression may experience symptoms less acutely than those with major depression disorder, WebMD notes that “the depression symptoms can linger for a long period of time, often two years or longer.” You might ostensibly be able to go about your daily routine with high functioning depression, despite persistent feelings of sadness or exhaustion. But the illness is still a serious one that warrants treatment. You’re worth more than your utility, and you deserve more from life than simply going through the motions. So if any of the following signs ring true, consider seeing your GP to find out how to get help.
You’re Sleeping Too Much Or Too Little
According to WebMD, “insomnia or excessive sleep almost every day” is another sign of high functioning depression. If you know before hitting the light switch that you’ll struggle to get to sleep, or you get 10 hours every night and still can’t stay awake at work, something more serious could be going on, and it might be worth speaking to a professional about it.
You’ve Got Physical Pain And You Don’t Know Why
Do you have a constant mysterious headache no amount of Nurofen will shift, or a backache no doctor can find the root of? Talkspace, an initiative designed to make therapy affordable for all, suggests that experiencing “aches or pains, headaches, cramps, or digestive problems without a clear physical cause” could indicate that you’re actually dealing with high functioning depression.
You Don’t Enjoy The Things You Used To
Speaking to Women’s Health Australia, psychologist Suzanne Leckie listed “experiencing less pleasure in usual activities” as a diagnostic criterion for high functioning depression. Too often, people with depression are told to simply cheer themselves up with a favourite TV show or hobby, ignorant to the reality that once-favourite activities have lost all their appeal. If this sounds all too familiar, don’t hesitate to make an appointment with a medical professional.
You Always Feel Worried Or Guilty
If you feel an inordinate sense of responsibility toward everything, can’t shake persistent worries, and frequently find yourself ruminating over past actions, you might be experiencing high functioning depression. The Mayo Clinic includes “feelings of guilt and worries over the past” in their list of symptoms; if they’re dominating your mental space, consider talking to your GP.
You’re Irritable And Easily Angered
Psychotherapist Annie Wright wrote for The Mighty, “if you find yourself exploding in a way that feels disproportionate to the event, if irritability and excessive anger are something you’re wrestling with, this may be a sign.” If you’re constantly tempted to blow up at people, or the slightest annoyance reduces you to tears of rage, resist the urge to demonise yourself — you might actually be living with high functioning depression.
You’re Constantly Exhausted
Another potential sign of high functioning depression is “decreased energy or fatigue,” according to Talkspace. Too often, we measure our capacities by the tasks we’ve been able to complete, ignoring the physical or mental toll these tasks are taking. Don’t minimise your exhaustion because you still make it to work on time — if the fatigue is persistent, schedule an appointment with a doctor.
You Feel Awful About Yourself
Psychology Today lists “low self-esteem” as one of the symptoms of high functioning depression. Though you might be reluctant to talk about your self-image, doing so can be the first step toward recognising your self-perception is skewed, and you are worth far more than your depression wants you to believe.
Your Friends And Family Think Everything’s Fine
... but you know it isn’t. As Suzanne Leckie explained in Women’s Health, “With PDD, people experience many of the same symptoms but to a lesser degree which enables them to still get out of bed in the morning and do much of what they need to do.” She added, “This means that the depression may not be evident to others and can come as a surprise to extended family and colleagues.” Don’t depend on the perceptions of others to determine whether you might have a problem — just because your depression isn’t immediately apparent, doesn’t mean it isn’t real.
Because high functioning depression is more difficult to detect than major depressive disorder, it's often swept under the rug, despite the distress it can cause. Worse, because high functioning depression or PDD typically persists over several years, it’s possible to simply adjust your baseline and believe that a state of constant unhappiness is just how it’s always been. But if you recognise yourself in the symptoms listed above, challenge your brain’s narrative and make an appointment with a doctor. Happiness is attainable. You deserve it.