Treatment for High Functioning Depression

Not everyone with depression shows it on the outside. Some people experience a form of “high functioning” depression, which is more internal than external, more hidden than visible. Thankfully, there is effective treatment for high functioning depression.

What is High Functioning Depression?

Most of us are aware of what depression looks and feels like, at least to some extent. When we think of depression we visualize someone who is sad, withdrawn, and not interested in their usual activities anymore.

However, depression is a complex mental health condition that presents in a variety of different ways. One of these ways is referred to as “high functioning” depression. This term describes someone with depression who can still function at work, school, or parenting.

Persistent Depressive Disorder

High functioning depression is not yet recognized as a clinical diagnosis in the DSM-5. Even so, mental health professionals liken this type of depression to persistent depressive disorder (PDD), also called dysthymia.

PDD refers to a form of depression with less severe symptoms, compared to major depressive disorder. PDD is called persistent because it can linger for two years or longer.

Another term that comes up when attempting to define high functioning depression is “smiling depression.” This describes the person struggling with symptoms of depression as being able to present a false sense of wellbeing. They can put a smile on their face that masks how they are really feeling inside. They are able to function at their jobs or in social settings and appear fine while actually battling depression.

What Causes High Functioning Depression?

Some of the same issues that cause regular forms of clinical depression can also be a trigger for high functioning depression. These possible causes include:

• A family history of depression
• A history of trauma
• Chronic levels of high stress at work, home, or school
• Having financial problems
• Dealing with a serious health setback or injury
• Relationship conflicts at home or work
• Living in an unsafe environment
• A health condition or side effects from a medication
• Substance abuse

Key Signs of High Functioning Depression

It is said that high functioning depression is like a mild form of PDD. This type of depression isn’t debilitating, but does impact quality of life. Some signs you might be dealing with high functioning depression include:

• Feeling sad or empty
• Fatigue or lack of energy
• Low self-esteem
• Changes in eating habits
• Sleep problems
• Feeling hopeless
• Avoiding social activities
• Trouble making decisions
• Feelings of guilt or shame about the past
• Being impatient or angry
• Loss of interest in usual daily activities

If you are struggling with ongoing, chronic symptoms of PDD you may think you have no option but to accept it. However, there is treatment for high functioning depression that can offer you some much-needed support. Keep reading.

How Does Living with High Functioning Depression Impact Someone’s Life?

Someone with mild PDD or high functioning depression often hides their condition. Instead of acknowledging the problem, they push through and put on a positive front. This may help them avoid attention about their mental health status, but it never gets them the treatment for high functioning depression they need.

There are various reasons why a person with this type of depression might try to hide it from others. Some of these include:

• They simply want to keep their mental health issues private
• They don’t want to become a burden to family members, friends, or coworkers
• They don’t want to appear weak to others
• They want to avoid attention
• They are in denial about how depression is affecting their life

Living with high functioning depression often leads to social withdrawal and isolation. This is because the person would rather be alone than to have to fake it in public or with friends. Also, the condition causes fatigue and sleep problems, so they don’t have the energy to even be social.

Holistic Therapies that Help High Functioning Depression

When you battle depression, self-care and healthy lifestyle habits can go a long way toward improving your daily quality of life. Consider adding these actions to your weekly routine to improve your mood state:

• Holistic self-care. Holistic methods can improve your overall mood by inducing a state of relaxation. These activities might include mindfulness meditation, yoga, massage therapy, or focused breath work.
• Nutrition. Adding certain foods to you diet can be helpful for someone with depression. These include leafy greens, avocados, turkey, walnuts, betties, fish and whole grains. Also, moderate the intake of sugary foods, alcohol, and caffeine.
• Exercise. Regular exercise benefits both physical and mental health. Exercise causes the release of endorphins and also produces serotonin and dopamine. All of these brain chemicals provide immense mental benefits, such as reducing stress, boosting mood, and improving sleep quality.

Comprehensive Depression Treatment

When the above methods do not result in any real improvements in your mental state, there are some treatment options to consider. Treatment for depression is available in three types of settings: private practice, outpatient programs, and residential treatment.

The good news is there is treatment for high functioning depression. For someone with this type of depression, the purpose of seeking treatment is to improve your quality of life. The three pillars of depression treatment include:

• Medication. Antidepressants may be helpful for some patients with PDD. SSRIs can take 4-6 weeks to reduce depression symptoms. If there is no result after six weeks, the doctor can trial a different drug.
• Psychotherapy. Working with a therapist can help you work through any underlying emotional issues that may be factors in the depression. Cognitive behavioral therapy can guide you away from negative thoughts and help to restore a sense of control.
• Group support. Support groups are a safe setting in which to discuss your depression with others who may have a similar condition.

Your secret struggle with PDD can be put behind you with high quality mental health treatment. Do not hesitate to seek the help you deserve.

Bodhi Mental Health Provides Treatment for High Functioning Depression

Bodhi Mental Health is an outpatient mental health program offering all levels of outpatient treatment. We can also guide you toward a leading residential treatment program that limits patient load to just six beds. Let us help you overcome this lingering form of depression. Reach out to the Bodhi team today at (877) 503-0638.

What Clinicians Know About High-Functioning Depression

“High-functioning depression” is not a formal DSM-5 diagnosis, but it describes a recognizable clinical pattern: persistent depressive symptoms that meet criteria for major depressive disorder or persistent depressive disorder (dysthymia) in a person who continues to perform at work, school, or home. The National Institute of Mental Health estimates that major depression affects roughly 8.4% of U.S. adults annually, and a substantial portion of those individuals never seek treatment because outward functioning masks internal suffering (NIMH: Depression).

Peer-reviewed research published through the National Library of Medicine indicates that persistent depressive disorder — particularly when it has lasted two years or more — is associated with greater functional impairment over time, higher rates of co-occurring anxiety, and reduced response to brief treatment interventions than episodic major depression (PMC: Persistent depressive disorder review). Evidence-based treatments include Cognitive Behavioral Therapy (CBT), interpersonal therapy, behavioral activation, and antidepressant medication coordinated with a prescribing psychiatrist.

The American Psychiatric Association also emphasizes that long-standing, lower-grade depression often responds best to combined treatment — medication plus psychotherapy — and that delayed care can deepen the condition over years (APA: What Is Depression?). For people who have been “managing” for years and are now experiencing burnout, suicidal thoughts, or a sense that outpatient therapy is not enough, a residential level of care can offer the time and structure to fully address what has been carried for too long.

If high-functioning depression has begun to erode your daily life, support is available. Learn more about our residential program, explore treatment programs, or verify insurance. You can apply now or call 877-883-0780.

This article is informational only and is not a substitute for individualized clinical advice. Please consult a qualified mental health clinician for diagnosis and treatment decisions.