Functional Depression in Its Peak Condition
High-functioning depression, also known as dysthymia, is a chronic and less severe form of depression that often goes unnoticed due to its subtle symptoms. Unlike major depressive disorder (MDD), high-functioning depression allows individuals to continue functioning relatively well in daily life, such as working, maintaining relationships, and socializing[1][3][5].
Symptoms of High-Functioning Depression
Individuals with high-functioning depression may experience persistent feelings of sadness or hopelessness, low energy and motivation, loss of interest in activities, low self-esteem, difficulty with decision-making, fatigue, insomnia, or feeling numb[1][3][5]. These symptoms tend to be chronic and mild-to-moderate.
Differences with Major Depression
In contrast, major depressive disorder involves more severe symptoms that significantly impair daily functioning, often causing a person to struggle with basic activities like getting out of bed, working, or interacting with others, typically during pronounced depressive episodes lasting at least two weeks[1][3]. Major depression can also include intense sadness, despair, or hopelessness, significant changes in appetite and sleep, social withdrawal, and possible thoughts of suicide[1][3].
Causes of High-Functioning Depression
Both high-functioning depression and major depression share similar causes, including genetic, environmental, and psychological factors[5]. High-functioning depression may be influenced by prolonged stressors or chronic low mood that is less intense but persistent[5]. Major depression can be triggered by more acute stressors or biological changes leading to severe episodes[5].
Effects on Daily Life
Individuals with high-functioning depression can mask their distress, continuing to meet responsibilities and appear outwardly "fine," even though they suffer internally[2][5]. This can lead to feelings of invalidation or guilt because their struggles are less visible. On the other hand, those with major depression often experience substantial disruption, potentially withdrawing from work, family, or social activities due to severe symptoms[1][3].
Risks and Implications
Untreated high-functioning depression may escalate into a major depressive episode in the future[1]. It is crucial to recognise and treat high-functioning depression, especially because it can be challenging to detect due to its subtle presentation.
Childhood Trauma and High-Functioning Depression
Emotional traumas in childhood, such as abandonment, abuse, or lack of emotional support, can contribute to the development of dysthymia[6]. Living under continuous stress or having complicated personal relationships can perpetuate this emotional state in those with dysthymia.
Keeping Up Appearances
Maintaining a facade of well-being can be draining for those with high-functioning depression due to the constant emotional struggle[7]. At work, those with high-functioning depression may complete tasks but feel a lack of fulfillment.
Recognising High-Functioning Depression
High-functioning depression is not yet part of the Diagnostic and Statistical Manual of Mental Disorders, but it is important to understand its manifestations and what can be done about it. Symptoms of high-functioning depression can include feeling dissatisfaction or sadness that doesn't go away, difficulty experiencing joy or excitement, trouble concentrating or making decisions, and feeling isolated[4].
[1] National Institute of Mental Health. (2021). Dysthymia. Retrieved from https://www.nimh.nih.gov/health/topics/persistent-depressive-disorder/index.shtml
[2] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
[3] Mayo Clinic Staff. (2021). Major depressive disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/major-depression/symptoms-causes/syc-20375453
[4] National Health Service (UK). (2021). Persistent depressive disorder. Retrieved from https://www.nhs.uk/mental-health/conditions/persistent-depressive-disorder-dysthymia/
[5] National Institute of Mental Health. (2021). Depression. Retrieved from https://www.nimh.nih.gov/health/topics/depression/index.shtml
[6] National Institute of Mental Health. (2021). Childhood Trauma. Retrieved from https://www.nimh.nih.gov/health/topics/childhood-trauma/index.shtml
[7] National Institute of Mental Health. (2021). Stress. Retrieved from https://www.nimh.nih.gov/health/topics/stress/index.shtml
- High-functioning depression, a form of depression that often goes unnoticed, can also be linked to childhood experiences such as emotional trauma, abandonment, or lack of emotional support, which may contribute to its development.
- Individuals with high-functioning depression might mask their inner struggles and continue to meet responsibilities, leading to feelings of invalidation or guilt because their mental health struggles are less visible compared to those with major depression.
- On the other hand, major depressive disorder is characterized by more severe symptoms and can significantly impair daily functioning, causing individuals to struggle with basic activities like getting out of bed, working, or interacting with others during pronounced depressive episodes.
- It's essential to understand the manifestations of high-functioning depression, which can include symptoms such as feeling dissatisfaction or sadness that doesn't go away, difficulty experiencing joy or excitement, trouble concentrating or making decisions, and feeling isolated, as these symptoms can indicate a need for mental-health intervention.
