By Sakuni Weerasinghe
First things first, high-functioning depression is not a clinical diagnosis you can find in the Diagnostic and Statistical Manual for Mental Disorders (DSM), a guide used by clinicians to diagnose mental health conditions. However, it is a term used by people, in a colloquial sense, to refer to the symptoms of depression that aren’t fairly obvious. The fact is that depression has many faces. For some, it might prevent them from socialising and studying for their exams. You might notice that your once very extroverted friend is withdrawing from outings more and more and does not show up for examinations. But have you ever come across someone who appears to be achieving one thing after the other, but when you have a conversation with them, they tell you they feel hopeless, tired, sad, or anxious? You may even be taken aback initially. “What are they talking about? They’re successful in every measure. What do they have to be sad about?”, you may wonder. This is exactly what is referred to by high-functioning depression.
Many of us expect the signs of mental health struggles to show, much like a wound on the skin. The truth is that most of these struggles are invisible. On the outside, a person with high-functioning depression would engage in their daily lives as usual – going to school or work, hanging out with friends, dressing well, and wearing a smile on their face. This paints a different picture of someone who is struggling with depression, doesn’t it? Usually, the term itself brings up an image of someone who is crying, remains in their room all day, and doesn’t come out to socialise much. This is precisely why practitioners highlight that depression looks different from person to person.
While ‘high-functioning depression’ is not a clinical term, the diagnosis that is closely associated with it that captures most of its characteristics is persistent depressive disorder, more commonly known as dysthymia. This is a long-lasting form of depression that can give rise to occasions of major depression from time to time. Since the term ‘high-functioning’ is associated with its symptoms, many assume that this form of depression isn’t bad or isn’t severe. However, we cannot ignore the distress it brings to those experiencing it. In fact, calling it ‘high-functioning’ may actually be minimising their experience.
Symptoms of persistent depressive disorder include:
- An increase or decrease in appetite
- Insomnia or hypersomnia
- Feeling empty, sad, and hopeless
- Feelings of anger, anxiousness, or irritability
- Difficulty making decisions
- Difficulties in concentrating
- Fatigue
- Self-criticism
- Low self-esteem