The shadow of stigma that surrounds depression and other mental health conditions is subtle yet widespread, often going unnoticed. It persists even when depression is being discussed openly, constraining how we understand and perceive the individuals living with depression and the different forms it can take. As such, certain indicators of high-functioning depression may be missed even by those well-versed in mental health matters.
Depression is frequently portrayed as affecting predominantly white, cisgender, heterosexual women, and depicted as an overwhelming, debilitating sorrow that confines sufferers to their beds. This perception fails to acknowledge the existence of high-functioning depression, thus depriving people of the opportunity to identify their condition and seek necessary help.
High-functioning depression, also known as persistent depressive disorder (PDD) or dysthymia, is a chronic form of depression, as explained by the Mayo Clinic. Although the symptoms of high functioning depression may be less severe than those of major depressive disorder, WebMD notes that the “depression symptoms can persist for a long time, often two years or longer.” High functioning depression allows individuals to maintain their daily routines despite enduring feelings of sadness or fatigue. However, it remains a serious condition that requires attention and treatment. Your worth extends beyond your productivity, and you deserve more than just going through the motions. If any of the following signs resonate with you, consider consulting your GP to explore potential treatments.
1. Persistent Feelings of Sadness or Emptiness

Persistent feelings of “sadness, emptiness or feeling down” are a major symptom of persistent depressive disorder, according to the Mayo Clinic. It’s normal not to feel joyous every moment of the day, but if you find that your usual state is one of sadness or numbness, it might be time to book an appointment with your doctor.
2. Disrupted Sleep Patterns

WebMD identifies “insomnia or excessive sleep almost every day” as another sign of high functioning depression. If you’re routinely struggling to sleep or consistently getting 10 hours of sleep yet still feel tired at work, it might indicate a deeper issue that warrants professional advice.
3. Unexplained Physical Pain

If you’re experiencing persistent headaches that no amount of painkillers can alleviate, or constant back pain with no discernible cause, it could be a sign of high functioning depression. Talkspace suggests that “aches or pains, headaches, cramps, or digestive problems without a clear physical cause” could be indicative of this condition.
4. Lack of Joy in Previously Enjoyed Activities

Psychologist Suzanne Leckie, in an interview with Women’s Health Australia, noted that “experiencing less pleasure in usual activities” is a diagnostic sign of high functioning depression. If activities you once enjoyed no longer bring you joy, it might be time to consult a healthcare professional.
5. Persistent Feelings of Guilt or Worry

If you constantly feel over-responsible, unable to let go of worries, and frequently mull over past actions, you could be dealing with high functioning depression. The Mayo Clinic includes “feelings of guilt and worries over the past” in their list of symptoms. If these feelings are dominating your thoughts, it may be worthwhile discussing this with your GP.
6. Increased Irritability and Anger

As psychotherapist Annie Wright wrote for The Mighty, if you find yourself overly reactive or struggling with irritability and excessive anger, it might be a sign of high functioning depression. If minor annoyances frequently trigger strong reactions in you, consider seeking help rather than blaming yourself.
7. Persistent Fatigue

“Decreased energy or fatigue” is another symptom of high functioning depression as noted by Talkspace. It’s important to acknowledge the physical and mental toll of your tasks, regardless of your ability to complete them. If you’re always feeling exhausted despite managing your responsibilities, it’s time to schedule an appointment with a doctor.
8. Low Self-Esteem

Psychology Today identifies “low self-esteem” as a symptom of high functioning depression. Discussing your self-image, although it might be difficult, can be the first step towards understanding that your self-worth is not defined by your depression.
9. Perception Gap Between You and Your Loved Ones

You may feel that something is wrong, but your friends and family may perceive everything as normal. Suzanne Leckie explained in Women’s Health that “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.” It’s essential to trust your feelings, even if your depression isn’t immediately visible to others.
High-functioning depression can be difficult to identify compared to major depressive disorder, and as a result, it often goes unaddressed despite the discomfort it can cause. Complicating matters, high functioning depression or PDD usually lasts for several years, leading individuals to adjust their baseline and assume that constant unhappiness is their norm. However, if you recognize yourself in the symptoms listed above, challenge this assumption and make an appointment with a healthcare professional. Achieving happiness is possible, and you are deserving of it.