The No. 1 Sign Of High-Functioning Depression People Often Miss

Some people don't even realize they're dealing with a form of depression.
Some people don't even realize they're dealing with a form of depression. Oscar Wong via Getty Images

While it’s not an official medical diagnosis, high-functioning depression is more common than most people think. That’s because, as the name suggests, a person with high-functioning depression doesn’t fit the “typical” profile that may come to mind when we think of someone living with depression.

People with high-functioning depression don’t sleep all day, and their colleagues or family members might not suspect anything is wrong. Instead, “the struggles are often hidden behind success and productivity,” explained licensed psychologist Natasha Trujillo.

Someone with high-functioning depression will probably not have issues performing well at work or fulfilling responsibilities at home. They may even use these productive actions to cope. Often, someone with high-functioning depression might not even know they’re depressed at all.

So, what are the signs to look out for if you suspect you might be dealing with high-functioning depression? And what can you do about it? We asked mental health experts, and here’s what they had to say.

The top sign of high-functioning depression most people miss

Trujillo says the top high-functioning depression sign to look out for is that you don’t experience any sustained sense of joy or pleasure, despite good things happening.

“People with high-functioning depression remain productive, successful, and able to achieve,” she said. “And yet, the person may not be able to maintain a mood of pride, joy, or pleasure for long, or they may pick apart a compliment or achievement to somehow make it ‘less than’ or inadequate in some way, emphasizing that they may not be deserving or they just got lucky.”

Therapist Becca Reedagrees with this. “Someone with high-functioning depression might feel disconnected, as if they are going through the motions without genuine engagement or joy,” she said. “This detachment can manifest as a lack of interest in activities they once enjoyed, a sense of being stuck in a routine or feeling emotionally flat even in situations that would typically bring about strong emotions.”

Trujillo emphasized that there are other signs a person might have high-functioning depression. These may include:

  • Forcing themselves to be social and go through the motions, even if they want to withdraw

  • Doing everything they’re supposed to do, but feeling like it takes more effort than it should

  • Having a hard time concentrating

  • Feeling fatigued, hopeless or worthless, even though they can’t explain why

  • Feeling sad most of the time, with little or no relief

  • Changes in sleeping and eating patterns

Therapy can be beneficial for people living with high-functioning depression.
Therapy can be beneficial for people living with high-functioning depression. simon2579 via Getty Images

What to do if you suspect you or a loved one is suffering from high-functioning depression

High-functioning depression is serious, and just as with more overt forms of depression, its consequences if untreated can include substance misuse and suicidal ideation.

In fact, someone with high-functioning depression might actually be at greater risk for suicide attempts because they feel so isolated in their experience, according to Saba Harouni Lurie, a licensed marriage and family therapist. So, getting help is key.

The first thing Trujillo encouraged is to work on being more open with loved ones about what you are experiencing.

“Being more vulnerable can help you gain support and connection,” she said. “You can also work on focusing on what in your life isn’t actually working for you, and initiate ways to change what’s maintaining your depression.” 

And of course, finding help from a mental health professional should be a priority.

“The most important thing to do is to seek [professional] support,” Lurie said. “Many people with high-functioning depression don’t seek out help, because they interpret their ability to still function relatively normally as a sign that they aren’t struggling as much as others with more overt symptoms may be.”

Reed noted that a therapist can provide you with someone to talk through difficult emotions with, and can offer invaluable coping skills that you may not be able to get from friends or family members.

“A therapist can provide you with tools to help you regulate your nervous system in an effort to increase resiliency and overall mood,” she said. “It can also be helpful to incorporate activities that nurture well-being, such as exercise, hobbies, and social time.”

Medications like SSRIs, also called antidepressants, are always an option as well, and they work well for many people. A psychiatrist or doctor should be able to chat with you about exploring a prescription.

High-functioning depression is tricky, and it can be hard to know if you’re dealing with it — and even harder to tell if a loved one is. But by looking out for certain signs, you can identify the issue and work toward getting necessary help as quickly as possible.

If you or someone you know needs help, call or text 988 or chat for mental health support. Additionally, you can find local mental health and crisis resources at Outside of the U.S., please visit the International Association for Suicide Prevention.