What High-Functioning Depression Really Looks Like

Many people imagine depression as being incapable of getting out of bed, losing interest in everything, and withdrawing from life altogether. Although all those symptoms may be true for many people, depression doesn't look the same for everyone. For some people, it's possible to live with depression and still appear functional at work, in relationships, and in day-to-day activities. This type of depression is also known as high-functioning depression, and it's more common than you might think.

Unlike persistent depressive disorder (PDD), high-functioning depression is more commonly associated with dysthymia, a lower-level, longer-term form of depression. Since people with high-functioning depression appear outwardly "fine," their struggles often go unnoticed, sometimes even by themselves.

What does it look like in reality? And how can you recognize it in yourself or someone you care about? Let's take a closer look.

The Mask of Productivity

In general, people with high-functioning depression maintain demanding jobs, show up for family obligations, and live seemingly normal lives. They may appear to have it all together: promotions at work, a tidy home, regular exercise routines, and an active social life.

But what others do not see is the mental and emotional exhaustion going on behind the scenes. As a result, productivity becomes a mask, something that hides the inner heaviness they carry with them every day.

A person with high-functioning depression might:

• Feel empty inside despite having a full schedule.

• Despite achieving their goals, they don't feel joy from the accomplishment.

• Using busyness as a coping mechanism to avoid painful emotions.

Signs and Symptoms of High-Functioning Depression

The signs are subtle, making them easy to miss. As opposed to major depressive disorder, where symptoms can feel acute and disruptive, high-functioning depression shows up in smaller, chronic ways. Among the most common indicators are:

Constant fatigue.

Despite getting enough sleep, people with high-functioning depression often feel exhausted. While they can push themselves through their routines, it takes extra effort that others don't see.

Low-level sadness or emptiness.

In contrast to overwhelming despair, it might feel like a gray cloud that never quite passes -- a dull sense of sadness that lingers.

Irritability or restlessness.

There are times when sadness manifests itself in irritability. As patience runs thin, small frustrations seem magnified.

Difficulty enjoying life.

Now, once-fun activities feel like obligations. It's hard to feel truly satisfied, no matter how positive an experience is, like a vacation or a hobby.

Overachievement or perfectionism.

Some people cope by striving harder -- always striving to be the best employee, the most reliable friend, or the one with it all together.

Isolation in disguise.

Even if an individual shows up to social events, they may feel emotionally disconnected, detached, or like they’re “going through the motions.”

Physical symptoms.

An underlying depression can lead to chronic headaches, muscle tension, stomach issues, or changes in appetite.

Why High-Functioning Depression Often Goes Unnoticed

Many people with high-functioning depression do not appear to be depressed. They may even be someone others admire for their work ethic, discipline, or ability to balance multiple tasks.

As such, it often goes unnoticed for a variety of reasons:

• Stigma and shame. The image of a successful or capable person does not fit with admitting depression. To avoid being perceived as weak, people may hide symptoms.

• Comparison. As long as they're still "functioning," they may convince themselves they don't have depression.

• External validation. When others thank you for being productive or reliable, it reinforces the mask, making it harder to admit that there's something wrong.

The Hidden Cost of Functioning

Although it may seem like everything is under control, living with untreated high-functioning depression can be difficult. When you push through without support, you may experience:

• Burnout and exhaustion.

• Strained relationships from emotional withdrawal.

• Decreased job satisfaction despite outward success.

• Increased risk of worsening depression or other mental health conditions.

The longer the cycle goes unrecognized, the more difficult it is to break.

How to Support Yourself or Someone You Care About

The first step in treating high-functioning depression is to recognize that it exists. The following steps can help you or someone close to you if you suspect you may be struggling:

Start with self-awareness.

Be aware of your emotional baseline. Even when life seems to be going well, do you often feel "numb," tired, or joyless? When an experience is named, it can be validated.

Talk about it.

When you share how you feel with a close friend, family member, or therapist, you can reduce the isolation that comes with keeping it all inside.

Seek professional help.

It is possible to diagnose and treat chronic depression with the help of a therapist or psychiatrist. Medications, therapy, or both may be used as treatments.

Make small lifestyle adjustments.

You can make a difference by setting realistic goals, practicing mindfulness, incorporating movement, and allowing yourself to rest.

Break the stigma.

Don't forget that depression can look different from staying in bed all day. By discussing high-functioning depression openly, others are more likely to recognize it in themselves.

When to Reach Out for Help

When you're still "checking all the boxes" in life, it's easy to minimize your struggles. Even if you appear to be functioning well on the outside, seeking help if you find yourself emptiness, sadness, or fatigue on a daily basis is worthwhile.

You should seek support if you notice any of the following warning signs:

• Persistent feelings of hopelessness or worthlessness.

• Increasing reliance on alcohol or substances to cope.

• Self-harm or suicidal thoughts.

For immediate help, dial your local emergency number right away or the 988 Suicide & Crisis Lifeline in the U.S.

The Bottom Line

High-functioning depression is real -- and it often hides in plain sight. It doesn't necessarily mean someone is not struggling if they appear successful, productive, or "fine". Behind the mask of functionality, someone may feel exhausted, disconnected, or joyless.

To break the cycle, you must recognize the signs. The ability to move from simply functioning to truly thriving can be achieved with awareness, compassion, and professional help.