Talking about mental health can be nerve-wracking, but one important thing to remember is that mental illnesses like anxiety and depression are common among people of all ages, genders, and social classes. According to the World Health Organisation, there are more than 264 million people of all ages living with depression worldwide.
People with depression may experience things like disturbed sleep and appetite and find it difficult to function at work, school, and social events while others may have depression and still be able to function at a high level while maintaining their extracurricular activities and social commitments. The latter is called high-functioning depression and although it's not a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM), it is a real thing and should not go unacknowledged.
What Is High-Functioning Depression?
"When I think of high-functioning depression, I think about people who meet the criteria in the DSM (the manual clinicians and health providers use to diagnose mental health conditions)," Jor-El Caraballo, LMHC, co-founder of Viva Wellness, told POPSUGAR. People who experience high-functioning depression meet the criteria for major depressive disorder and can function in their daily life, according to Caraballo. "This person might still be going to work, they might still be in a relationship, they might still be able to take care of themselves and their family, but they really are struggling internally," he explained.
Although anyone can experience high-functioning depression, Caraballo said that it's often more prevalent in women, especially Black women. In his opinion, Black women may identify with high-functioning depression more than non-Black people because Black people may not be well versed in the idea of what depression is and because Black people and people of colour tend to suppress and push away the idea of having depression.
Symptoms of High-Functioning Depression
Exhibiting classic depressive symptoms like fatigue, the inability to think or concentrate, and a decrease or increase in appetite are indicators someone has high-functioning depression, according to Caraballo. Additionally, people may experience difficulty getting out of bed or feeling as if they don't enjoy anything anymore, he said.
"This person tends to have lost their mojo for life," Perpetua Neo, DClinPsy, MPhil, executive coach and psychologist, told POPSUGAR. Someone with high-functioning depression may no longer have goals, enjoy their life, hobbies, friendships, or feel motivated to do anything, she explained. Other signs of high-functioning depression are the desire to sleep a lot, the inability to sleep, ruminating on the past, and feeling hopeless about the future, according to Dr. Neo.
"For Black people in particular, one of the symptoms that we don't think about a lot is irritability and agitation."
"One of the things that I've seen and what has also been present in the research is that for Black people in particular, one of the symptoms that we don't think about a lot is irritability and agitation," Caraballo said.
In his opinion, systematic inequalities are one reason irritability and agitation may be more prominent in Black people and people of colour with depression. Compared to those who don't have the same lived experiences as Black people and people of colour, these systematic inequalities can make Black people and people of colour more prone to anger, to fear, and to anxiety when dealing with structural issues "which can very much be exasperated to something like depression," Caraballo said.
Although someone may appear to be "good" or functional to the mainstream, like having a successful career and a lot of friends, Caraballo said the inability to enjoy things often exists in a "very nondisruptive way in someone's day-to-day." Examples of this are no longer participating in hobbies or doing things that used to make one feel happy such as hosting game night with friends. Dr. Neo added that people with high-functioning depression show up to commitments like work even if they feel burned out.
How to Manage and Treat High-Functioning Depression
If you believe you're experiencing high-functioning depression, you may be wondering what your options are to manage and treat it. Dr. Neo recommends seeking professional help if you are consistently experiencing symptoms of high-functioning depression for four weeks.
"I advocate for therapy. I definitely think that's the best option just because it offers you the possibility of a mirror. To have someone who can see you without being you is incredibly helpful," Caraballo said. For those who are financially limited, Caraballo recommends utilising resources such as the Open Path Collective, a directory of therapists offering sliding-scale and low-fee sessions. Additionally, Caraballo said to inquire within your local community clinics about low-fee or free options to work with a counsellor or therapist.
"Outside of that, I would encourage people to think about what are the things that have pulled them out of difficult situations before," Caraballo said. He also recommends making a list of things that have helped you cope and helped you feel better in the past. If you can't participate in those things, such as going to the beach, consider the next best alternative like listening to beach soundscapes.
"You are not alone, there's a name for it."
"These are obviously going to be ways to cope but they aren't going to 'fix the problem,' but it can help you get to a better place, definitely," Caraballo said. He also recommends trying new things like meditating, exercising, and focusing on your nutrition, "because what we now know is that there is a big connection between gut health and mental health."
Another coping method Dr. Neo recommends is focusing on the one thing that preoccupies you the most. "Solve that problem then you're going to feel that there is hope to solving everything else," she said. Ultimately, you've got to find what type of treatment works best for you whether it's antidepressants, talk therapy, or a combination of treatments. "You are not alone, there's a name for it. This realisation can actually be very freeing. Knowing that you are not alone is super important," Dr. Neo said.