What Is High Functioning Depression?
High functioning depression (also called persistent depressive disorder or PDD) is a condition where people experience many symptoms of depression (usually, but not always, at a less severe level) and are still able to function almost normally.
What does it mean to be high functioning? On the outside, someone may appear to be totally fine, but inside, they are constantly struggling and have been for at least two years.
High functioning anxiety and depression tend to occur together, compounding the symptoms that a person has to deal with.
Chronic low-level depression, like PDD and dysthymia, affects around 1.5% of American adults each year, which means millions of people are quietly dealing with a burden that is hard for many to understand.
Symptoms and Diagnosis of High-Functioning Depression
High functioning depression symptoms must include a depressed mood for most of the day for at least two years.
Other symptoms include two or more of the following:
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Eating more or less than usual
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Sleeping too much or too little
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Low self-esteem
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Fatigue and lack of energy
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Feeling hopeless or sad
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Trouble concentrating and making decisions
These symptoms must impair normal living and are not better explained by another mental illness or accompanied by mania.
Further, the ability to proceed through daily activities does not mean someone cannot struggle with depression. “Depression may inhibit the desire for activity and action, but high functioning individuals tend to forge ahead in an effort to succeed with goals,” according to Maya Mendez, PhD, psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica, California
Explaining High Functioning Depression to Friends and Family
It’s not easy to explain high functioning depression to friends and family. They may tell you things like “just stop feeling sorry for yourself” or “what do you have to be sad about?” Some may even ask, "is high functioning depression real?” One of the best ways to help explain your condition is to provide people with resources on depression.
Spend some time finding an article or video on depression that you relate to and give it to your friends and family to help them understand.
Say, “I’ve been struggling with this, and I know you may not understand, but I really need your support right now.”
You can also find communities of people in the mental health space on Twitter, YouTube, and other social media platforms. Finding other people who DO understand can help lessen the blow from the people who do not.
There is something powerful about connecting with other people who have similar struggles as you, and you may be relieved to know that you are not alone.
How to Spot High Functioning Depression in Yourself and Others
It’s hard enough to recognize high functioning depression in yourself. It’s especially difficult to spot in others. High functioning depression can look like laziness or feel like emptiness. When in doubt, it’s always best to talk to a professional.
Frequently Asked Questions About High Functioning Depression
People with high functioning depression are still able to do most of their daily activities, including holding down a job or caring for their family. Severe depression can take away a person’s ability to care for themselves, so being high functioning simply means you’re battling through your symptoms to appear “normal,” even if you don’t feel that way inside.
There is no single most reliable symptom of depression. Symptoms of depression can include weight or appetite changes, sleep changes, feelings of hopelessness or helplessness, self-loathing, loss of energy, unexplained aches and pains, concentration problems, reckless behavior, loss of interest in activities you used to enjoy, and irritability or anger.
There is no single highest cause of depression. Depression tends to have a biological or genetic component, but there are many relevant causes that may affect individuals differently.
There are more than 4 major causes of depression. Things that can cause depression include genetics, age, gender, health conditions, medications or recreational drugs, stressful events or major changes to your life, and grief and trauma.
In many cases, yes, primary care doctors can prescribe antidepressants. Primary care doctors may be less comfortable prescribing mood stabilizers for conditions like bipolar disorder. That said, if you're depressed you can book a virtual appointment and speak to a doctor online about your treatment options. If the online doctor finds that you may benefit from antidepressants they will electronically send your prescription to the pharmacy of your choice. This offers a convenient option to get antidepressants online as part of your treatment plan.
Online doctors can’t prescribe controlled substances like Xanax.
Are There Online Psychiatrists or Therapists?
Yes, online psychiatrists and therapists are available to provide mental health support online. They typically offer talk therapy via phone or video and text therapy is often available. Online psychiatrists can prescribe necessary medications that are not classified as controlled substances.
If you’re curious about online therapy, try booking a therapy appointment with PlushCare. Our virtual therapists can provide the help you need from the comfort and safety of your home.
Keep in mind, online appointments aren’t for everybody. An online doctor cannot prescribe controlled substances like Xanax - but they are an excellent option for most people struggling with high functioning depression.
Online Therapy Pros and Cons
Here are some online therapy pros and cons:
Pros:
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Accessibility
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Affordability
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Convenience
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Anonymity
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Reduced social stigma
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More ways to communicate than just talking (i.e. text therapy)
Cons:
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May not be covered by insurance
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Might be required to find an in-state provider
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Technology can be unreliable
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Harder for therapists to see body language or hear verbal cues
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Lack of response to crisis situations
Talk to an Online Therapist About High Functioning Depression
PlushCare offers online therapy for individuals 18 and older. Our licensed therapists can provide you with emotional support and help treat your high functioning depression.
Depression is 100% treatable and the sooner you begin treatment the easier your road to recovery may be. You’ll meet with your trusted therapist weekly to receive emotional support and development. Don’t let high functioning depression control your life anymore.
High Functioning Depression Medication Treatment
If you need help combatting depressive episodes, PlushCare is here for you. Our therapist or doctor will listen to your symptoms and work with you to create a comprehensive treatment plan, including necessary medications.
If they think it’s appropriate, they can electronically send a prescription for an antidepressant to your local pharmacy.
Common Antidepressants Our PlushCare Doctors Prescribe
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Wellbutrin
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Prozac
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Lexapro
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Cymbalta
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Zoloft
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Paxil
Read More About Depression
Sources
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Rottenberg J, Devendorf AR, Kashdan TB, Disabato DJ. The Curious Neglect of High Functioning After Psychopathology: The Case of Depression. Perspectives on Psychological Science. 2018;13(5):549-566. doi:10.1177/1745691618769868. Accessed on January 11, 2021.
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cdc.gov. Mental Health Conditions: Depression and Anxiety. Accessed on January 11, 2021 at https://www.cdc.gov/tobacco/campaign/tips/diseases/depression-anxiety.html
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adaa.org. Depression and Anxiety. Accessed on February 14, 2021 at https://adaa.org/understanding-anxiety/depression
