Often when we think of depression, we imagine an individual who struggles with completing all tasks of daily living, a flawed or grim perspective on any and everything, one who is isolative from family and friends and even one who has endorsed feelings of suicidality. While depression can take many forms and this classic description of a depressed individual is close to accurate, there are far more people suffering from dysthymia or high functioning depression than not. So what is high functioning depression? High functioning depression is complicated to understand because those who suffer from it blend in so well it makes it difficult recognize and treat; especially for the individual suffering with it. High functioning depression affects nearly 350 million people worldwide.
Like major depressive disorder, high functioning depression cause changes in sleep, appetite, social and emotional difficulties, however the problem is that it’s harder to recognize. One reason is that people have difficulty comprehending their symptoms. People often misconstrue feelings of irritability, fatigue, or emotional sensitivity as something related to work, family, personal or medical problems. Depressive symptoms can be difficult to comprehend in individuals who are high functioning because they underestimate hard work, and caring for themselves, families and others as something that individuals who are chronically depressed would do. Everyday activities like getting out of bed and grooming is very difficult, people struggle with the stigma of others judging them if they are challenged by completing daily tasks. The symptoms of depression are fluid which makes depression difficult to understand. What can be seen as anger in one individual, can be underlying depression. People who struggle with high functioning depression often don’t believe that they are depressed because they can blend in and appear normal. However, these individuals struggle internally with depression, but they mask it by overcompensation in other areas of their life. They may look like they have it all together and functioning well but inside they are minutes or seconds away from a breakdown. With high functioning depression, what you see isn’t always what you get. There is a deeper issue than the depression. People with high functioning depression often have negative thoughts about themselves and about the world. The negative thoughts are exhausting even when they try to think positively to change the thoughts. If people with depression could just “feel better”, I’m sure they would, but unfortunately depression doesn’t work that way. Depression is a serious physiological disorder that affects areas in the brain. With this, depression also comes with physical symptoms as well. Therefore, its not that people want to feel “depressed” or are being “lazy”, it’s a deeper issue that we cannot see or understand by just looking at someone.
The most effective way to combat depression is through treatment and support. Depression, even in the most severe cases can be treated. Treatment consists of a number of things that an individual can do on his/her own or seek help. The first form of treatment is therapy. Therapy can help individuals learn about depression, risk factors and help to challenge those negative thoughts. Therapy may also include medication. Other non-clinical forms of treatment includes changing one’s lifestyle including changing one’s diet and exercise patterns, mediation or some other form of stress management techniques, and practicing good self-self. Many of the female clients I see in practice struggle with depression because they lack assertive communication skills. Women often struggle with this idea of being a “super woman”; having to do it all even at the expense of her own self care. Therefore, teaching communication skills to help women feel empowered but not guilty to say no or to delegate a task to someone else. Last, support from family and friends is key to managing depression. Calling, texting, or visiting a love one reinforces that they are not alone and gentle gestures goes a long way.