How to identify high functioning depression

It is challenging to diagnose high-functioning depression – or dysthymia – because most people can function almost normally but face a big internal struggle. Symptoms vary in severity, so seeking professional help is sometimes not considered. Left untreated, it can lead to prolonged distress and upset to our mental wellbeing. To be diagnosed, symptoms must occur on most days for at least two years without any relief for two months of that time. According to the National Institute of Clinical Excellence (NICE) Cognitive Behavioural Therapy or CBT is recommended as an effective psychological treatment to overcome depression and maintain your mental health. 

As a result of the pandemic, one in eight UK adults developed moderate to severe depressive symptoms. And the problem with high-functioning depression is there is no one set of rules for everyone. On the surface, everything could be ok. Friends and family would describe you as outgoing, bubbly, and sociable. Remember, those living with high-functioning depression can maintain relationships, their work life and fulfil all their duties and life responsibilities. So, it is when we are behind closed doors and left alone with our thoughts that the real issue can be seen.

It is important to understand what symptoms to look out for to seek the correct support. Here, Onebright’s Clinical Director, Lee Grant, identifies common signs of high functioning depression.

One extreme or the other

Stress and eating poorly are linked to an increased risk of anxiety and depression. Those suffering from high-functioning depression find they either have a decreased appetite or are overeating. Difficulty in stopping and never feeling satisfied occur when you are emotionally eating. Very much like depression, these symptoms can be treated with Cognitive Behavioural Therapy (CBT) where you will identify what triggers led to overeating to find both immediate and long-term management techniques. 

Another area of day-to-day life affected is sleep (insomnia or oversleeping). It is common to feel tired all the time, even if you get enough or too much sleep. We often hear people beating themselves up saying thing like “I am lazy”, but the symptoms of depression means we simply cannot summon the energy needed to function at a normal level and complete our usual tasks.

Always feeling low

One of the most common symptoms of high-functioning depression is feeling down most of the time. Generally, low moods are almost always present, and it may feel like you will never get relief. Fortunately for many, they can have periods of feeling happy but it doesn’t last long. Especially during the pandemic, feelings of hopelessness have been more prevalent amongst us all as we continue to hear bad news. Low moods can contribute to the inability to concentrate and make decisions, therefore negatively impacting your work life. 

Feeling emotionally exhausted

Living with high-functioning depression is exhausting. Some people struggle to stay in tune with their emotions and tend to ignore signs they are emotionally spent. We know that faking a smile all day can take its toll on us. So much so, that since the pandemic began, over two in five adults experiencing some form of depression during the pandemic said their relationships were being affected. Couple this with the need for external validation and peer acceptance, sufferers from high-functioning depression can easily find themselves trying to maintain a false facade, which only seeks to put more and more pressure on their already fragile mental state. 

Setting unrealistic goals

A common thread amongst sufferers is a determined drive towards their own unrealistic ideas of perfection. This can cause severe damage to self-esteem and mental health when striving for the unobtainable perfection, leaving the person feeling like a failure. It’s important to remember that it’s not about underselling yourself. It’s about understanding that not every goal we aim for is within our reach especially unrealistic perfection – sometime excellent is good enough! At the same time we must be ready for when something doesn’t work out and be emotionally prepared to accept it. Although sufferers appear to be keeping it together to many, the reality is that the longer they go without seeking treatment, the more their depressive symptoms will continue.

The struggle with high-functioning depression is that there is always a breaking point, which is not always known to the sufferer. Although they can continue for months and even years trying to juggle many different responsibilities and keep all balls in the air, they will eventually reach their limits. In truth, high-functioning depression is unsustainable.

At Onebright, our goal is to encourage vulnerable people to stop dismissing signs of depression, reach out for the support they need and get back to feeling like themselves.

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