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  • Grace Dowd

High Functioning Depression: What is it?

You may have heard the terms used before of functional depression, high-functioning depression, or even mild depression. But what do these terms actually mean, and are they legitimate diagnoses? You may also be asking yourself “How does that change my experience of depression and what to do about it?”

Functional depression, or high functioning depression, is just a term that was created through the lived experience of those who struggle with depression while still participating in daily life. The official diagnostic term is Persistent Depressive Disorder. For those with high-functioning depression or PDD, you still experience symptoms of depression, but it may appear more “concealed” or even appear to those around you that you are “just fine.” Though PDD is less severe than MDD (Major Depressive Disorder), the experience that folks have with PDD can feel debilitating.

Many individuals struggling with functional depression may struggle with their self worth and esteem, feelings of hopelessness, or maybe even feeling like a failure. It can be hard to identify high functioning depression within yourself, because of our perception that those who struggle with depression often struggle to go to work, perform at school, or even get out of bed. Even if you are still doing all of those things, it does not mean that you aren’t struggling.

The DSM 5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) describes the following symptoms of those who are struggling with PDD. These symptoms in adults must be consistent for 2 years on most days with no more than 2 months of relief. Two or more of the following must be present:

1. Poor appetite or overeating.

2. Insomnia or hypersomnia.

3. Low energy or fatigue.

4. Low self-esteem.

5. Poor concentration or difficulty making decisions.

6. Feelings of hopelessness.

As you can see, the symptoms can be broad and look very different for each person. You may be feeling down, struggling with poor appetite, and insomnia. While another person may have poor concentration and deal with hypersomnia. The fact is, depression can manifest very differently in each person, and it’s important to recognize that your experience of depression does not have to look like being stuck in bed for it to be valid that you are struggling.

Once you have been able to identify that there is a problem and you are struggling with depression, there are a few things that you can do to help:

1. Talk to someone

Whether it be a trusted friend, your partner, or a family member, it can be helpful to let someone know that you are struggling. Allowing someone in can help ease the burden and the loneliness that you may feel in the struggle. It’s important to identify if this is the right choice for you.

2. Prioritize self care

Adding another item to your plate may sound like the last thing that you should worry about, but this is actually a proven method to improve your overall mood. In cognitive behavioral therapy, there is the theory of behavioral activation: we may lack the motivation to do the self-care activity (whether it be going for a walk, doing yoga, or something else), but by engaging in it we can still benefit from the positive emotions it will elicit. The more that we do it, the more we want to continue engaging in activities that provide positive emotions and endorphins.

3. Seek professional help

It’s okay to need additional support during difficult times. Sometimes this means seeking out a therapist to help you sort through the depression, or finding the right psychiatrist to manage the symptoms. It doesn’t have to be a forever decision. It’s important to remember that taking care of our mental health is a holistic approach and we should include all parts of ourselves - body, mind, and spirit. If a therapist or psychiatrist is not accessible to you, see what non-profits are in your area offering support groups to those struggling with their mental health. These, most often, are free.

The fog does not last forever. Find the glimmers where you can, and seek out additional support when necessary. We are here for you.



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