High-Functioning Depression: Causes, Symptoms, and Treatment

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23 January 2024

10 Mins

Do you feel tired, demotivated, hopeless, or even have low self-esteem, but still act as if everything is okay when you go about your everyday activities? Pause for a moment and think about it because these signs could point to a condition known as “high functioning depression," which means you might look fit on the outside but are struggling with a roller coaster of emotions and thoughts on the inside.

When you are going through such a situation, it can be difficult to ask someone for help or express your feelings openly. This might cause you to act tough, which can become really exhausting at times. So, let's discuss the emotional and physical signs of high functioning depression and explore ways to deal with it.

If you or someone you know is dealing with this condition, read on to understand it better and find the help you need.

high functioning depression

What Is High-Functioning Depression?

High functioning depression, also known as persistent depressive disorder (PDD), refers to a type of depression where people can experience many of the symptoms of depression but are still able to maintain a relatively normal level of daily functioning.

Unlike other forms of depression, high functioning depression may not be immediately noticeable to others because people with this condition often mask their symptoms and continue with their responsibilities.

With this condition, even if a person is feeling good on the outside—going to work, spending time with friends—on the inside, they may be struggling with feelings of sadness when they are alone or lack energy. As it is not always easy to recognize, it seems as if they are wearing a mask, which makes it hard for others to see what they are feeling.

It can be hard to lead a full-fledged life with high-functioning depression; talk to a professional expert and get to the root cause of it for free.

Signs and Symptoms of High-Functioning Depression

High-functioning depression shares common symptoms with other types of depression, including a range of emotional and physical signs. The intensity of high functioning depression symptoms can vary, and people may face both psychological and physical challenges. So, let’s dig deeper into these signs:

Emotional symptoms

  • Persistent feelings of sadness
  • Hopelessness
  • Lack of enjoyment in activities
  • Difficulty concentrating
  • Irritability
  • Feeling overwhelmed
  • Self-critical thoughts

emotional response

Physical symptoms

  • Fatigue or low-energy
  • Changes in appetite or weight
  • Sleep disturbances (insomnia or oversleeping)
  • Physical pain
  • Tension or restlessness
  • Reduced libido (loss of interest in sex)
  • Slow movements or speech

physical symptoms

How to Diagnose High-Functioning Depression

Since high-functioning depression cannot be clinically identified as a diagnosis, if someone seems fine externally and still shows signs of depression, it might be high functioning depression or another kind of depression

If a person shows symptoms of depression, a healthcare provider usually runs tests to make sure no other health problems are causing these symptoms. Once other potential causes have been eliminated, a healthcare provider or mental health professional will ask you questions to better understand the symptoms. The questions may include inquiries about the family history of depression or other mental health conditions so that your therapist can give an accurate diagnosis and create a customized plan to treat the condition.

how to diagnose high functioning depression

What Causes High-Functioning Depression?

There are various causes of high-functioning depression that may vary from person to person. It's often a combination of biological, psychological, and environmental factors. Some potential reasons include:

1. Brain chemistry

High-functioning depression may be associated with imbalances in neurotransmitters, such as serotonin and dopamine. These chemicals play a crucial role in regulating mood and emotions, so disruptions in their levels can impact how the brain processes information and manages stress, which can result in high functioning depression symptoms.

2. Genetics

A family history of depression or related mental health conditions can increase the possibility of developing high-functioning depression. There may be genetic factors that influence how people respond to stress or regulate their emotions, contributing to this form of depression.

3. Life events

Stressful life events like work-related stress, relationship difficulties, financial pressures, or major life changes like a move or loss can overwhelm a person's coping mechanism and can act as triggers for high-functioning depression, leading to the onset or worsening of depressive symptoms.

life events

4. Personality traits

Certain personality traits may make people more prone to high-functioning depression. For example, perfectionism, where people set unrealistically high standards for themselves, can create chronic stress and contribute to depressive feelings. Moreover, people who internalize their emotions and do not express them openly may also be at a higher risk.

5. Hormonal changes

Hormonal fluctuations, particularly in women, can influence mood and contribute to high-functioning depression. This is often observed in connection with hormonal changes occurring during the menstrual cycle, pregnancy, postpartum period, and menopause.

6. Chronic health conditions

Long-term physical health issues, such as chronic pain, autoimmune disorders, or neurological conditions, can have a significant impact on mental health. The challenges associated with managing a chronic health condition may lead to the development of high-functioning depression.

chronic health conditions

The Challenges of Living with High-Functioning Depression

Living with high-functioning depression has a set of unique challenges that may not always be apparent to others. These challenges can impact various aspects of a person's life and result in a complex and often hidden struggle.

Here are some key challenges with functional depression:

1. Invisible struggle

One of the primary challenges is the hidden nature of high-functioning depression. Outwardly, people may appear fine, maintaining their daily responsibilities and duties. However, internally, they deal with persistent feelings of sadness, hopelessness, and fatigue, making it difficult for others to recognize their emotional turmoil.

2. Hiding emotions

People with high-functioning depression often become proficient at hiding their true emotions. This constant effort to appear okay can be emotionally draining and may contribute to a sense of isolation, as others may not realize the internal struggles the person is facing.

hiding emotions

3. Maintaining daily function

When you are feeling depressed, juggling work, relationships, and daily tasks can become a challenge to accomplish. People with high-functioning depression may push themselves to meet expectations, leading to increased stress and exhaustion.

4. Social withdrawal

Even though people with high-functioning depression still socialize, they might quietly withdraw emotionally. Engaging in social activities may become a taxing effort, as people with high-functioning depression may feel disconnected or unable to fully participate in social interactions.

social withdrawal

5. Perfectionism

Some people dealing with high-functioning depression might struggle with perfectionism, where they set extremely high standards for themselves. This can increase internal pressure and contribute to a cycle of self-criticism.

It can be quite challenging to lead a happy life with high-functioning depression; make space for your new self by talking to a professional expert for free.

How to Deal with High-Functioning Depression

Dealing with high-functioning depression involves a combination of self-awareness, self-care, and seeking support from others. Here are some strategies to help manage and cope with high-functioning depression:

1. Recognize your feelings of depression

The first step in dealing with high-functioning depression is realizing and accepting that you are going through it. If you are not sure, talking to a professional can help you figure it out. Avoid self-judgment and understand that experiencing depression, even in a high-functioning state, is a valid and common challenge.

2. Talk to someone you trust

Share your feelings with a friend, family member, or healthcare provider, like a counselor or therapist, as it can help you understand and work through your emotions freely. If talking feels tough at first, try writing down your feelings.

For better support, your therapists can help you explore the root causes of your depression, develop coping strategies, and provide a safe space to express your thoughts and feelings openly.

talk to someone you trust

3. Take care of yourself

Ensure to practice self-care to support your mental health, which includes practices like mindfulness, meditation, and grounding exercises. Moreover, don't forget to take breaks for your mental health, which can include a short walk, a moment of deep breathing, or engaging in a hobby to maintain a healthy mental state.

4. Make positive changes to your lifestyle

To manage your symptoms, look at your daily routine, eliminate unproductive practices, and make positive adjustments. Ensure you get enough sleep, engage in physical activity, and maintain a balanced diet, as even these small changes in your daily routine can make a big difference in how you feel.

make positive changes to your lifestyle

5. Stay active to boost your energy

Engaging in physical activity is an excellent method for handling symptoms of depression because it can stimulate the release of feel-good chemicals in your brain. Try activities that make your heart beat faster or assist in stretching and strengthening your muscles to enhance your energy and mood.

6. Develop mindfulness

Mindfulness is a mental state and practice that involves being fully present and engaged in the current moment without judgment and being aware of one's thoughts, feelings, bodily sensations, and the surrounding environment. Integrate mindfulness practices into your routine, such as meditation or deep-breathing exercises, as they can help you stay present, reduce anxiety, and improve your overall mental resilience.

develop mindfulness

Treat High-Functioning Depression with Now&Me

High-functioning depression can impact people in subtle yet significant ways, and seeking support is a crucial step toward managing its effects. If you are looking for help, Now&Me provides an affordable platform for those dealing with high-functioning depression to connect with the right experts 24x7 and find the help they need, starting at just Rs. 30.

Now&Me also provides a medium to connect with a community that understands and shares similar experiences, where you can convey your thoughts and stories and find emotional support from others.

Moreover, if you are not ready for therapy or find it hard to consult a therapist, you can explore our self-help resources to start your healing journey and find the root cause of your depressive symptoms through mindful efforts. To get started, simply download the Now&Me app and take a positive step toward managing high-functioning depression.

Not getting treatment for high-functioning depression at the right time can lead to dire consequences; talk to a professional expert right away for free.


  1. The depressive spectrum: diagnostic classification and course. Journal of Affective Disorders. 1997. https://pubmed.ncbi.nlm.nih.gov/9268773/ Persistent Depressive Disorder. StatPearls Publishing. 2022. https://www.ncbi.nlm.nih.gov/books/NBK541052/

  2. The effects of stressful life events on depression. Annual review of psychology. 1997. https://pubmed.ncbi.nlm.nih.gov/9046559/

  3. Depression, anxiety, and post-traumatic stress disorder among youth in low and middle income countries: A review of prevalence and treatment interventions. Asian journal of psychiatry. 2018. https://pubmed.ncbi.nlm.nih.gov/29117922/

  4. Genetic determinants of depression: recent findings and future directions. Harvard Review of Psychiatry. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4309382/


If you are wondering whether you have high-functioning depression, consider your emotions and behaviors. When you often experience a continuous low mood, lack of energy, or find it hard to stay motivated for up to 2 weeks while still managing your daily responsibilities, you might be dealing with high-functioning depression.

High-functioning depression may not be immediately obvious to others. On the outside, you might seem fine—going to work, socializing, and fulfilling obligations. However, internally, you may struggle with feelings of sadness, hopelessness, and a persistent lack of energy and motivation. It makes it challenging for others to see the emotional disruption you are experiencing.

Yes, high-functioning depression is a real mental health condition. Even if someone appears to be doing well on the outside, they may struggle with the emotional and physical symptoms of depression. To promote better mental health, it's essential to recognize and address this form of depression as well.

To determine if you have high-functioning depression, pay attention to constant feelings of sadness, low energy, and difficulty staying motivated despite outwardly appearing fine. If these symptoms persist for up to 2 weeks, it's advisable to consult with a healthcare professional who can provide a thorough evaluation and guidance.

Treatment for high-functioning depression often involves a combination of therapy, support groups, and medication (in some cases). Seeking professional help is crucial, as therapists can help you explore the root causes and provide coping strategies tailored to your specific situation.

Yes, it's possible to be depressed and still function. High-functioning depression is characterized by people appearing outwardly functional while dealing with the internal challenges of depression. Seeking support from friends, family, or mental health professionals can make a significant difference in managing and treating depression.

Now&Me articles are written by experienced mental health contributors and are purely based on scientific research and evidence-based practices, which are thoroughly reviewed by experts, including therapists and psychologists with various specialties, to ensure accuracy and alignment with current industry standards.

However, it is important to note that the information provided is not a substitute for professional medical advice, diagnosis, or treatment. Individual circumstances vary, and it is advisable to consult with a qualified mental health professional for personalized advice and guidance.

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