Could you have high-functioning depression — without you or anyone you love knowing it? Sadly, the answer is yes. Roughly 8.7% of all adults experience at least one episode of depression yearly, and many live with dysthymia. What’s that? It’s now called persistent depressive disorder and it affects how they think and feel about themselves. 

However, these individuals are often such high achievers that no one around them notices the problem. Furthermore, they may push their persistent blues aside. After all, we live in a society plagued by positivity and rugged individualism — they’re likely to be told to “just cheer up,” their life isn’t that bad and they should be happy for what they have if they reach out. As a result, they hide their suffering behind an outwardly smiling mask.  

However, their struggles are very real and dysthymia can sap the joy out of life like a vampire. How do you know if you or someone you love is affected? Here are eight signs of high-functioning depression. 

1. Fatigue

Is “I’m just a little tired,” your go-to response when someone asks you if you’ve been feeling down or under the weather? If you never seem to regain that spring you once had in your step, it could be a sign of high-functioning depression. 

Please keep in mind that many disorders have similar symptoms. Constant fatigue can also be a sign of the following conditions, so please consider booking an appointment with your doctor for an evaluation if you have the means. 

• Chronic infection or inflammation: You could have an unhealed infection or an autoimmune disorder. 
• Chronic fatigue syndrome: Researchers remain puzzled by this illness, but many believe it results from viral infection. 
• Diabetes: Over 80 million Americans live with diabetes or prediabetes. 
• Fibromyalgia: This mysterious illness also involves widespread pain.
• Hypothyroidism: If your thyroid is sluggish, you feel fatigued. This condition occurs most often in women, although men can also have it. 

However, high-functioning depression may be the underlying cause. Seeing your physician allows them to prescribe medications that may help. It often takes considerable time to find the right treatment, and the sooner you begin, the sooner you’ll find the right intervention. 

2. Appearing Outwardly Happy 

Perhaps the most frustrating sign of high-functioning depression is that people with dysthymia often appear outwardly happy. Much of this phenomenon is a product of culture, especially in women. Society places a high value on cheerful and compliant females, doing what someone asks of them without complaint. 

Toxic positivity also plays a crucial role in masking high-functioning depression. While there are decided health benefits to looking on life’s bright side, the “cheer up” directive becomes poisonous when it invalidates your life experience, pretending a bad situation is okay when there’s nothing alright about it. 

Again, the issue isn’t the individual — it’s society. People today face more hardships than generations before. Already, millennials have a lower standard of living than their parents, and it doesn’t look like the tide is turning for Gen Z. Nevertheless, self-help gurus everywhere blame the issue on individual mindset, making many with high-functioning depression believe the problem is with them when the cause is a toxic environment. 

3. In Pursuit of Perfection

No matter how hard the challenge, people with high-functioning depression often tackle it, anyway. Furthermore, they tend to demand more of themselves than they ever would of others, insisting on perfection and internalizing the message that any failures are their fault and theirs alone. 

It’s fabulous to take personal accountability for mistakes. However, these individuals take perfectionism to such extremes it can paralyze them. For example, they may procrastinate until the very last minute so that they psychologically have an “excuse” for not doing their best. 

People with high-functioning depression often suffer from imposter syndrome, believing they aren’t worthy of any success. They even assign reasons such as luck to their triumphs when their hard work led to gold.

4. Loss of Interest in Fun 

As much as people with high-functioning depression may work hard, they skip out on the “play hard” part of that equation. Many people with this disorder find it impossible to relax and get into the spirit of things, even when they do take a break. They may micromanage every day they take off, using it for things like house cleaning and DIY projects instead of kicking back with a novel or enjoying a relaxing evening with friends and family. 

While there’s nothing wrong with tidying or fixing up the homestead, rest is equally vital. Chronic stress or the pressure to always be “on” can upset the balance of multiple neurotransmitters, reinforcing the dysthymic state. 

5. Appetite and Sleep Changes 

Appetite and sleep changes may be the signs of high-functioning depression that are easiest for family and loved ones to recognize. Pay attention if someone in your life exhibits the following symptoms:

• Eating too little: It’s no big deal to miss the occasional meal. However, people with high-functioning depression might literally “forget” to eat as their condition impacts memory. Furthermore, they may simply lack the energy to make anything, so overwhelmed are they with maintaining their positive image. 
• Eating too much: Conversely, some people with high-functioning depression may attempt to self-medicate with foods. The problem is that many high-carbohydrate comfort meals that temporarily boost serotonin and dopamine levels also lead to weight gain. This dynamic can create a vicious cycle where the person overindulges, then feels guilty for doing so. The negative feelings invariably lead to another binge. 
• Sleeping too little: Some people with high-functioning depression skip out on sleep, remaining restless during the night as they get up to take care of “just one more thing” and end up burning the midnight oil. 
• Sleeping too much: Though less common, some people with high-functioning depression may sleep too much. For example, an overachieving student might go right to bed after school and study, leaving no time for socializing or relaxing.

6. Difficulty With Focus 

As hard as many people with high-functioning depression push themselves, they could still find themselves struggling at work. That’s because their condition taxes their mental reserves, making it difficult to concentrate. 

As a result, they may make careless mistakes. Instead of taking these “oops” moments as a time to reflect and step back, they create a vicious cycle by berating themselves for their failure. This dynamic fuels their perfectionistic tendencies — they’re convinced if they just try a little harder, they won’t repeat the error. 

7. Irritability 

People with high-functioning depression may never look like the stereotypical morose “patient” who spends all day in bed. Instead, their inner emotional turmoil often erupts as irritability. They may lose their cool over the slightest infraction or give off an edgy, unapproachable vibe. 

Often, this irritability stems from the comorbid anxiety such individuals often feel daily. Convinced that everything could fall apart at any moment, they insist on keeping tight reins on schedules and deadlines to the exclusion of being human. For example, they might blow up at their child for leaving an unwashed plate in their room instead of realizing that Junior likely forgot it. 

8. Feeling Sad and Hopeless 

Underneath their outward demeanor, people with high-functioning depression have a deep core sense of sadness and hopelessness that never lifts. Despite their efforts or progress, they remain convinced that nothing they do genuinely makes a difference. They believe they will always feel like they do, ascribing their condition to “just the way things are” instead of seeking help. 

Sadly, some individuals may reach their breaking point. If you’re having recurrent thoughts of self-harm or suicide, please seek help. The National Suicide Prevention Hotline is free and can put you in touch with resources that may help. All you have to do is call or text 988 from your phone. The old 1-800-273-8255 number remains in service, but some prefer texting to talking. 

Above all, please understand that it isn’t normal to feel this way. Please seek healthy outlets that can help you restore balance. These include the following interventions:

• Cognitive-Behavioral Therapy: This modality emphasizes reframing negative thoughts in a more realistic light. 
• Medications
• Mindfulness training 
• Yoga 
• Healthy hobbies like gardening 

Signs of High-Functioning Depression

The world may never know if you or someone you love has high-functioning depression. However, that doesn’t make the pain less real. 

Watch for the above signs of high-functioning depression in yourself and those you love. You can recover and feel like your old self again with the right treatment.