Sarah Biren
Sarah Biren
February 19, 2024 ·  4 min read

14 Signs You Have High Functioning Depression, Because It Can Look Different To How You’d Imagine

When many people think of depression, they think of individuals too sad to get out of bed or other popular images touted by Hollywood. Unfortunately, despite being widely discussed, depression’s stigma lingers. It’s difficult for those suffering from it to hear these untrue cliches about what they’re going through, and it may prevent them from seeking help in fear of being called lazy or dramatic or “making it all up”. But the stigma has another more insidious outcome. 

Many people may suffer from depression and not even realize it. They might be struggling intensely but assume they are fine because they are able to get out of bed in the mornings. But high functioning depression is unfortunately common, and its symptoms are often overlooked, leaving people to suffer without realizing they don’t have to. Here are the signs of high functioning depression, and more importantly, here are ways to find help.

Read More: 13 Habits of People With Concealed Depression

What is High Functioning Depression?

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Keep in mind, high functioning depression is not recognized as a clinical disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Therefore, the term is controversial among mental health professionals. It’s a potentially misleading label since it’s open to personal interpretation depending on people’s personal opinions toward mental illness and treatment. But it tends to be used to describe a type of depression where people can live a relatively “normal” life, going to work and maintaining relationships. [1]


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However, high functioning depression is sometimes used to describe persistent depressive disorder, also called dysthymia. PDD is a clinical diagnosis and it’s one variation of chronic depression. While people with it may experience less acute symptoms compared to those with major depression disorder, their symptoms linger for an extended period of time, for at least two years or more. They may also have periods of feeling normal that last under two months. People with it may be able to carry on with their usual routine despite their symptoms, which is why so many cases go untreated. But people shouldn’t let this condition spoil their quality of life. 

Just because you can go through the motions of life doesn’t mean you have to live that way

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As you read the list, perhaps the symptoms will feel uncomfortably familiar, but don’t let that make you despair. Instead, let it encourage you. You finally have an answer for why you feel the way you do, proof that you haven’t been making this up, and therefore there are real treatments available that can help you. With that in mind, let’s get on to the list. Symptoms and their severity vary depending on the person, but here are some signs to look for:

Signs of High Functioning Depression

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  1. Low self-esteem
  2. Excessive anger, anxiety, or irritability
  3. Often feeling empty or sad
  4. Feeling hopeless or pessimistic
  5. Self-loathing
  6. Feeling guilty or worthless
  7. Avoiding social interaction
  8. Increase or decrease in appetite
  9. Low energy and fatigue
  10. Sleeping too much or too little
  11. Difficult concentrating, remembering, or making decisions
  12. Reduced activity and productivity
  13. Losing interest in things you usually enjoy
  14. Ruminating about death, self-harm, or suicide

What Causes Depression?

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While depression doesn’t always come from a trigger, some factors are more likely to spring a depressive episode. These can include traumatic events like the loss of a loved one, loneliness, major life changes, and chronic pain and medical conditions. [2] There are also risk factors based on individuals’ personalities, lives, and backgrounds.

Read More: High-Functioning Depression: 16 Truths Sufferers Wish You Knew

These can include:

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  • Trauma
  • Life stressors
  • Neuroticism
  • Prior mental illness
  • Anxiety
  • Low self-esteem
  • Taking certain medications
  • Using substances like alcohol and recreational drugs that can cause or exacerbate symptoms
  • Family history of mental illness

You Don’t Have to Suffer Quietly

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There is no symptom severity ‘limit’ for what you can and should seek help for,” says Mirela Loftus, MD, PhD, a psychiatrist and medical director at Newport Academy. “If you experience any of the aforementioned symptoms, the first step is to talk to your primary care physician or another healthcare provider.”

Treating The Problem

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High functioning depression, or rather, PDD is usually treated with cognitive behavioral therapy, where the therapist listens to the patient’s experience and helps them replace unhelpful behaviors and thinking patterns with beneficial ones. “Talking to a therapist can help navigate the stress one is experiencing, and if the depression manifests with physical symptoms [such as sleep problems or changes in appetite], antidepressant medications may become a consideration,” says Loftus. [3]

Read More: How to Tell the Subtle Differences Between Laziness and Depression

Self-care and lifestyle changes are also important aspects of treatment

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Although depression fatigue gets in the way of functioning, making an effort to practice healthy behaviors could go a long way to feeling better in the long-term.

Here are some changes to try:

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  • Waking up and going to bed at the same time every day
  • Engaging in some form of physical activity or exercise
  • Eat a well-balanced diet rich in fruit and vegetables
  • Contact loved ones for support or join a support group
  • Journal, meditate, or make art

Read More: Using Social Media is Causing Anxiety, Stress and Depression


  1. “What is high-functioning depression?” Medical News Today. Steph Coelho. June 9, 2020
  2. “What Is ‘High-Functioning’ Depression?Very Well Mind. Santana Gupta.June 12, 2022
  3. “Is High-Functioning Depression a Real Diagnosis?” Everyday Health. Michelle Pugle. April 1, 2022