What Is High-Functioning Depression?

Anyone can be depressed, regardless of age or gender. It can hit when you least expect it, but the symptoms often go away on their own with no lingering effect. But when symptoms drag out and begin affecting your quality of life, you may be diagnosed with major depressive disorder or depression. Some people often forge ahead, continuing to excel in their personal and professional lives, without realizing they may have a dangerous mental illness called high-functioning depression.

How Many People Have Depression?

Millions of people in the U.S. struggle with high-functioning and other kinds of depression, making it one of its most common and costly medical conditions. According to a U.S. National Institute of Mental Health study, depression will affect nearly 21 million adults in 2020.

Globally, the numbers are much higher. The World Health Organization (WHO) estimates that depression affects 5% of all adults worldwide or more than 280 million people. Because of this, WHO officials call depression a leading source of disability.

The Cost of High-Functioning and Other Types of Depression

All kinds of mental health disorders like high-functioning depression (also called dysthymia) affect people differently at home, work, school, and socially. One of the biggest detriments of depression is the economic burden it creates. According to the Center for Workplace Mental Health, the economic cost of depression is more than $200 billion each year. The American Journal of Managed Care paints an even more horrific picture, noting that treating depression accounts for nearly 46% of all healthcare dollars spent each year in the U.S.

Understanding High-Functioning Depression

According to the experts at Johns Hopkins Medicine, high-functioning depression or dysthymia is a weaker but long-term kind of depression. It’s also known as persistent depressive disorder. People who have it may experience occasional episodes of major depression.

High-functioning depression is a kind of depression that blends in, chameleon-like, or flies under the radar in most people’s lives until its consequences become unmistakably dangerous. Because it progresses slowly, it’s not only hard for people to recognize, but it’s difficult to be diagnosed. This kind of fabric soon becomes woven into the fabric of someone’s life, making it hard to distinguish it from just having a bad day or being afflicted by a more serious condition.

If you have high-functioning depression, it’s hard to stay upbeat even during what should be happy moments. People unfamiliar may describe you as gloomy, a regular complainer, and someone unable to have fun. Dysthymia may not be as severe as some kinds of depression, but your moods can run the whole gamut between mild, moderate, or severe. 

Symptoms of high-functioning depression to watch for include:

  • Not being interested in daily activities
  • You’re sad, empty, or have a low mood
  • You’re driven to succeed and don’t like excuses
  • You have a sense of hopelessness
  • Fatigue and low energy
  • You have poor self-esteem, criticize yourself often, and generally feel incapable
  • Problems concentrating and making decisions
  • You’re easily irritated and show extreme anger
  • You don’t do much and are less effective and productive than you used to be
  • Social activities are a turn-off
  • You feel guilty and constantly worry about the past
  • Changes in appetite and weight
  • Sleep troubles

There is no apparent reason for this kind of depression. Experts think chemical imbalances may cause it in the brain (problems with faulty neurotransmitters can be treated), but other factors are believed to contribute, too. There could be environmental, psychological, biological, and genetic influencers. Chronic stress is common in people with high-functioning depression. Still, genetics are thought to play a role as dysthymia tends to run in families – even though a specific gene hasn’t been identified.

High-functioning depression is a kind of mood disorder, often grouped with major depression, bipolar disorder, and mood disorders related to a pre-existing health issue or even from substance abuse or taking certain medications. These are attended by certain risks, like having a blood relative with mental illness, high stress in your life, certain personality traits, and whether you’ve been diagnosed with another mental illness.

In most cases, diagnosis involves:

  • A physical examination to document the personal and family medical history and rule out or confirm an underlying condition that may cause your symptoms.
  • A psychiatric assessment, with symptoms being compared to the Diagnostic and Statistical Manual of Mental Disorders criteria.

Treatment options may include counseling, antidepressants or other medicine, lifestyle changes, or ketamine therapy.


Why Don’t People Talk About Suicide?

While people often talk about physical ailments or medical conditions, they rarely openly discuss mental health issues they may be experiencing. This could happen for many reasons, but prevention efforts may lag if we don’t understand why people don’t talk about suicide.

Warning Signs for Suicide

If you suspect that someone is contemplating suicide but aren’t ready to talk with that person yet, there are warning signs to watch for:

  • Potential substance abuse
  • Destructive behavior
  • The person self-isolates from loved ones and the community
  • Dramatic shifts in mood 
  • Impetuous or reckless conduct
  • Accumulating drugs or purchasing a weapon
  • Giving away personal belongings
  • Getting their personal affairs in order
  • Making the rounds with final good-byes

Facts About Suicide

The U.S. Centers for Disease Control and Prevention (CDC) considers suicide a serious public health risk. Here are some facts to be aware of:

  • Suicide resulted in nearly 46,000 deaths in 2020.
  • Suicide affects people of all ages and is a leading cause of death for people 10 to 64 years old.
  • More than 12 million adults thought about suicide in 2020.
  • Suicide results in one death every 11 minutes.
  • It’s estimated that suicide costs America $70 billion annually.

Risk Factors

The CDC estimates that 46% of people who die by suicide experienced a documented mental health condition. Risk factors to watch for include:

  • Family history.
  • Substance abuse.
  • Intoxication at the time of the suicide attempt.
  • Access to lethal means to attempt suicide.
  • History of abuse or traumatic situations.
  • Lengthy periods of stress and inability to manage it.
  • Suffering a personal loss or tragedy.

If you think someone is considering suicide, reach out to that person. Talking to them may be a key to prevention.

Are Women More Susceptible?

The U.S. Centers for Disease Control and Prevention (CDC) says that women are more likely to try suicide than men, but fewer go through with it compared to men. This could be because men often use more lethal methods, including firearms, hanging, or suffocation. On the other hand, women make attempts by trying to poison themselves by overdosing on prescription or non-prescription medicine. Unfortunately, recent data paints a chilling portrait – that women may be starting to use more lethal means just like men.

Reasons Why the Topic of Suicide is Largely Avoided

One of the biggest reasons people don’t talk about suicide is the stigma underpinning the topic. Even now, it’s often a taboo subject. There are three kinds of stigma that we can talk about specific to suicide, but which also apply to many other sensitive topics:

  • Stigma is a big reason why some people don’t get help for mental illness. This is when someone perceives you badly due to a unique characteristic or personal attribute that they think is a disadvantage. This negative stereotype is often experienced by a person struggling with mental illness.
  • Social stigma. When talking about health topics like suicide, social stigma refers to the negative link between someone or a group of people who have a stake in certain features and an explicit disease. This could result in someone facing discrimination, being labeled, typecast, being treated apart from others, or experiencing a loss of standing because of a supposed connection with a disease.
  • Perceived stigma/self-stigma is when the person internalizes their perception of discrimination related to mental illness and fails to seek care because of it.

Other reasons people don’t talk about suicide may include public humiliation and shaming, which is part of the broader discussion of the dangers of the stigma of suicide. Today, with mobile devices, fast internet connections, and social media, instances of embarrassment have been known to drive people to suicide because they feel ashamed and can’t talk about what is going on.

Diagnosis & Treatment

If you’re considering suicide, get immediate medical care. Your healthcare provider or mental health specialist is best equipped to handle a diagnosis, which may rely on:

  • Your overall mental health. Assessment will include asking about symptoms, thoughts, feelings, behaviors, and personal and family history of suicide attempts and mental illness.
  • A physical examination to determine if there’s a medical reason for symptoms.
  • Assessing evidence of alcohol or substance abuse.
  • Determining whether any medicine you take is affecting your mental health.

If you or a loved one is in an emergency, call the suicide prevention hotline for immediate help. Standard treatment options for non-emergency situations often include psychotherapy, prescription medicine, self-help, or ketamine therapy based on your health and the symptoms you’re experiencing.

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