Man with glasses at sunset

"Using terms like ‘high functioning depression’ both challenge and reinforce existing mental health stigma."

The term “high functioning depression” has started to appear more frequently (especially online), though the actual meaning of the term is often unclear. 

Is “high functioning depression” a real disorder?

While the term is used quite frequently in popular culture, high functioning depression is not a clinical disorder and is not recognized as a distinct form of depression by the DSM-5 (the most widely used and established psychiatric manual for the diagnosis of clinical disorders).[1] 

Though no official definition exists, many mental health professionals believe the term has emerged to refer to persistent depressive disorder (also known as dysthymia). 

“High functioning depression” is often used to describe a person who chronically suffers from symptoms of depression, but is still able to maintain their “normal” day-to-day functioning. “High functioning depression” can also be used to reference someone who has mostly recovered from depression, but is still dealing with more mild ongoing symptoms.

The meaning of “high functioning” likely refers to a person’s capacity to maintain reasonable work and social functioning while suffering from symptoms of depression.[2] This suggests that individuals with “high functioning depression” withdraw less from society and are still able to keep up with daily tasks, despite dealing with some of the symptoms of major depressive disorder. 

The usage of the term “high functioning depression” may stem from another informal condition called “high functioning anxiety”. Similarly, “high functioning anxiety” is not an officially recognized mental disorder, but is commonly used to describe people who experience mild but long lasting anxiety symptoms. The struggles of those with “high functioning anxiety” may go largely unnoticed by others because of their outward success and perceived ability to keep up with everyday life.[3]

What are the signs and symptoms of “high functioning depression” or persistent depressive disorder?

Because “high functioning depression” lacks a concrete definition or formal recognition by the psychiatric community, we can instead look at persistent depressive disorder (PDD), which is an official diagnosis recognized by mental health professionals . PDD, which is also known as ‘dysthymia’, is a distinct form of depression categorized by symptoms that are less intense, but longer lasting (often over 2 years in length – hence the “persistent” in PDD) than major depressive disorder (MDD).[4]

PDD shares many symptoms with MDD and other forms of depression, but differs in its severity and persistence. These symptoms include:[5]

  • Prolonged feelings of sadness or emptiness. 
  • Inability to concentrate.
  • Lack of energy or focus. 
  • Changes in diet and exercise (often attributed to under- and over-eating).
  • Changes in sleep patterns ( sleeping too much, or not enough).
  • Low self-esteem.

Why is the term “high functioning depression” being used, and how does it impact depression stigma?

Use of terms like ‘high functioning depression’ can both challenge or reinforce existing mental health stigma. 

Unfortunately, many people have unconscious biases and believe in incorrect stereotypes about how men battling depression might speak, act, or look. Slowly, this has been changing as more and more male athletes, celebrities, musicians, and community members have been opening up about their experiences with depression. However, many guys dealing with depression may avoid the term “major depression” because of its heavy weight and negative connotations.

For some guys, self-labeling as “high functioning” can be helpful because it serves as a reminder of the significant progress they’ve made in their recovery. As their symptoms reduce in severity, they may no longer identify as strongly with the diagnosis of major depressive disorder and find that shifting to “high functioning depression” instills feelings of growth, progression, and recovery, making them feel more in control of their depression. 

Using the term “high functioning” to describe someone with depression goes against the negative stereotypes surrounding what men can accomplish while battling depression. However, it also implies that some men with depression are “low functioning”. As such, the term “high functioning depression” is a double edged sword, challenging existing stereotypes, but also possibly leading to more confusion and stigma for men with depression who don’t fall in the “high functioning” category. 

How can PDD or “high functioning depression” be treated?

Once identified, it is common for medical professionals to recommend therapy or medication to treat PDD. In addition to following the advice of medical professionals, there are various self-help techniques we can use in tandem to improve the mild yet persistent symptoms associated with PDD. Such strategies include:[5]

“High functioning depression” is still depression

It is important to remember that all forms of depression deserve our attention, and require professional treatment and support. 

Although we may find it helpful to label ourselves as “high functioning”, that does not mean we should then downplay the importance and potential severity of the thoughts and feelings we are experiencing. 

It’s important to recognize that PDD (even when referred to as “high functioning depression”) is a chronic form of depression, so even though it may sound less serious than major depressive disorder, it isn’t something we can expect to recover from overnight or on our own. Proper medical support, good self-care, and hard work are key to continuing on the road to recovery for depression of any severity.

Although different forms of depression manifest in unique ways, they can all be very difficult to deal with and greatly impact our everyday life, especially when left untreated. 

It’s never too early nor too late to reach out

Any lasting symptoms of depression, mild or severe, should be taken seriously . If you have not yet received a diagnosis but suspect you may be dealing with some form of depression, don’t push it aside and hope it gets better without taking action. 

This is especially true with “high functioning depression” or PDD. It can be tempting to dismiss your symptoms if you are still able to function socially or at work, but PDD is still serious and can interfere with your life. Fortunately, there are steps that can be taken to greatly improve your mental health.

Reaching out to your family and friends is a good starting point. Additionally, many professional services are available to help guide you on your path to recovery. 

If you aren’t sure where to start, our Self Check can help you see the impact of your symptoms and point you towards further resources.

Taking care of your mental health should be a top priority. For more information and a guide to the recovery process, see our Take Action page. 


References

  1. Medical News Today. (2020, June 9). What is high functioning depression? https://www.medicalnewstoday.com/articles/high-functioning-depression#definition
  2. Hirschfeld, R., Montgomery, S., Keller, M., Kasper, S., Schatzberg, A., Moller, H., Healy, D., Baldwin, D., Humble, M., Versiani, M., Montenegro, R., & Bourgeois, M. (2000). Social functioning in depression: A review. The Journal of Clinical Psychiatry, 61(4), 68-75. https://www.psychiatrist.com/jcp/depression/social-functioning-depression-review/
  3. Forbes. (2022, June 27). High-functioning anxiety: What it is, symptoms and treatment. Forbes health. https://www.forbes.com/health/mind/what-is-high-functioning-anxiety/
  4. WebMD. (2020, September 27). Dysthymia (mild, chronic depression).  https://www.webmd.com/depression/guide/chronic-depression-dysthymia
  5. Johns Hopkins. (n.d.). Dysthymia. Hopkins medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/dysthymia

Free Self Guided Courses for Men: New Feature

We're excited to launch our free self-guided courses: Managing Anger and Irritability, Rewiring Negative Thoughts, and Mindfulness for Men.

View Courses