High-functioning depression is characterized by a low level of daily sadness and is frequently invisible to friends, family, and coworkers. Learn more about the signs and treatment of high-functioning depression.

People with high-functioning depression successfully continue daily activities while experiencing periods of sorrow or hopelessness that negatively impact their overall happiness. Treatment for high-functioning depression can resolve symptoms, improve well-being and prevent the development of more severe depression.

What is High-Functioning Depression?

High-functioning depression is also called dysthymia, or persistent depressive disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), persistent depressive disorder is a form of chronic depression characterized by a depressed mood lasting at least two years. For children and adolescents, the mood can be irritable rather than sad and the time requirement is one year. For all age groups, symptoms are not absent for greater than two months.

People with high-functioning depression experience a depressed mood for most of the day and on more days than not. Although high-functioning depression shares signs with other types of depression such as major depressive disorder, the symptoms are less severe and interfere less with daily activities. For example, people with high-functioning depression may have successful careers, healthy relationships, and active social lives. As a result, high-functioning depression may be invisible to family, friends, and coworkers. However, the chronic, low level of sadness of high-functioning depression can negatively impact a person’s physical and mental health over time. Proper diagnosis and treatment can help resolve symptoms and improve the quality of life for a person living with high-functioning depression.

Signs of High-Functioning Depression

Since debilitating depressive periods do not characterize high-functioning depression, the signs are often difficult to recognize. People with high-functioning depression often fail to seek help because the disorder has become so much a part of them that they believe their symptoms reflect normal life. 

Symptoms of high-functioning depression include:

  • Feeling empty or sad
  • Lack of interest in everyday activities
  • Lack of appetite or overeating
  • Sleep problems
  • Low energy or fatigue
  • Low self-esteem
  • Difficulty concentrating
  • Irritability
  • Hopelessness
  • Trouble making decisions

Living with High-Functioning Depression

A person living with high-functioning depression may experience several different thoughts or emotions daily, such as:

  • Gloomy mood: feeling sad throughout the day, making it challenging to experience enjoyment when participating in favorite activities or social situations
  • Exhaustion despite sleeping well: gathering the energy to get out of bed and make it through the day may be challenging
  • Irritability: having a short fuse when dealing with others
  • Self-criticism: continually feeling bad about one’s self
  • Weight changes: gaining or losing weight without trying to due to over or under-eating
  • Excessive worry: constantly questioning past and present decisions and what they mean for the future
  • Extreme stress: small, daily problems cause a great deal of stress
  • Substance use: dealing with chronic everyday sadness may lead to substance use

 A person dealing with high-functioning depression may carry on with their daily lives while suffering inside. Without knowing how to deal with their underlying depression, a person with high-functioning depression may try to distract themselves from their sadness by using alcohol or other substances. However, there are many successful coping strategies and treatments for dealing with high-functioning depression.

Associated Stigma

The stigma surrounding depression and other mental health conditions can make seeking help difficult. Depression stigma includes the belief that only those with severe symptoms, such as inability to function in daily life or suicidal thoughts, require treatment. This stigma can cause those with high-functioning depression to believe they should quietly tolerate their symptoms. 

However, high-functioning depression is a severe disorder that can be debilitating. More than half of people with high-functioning depression, or dysthymia, eventually have an episode of major depression. Thus, seeking proper diagnosis and treatment for high-functioning depression is critical.

Am I Depressed?

If you are wondering, “do I have high functioning depression?”, you should seek help from a qualified mental health professional. They will be able to identify symptoms of high-functioning depression and develop a treatment plan. A brief set of test questions, like this one, can also help you evaluate your symptoms and be used as a guide for discussing them with a mental health professional.  

Treatment for High-Functioning Depression

Treatment for high functioning depression can vary depending on the patient and the type and severity of their symptoms. High-functioning depression treatment includes both psychotherapy and medications, as the combination of both therapies is more effective than either treatment independently.

Psychotherapy, or talk therapy, with a qualified mental health professional can help a person with high functioning depression:

  • Identify negative thought patterns and learn how to replace them with positive ideas
  • Recognize triggers and learn how to deal with them in a healthy way
  • Develop coping strategies to resolve symptoms, include journaling, exercise, and meditation
  • Discover ways to enrich relationships with family and friends
  • Gain problem-solving skills to deal with life’s challenges

Psychotherapy can also involve group or family therapy and cognitive-behavioral therapy (CBT), a form of treatment that consists of focusing on how thoughts, beliefs, and attitudes lead to problematic behaviors.

Along with psychotherapy for the treatment of high-functioning depression, medications are also sometimes necessary. Medications used to treat high-functioning depression include antidepressants such as:

If you or a loved one is dealing with high-functioning depression along with an addiction, help is available. The Recovery Village has locations across the country, staffed with mental health professionals who have experience working with substance use and depressive disorders. To learn more, call The Recovery Village today to speak with a representative.

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Editor – Renee Deveney
As a contributor for Advanced Recovery Systems, Renee Deveney is passionate about helping people struggling with substance use disorder. With a family history of addiction, Renee is committed to opening up a proactive dialogue about substance use and mental health. Read more
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Medically Reviewed By – Dr. Candace Crowley, PhD
Dr. Candace Crowley received her B.S. in Biochemistry from Cal Poly, San Luis Obispo, and her Ph.D. in Immunology from UC Davis, where her thesis focused on immune modulation in childhood asthma. Read more

Greenstein, Laura. “Understanding Dysthymia.” National Alliance on Mental Illness, January 17, 2018. Accessed June 12, 2019.

Patel, Raj and Rose, Gregory. “Persistent Depressive Disorder (Dysthymia).” StatPearls, May 4, 2019. Accessed June 11, 2019.

Dysthymia.” Harvard Health Publishing, March 2014. Accessed June 11, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.