Walking around with high-functioning depression can often feel like you’re playing a part, wearing a costume but terrified that someone will notice your wig slip, that your depression will peek through your makeup. Struggling with depression is hard enough, but it’s only worsened by the myths and assumptions held about high-functioning depression.
People often are surprised to hear that I struggle with depression, as I do a good job of hiding it, too good a job. It makes me feel like an imposter for even saying that I’m depressed as if the high-functioning quality is a failure in my ability to be depressed. But this is simply how my depression manifests, how my personality disorder interacts with it. It doesn’t minimise my pain and experiences, and it doesn’t mean that I’m less worthy of help or compassion, even when my depression tries to tell me that I am.
Here are the eight biggest myths of high-functioning depression, the things that people wrongly assume or don’t consider enough. Each high-functioning depression myth is approached and explained, but remember that this will never cover each unique experience. It’s merely a collection of the most common, but I hope to leave room to each individual.
This is the biggest myth and one that applies for regular depression or any other mental illness as well. There’s the idea that you’re not actually struggling, that you’re exaggerating or just wallowing. It rings even more true for HFD as you don’t look like you’re struggling, your entire existence is based on that. Because if you seem fine, maybe you are fine and maybe you can keep going. So you wipe away your tears, you wear long sleeves, and you go above and beyond. Someone who is excelling at work or school, take on additional projects or tasks and has a thriving social life can’t be someone suffering from depression. But they could be. And if they reach a point of being able to share this, they definitely are, as this was no easy feat for them.
Appearing to cope does not mean that you are coping. Seeming happy does not mean that you are happy. We create an entire billion-dollar industry around acting, and yet refuse to consider that people in our lives may be doing that every day. Stop basing your opinion on their mental illness on how they appear and how wide their smile is, and base it only on what they say their experience is. Or even better, stop having an opinion on it.
If you’re doing so well in your work or school, you can’t be struggling that much. You’re getting up every day and doing what people without depression do, or even more, so you must be fine. Once more, it isn’t about what you see, but rather what they experience. Also, because their work/study may be their lifeline, and the routine is what drives them forward. They could feel like they have to do it, their following all the motions without being truly present.
Additionally, it may actually be a symptom of their suffering. I overworked myself as part of my high-functioning depression. It was a way of distracting myself from the dark thoughts, never stopping still so that I could keep going and pretending I was okay. I took on everything and went to social events because I felt like I had to. I had low self-esteem and was desperate to make people like me. The constant fear of not being good enough, of being left by everybody I cared about, loomed over me. And so I worked. I worked harder. I just kept working. It was too scary to stop and so I didn’t, because if I stopped, I didn’t know how I would ever get up again.
Don’t use this as evidence that they’re not depressed, but rather see it as the proof that they are. They may be doing the same as others, but it is far more difficult for them.
They may also be incapable of functioning in each area of their life, “an individual withfunctional depression might still experience impairments in one area of their lives or another” (Morin, 2020). This could include their social life, family life, part-time job or studies.
If you function so well, you clearly know what’s wrong with you, and you’ll get help! I honestly wish it was that simple. Let’s break this down. Being high-functioning does not mean that you’re functioning well or in anything resembling a healthy manner. It means that you appear to, you get things done and carry on as usual. This also means that you might not even recognise what is wrong with you. You could think your range of emotions is normal, that everyone else experiences such extreme sadness and fatigue. You could know that something is wrong with you, that you shouldn’t be hurting yourself, but not recognise it to be depression.
I didn’t know I was depressed or self-harming at first; it crept in so slowly that it just felt like who I was. Even once I recognised that hurting myself was self-harm, I didn’t give myself the label of depression. I didn’t feel like I deserved it, because I didn’t have a specific reason for it and because I was high-functioning. When you manage to do everything and function in social situations, it can almost feel wrong to call yourself depressed, as if it is insulting to people who ‘actually have depression’. High-functioning depression is still depression, and you still deserve treatment.
And then even if you know that you’re depressed, you could put off getting help. Because things seem like they’re working, you’re able to go on, and so you just get by. You don’t want to get help because then you have to stop doing the things you’re doing. You’ll have to talk about it and get rid of your coping mechanisms, and those feel better than actually feeling your pain. You’ll get the official label of depression, and that’s scary and can impact how people see you, unfortunately.
Sometimes I wonder if people who aren’t high-functioning in their depression could be more likely to seek help, as they have to, they’re pushed to those limits. They can’t get up, or they can’t appear to function, as so they’re brought to the extreme quicker and provided assistance. Whilst people with high-functioning depression carry around the idea that they won’t be believed or that a therapist wouldn’t want to help them. That’s not the truth, and don’t let your mind ever tell you that it is.
Since you may be less likely to seek help, that means you won’t get access to medication as quickly either. You don’t think anything is wrong with how you’re going, or you don’t want it to stop, and medication could do precisely that.
Aside from that is also that you may not think you deserve medication or need it. Medication is often villanised, and who would subject themselves to that stigma unless they deemed it necessary? If you’re struggling to get by each day and low-functioning, you’re more likely to be offered medication or ask for it. Something has to change; you need that boost. But when you’re high-functioning, it can be seen as less needed, as you manage so why turn to medication? Often medication can be the solution; it can help to wean you off self-sabotaging behaviours and aid your recovery. Sometimes it won’t be, but you might still try it first. Just because you’re high-functioning, it doesn’t mean that you’re already on medication and this is a depressed person with medication, it also doesn’t mean you’re more likely to get it.
A lot of people won’t realise that anything is wrong with you, because you paint your picture so well. If someone smiles, gets their job done and has friends, we assume they’re fine and nothing darker brews beneath the surface. So we don’t ask. Even if they slip up, even if we see a scar, even if they drink too much. We don’t ask because we don’t have to, because it seems easier not to.
“People who appear to be functioning well don’t think they should feel depressed and may be embarrassed by it.” — Dr. Eva Stubits
If no one asks, it can be so hard to start the conversation and admit that you’re actually struggling. You don’t have an opening. But worst than that is that you may feel like you don’t have proof. Why should anyone believe you? This is the voice of depression trying to keep you in its grasp, but sadly its roots lie in our societal beliefs about depression. I wasn’t believed the first time I opened up, and it was incredibly difficult. I was made to doubt myself and struggled in silence for more years. But every time since, I have been fortunate enough to be believed, to be heard. And I work hard to be that person for others. It’s about telling the right person and coming to a place where you recognise that the most important person to believe you is yourself.
It isn’t easier to tell people just because you’re high-functioning, it can be more challenging as you doubt yourself, and you’ve hidden things too well. It can be a surprise to people, which isn’t what you want to hear as it only confirms your worst thoughts.
High-functioning depression doesn’t always mean that you were depressed and are now working towards better. It can be your start point, from which you further unravel. It can also be your only point. My personality disorder makes me feel like I have to work twice as hard to earn the people in my life and stop them from abandoning me, and so my depression was always high-functioning. I was miserable and lonely but determined not to end up alone. It could be different for someone else. But don’t assume that someone is ‘recovered’ as high-functioning depression is a struggle as well; it isn’t ‘easy’ in the slightest. You’re still hurting and struggling, yet you can’t let your walls down or admit it. You’re going harder than you should and trying to be what everyone expects from you.
We don’t like to think about self-harm, because everything in our evolution is centred around survival. Humans don’t want to die, and so why would we hurt ourselves intentionally? When we do consider self-harm, we hold specific misconceptions about it, and we label it as a teenager thing or something suicidal people do. Self-harm is far more complicated than I could ever put into words, but for now, I’ll settle on this.
Self-harm is a part of depression and the pain that needs to be released somehow. Just because your depression is high-functioning, that doesn’t mean you won’t be self-harming. CEOs can self-harm, teachers can self-harm, university students can self-harm, lawyers can self-harm, the list goes on. Just because someone seems accomplished and productive, it doesn’t mean they’re not hurting themselves, simply that they mask it well.
And let’s not forget that self-harm isn’t just cutting yourself, there are many other forms of self-harm, including self-sabotaging behaviours, binge drinking and starving yourself to name a few. Just because you don’t see their self-harm, that doesn’t mean that it isn’t there.
Depression isn’t just sadness, and this goes for high-functioning depression as well. It’s feeling exhausted, mainly because you’re pushing yourself to go as hard as everyone else, but you’re not like them, you’re depressed and so tired. You’re tired when you wake up and tired when you go to sleep. You’re so tired, and you just want it to stop. Sleep problems often accompany depression.
There can be an increased or decreased appetite, leading to overeating or starving yourself. This can be intentional, as a way to fill the void or punish yourself, or also accidental, as you just don’t care anymore.
There may be anger, as depression can be evoked as anger. Anger with specific people, or even the world as a whole. There is an injustice brewing within and irritability seething out of your pores.
A lot of self-loathing going on. Feelings of insecurity or the more overt self-hatred. This can lead to self-harm, as you are essentially trying to punish yourself, or can simply be internalised.
There are also physical complaints, such as muscle aches, headaches or stomach pain. We don’t know if these have biological causes or are a placebo, but they’re frequent in individuals struggling with depression.
Finally, although the list could honestly go on, there is a loss of interest in things you previously enjoyed. You can feel bored and restless; you struggle to concentrate. This also links to a numbness. Often depression isn’t sadness, but rather the absence of any other emotion, including happiness. You feel empty, and so you try to fill the void but fail time and time again. You’re numb as if you’re emotional core has been wrapped tightly in bubble wrap, desperate for a pop.
Whatever emotions you see may not be the whole story. The smile decorating their face in public could mask the tears that fall freely in private. Who we present to the world is rarely our entire self, and just because someone appears okay, it doesn’t mean that their struggle deserves less sympathy. Try not to make assumptions about high-functioning depression, and instead just ask them. If you’re curious, if you hold other myths about it, simply ask them. Perhaps they won’t feel comfortable sharing, or maybe they’ll appreciate the opportunity and opening. When in doubt, provide compassion, as compassion never hurts.
Did I miss a myth of high-functioning depression that you’ve encountered? Let me know in the comments.
Welcome to Symptoms of Living! A place where I like to relieve myself of the barrage of thoughts and ideas filling my mind. Here I'll take a look at various topics, from books to BPD, series to self-harm, there's nothing that we can't, and shouldn't, talk about.
Having struggled with mental illness since the age of 15, one of the hardest parts was how alone I felt in it. While mental illness is beginning to be discussed more openly, and featured in the media, I still think there is room for improvement. So whether it is mental illness or merely mental health, a bad day or a bad year, let's make this a place to approach it and strip it back. Everyone has their own symptoms of living, and you certainly won't be the only one with it.
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