Dual Diagnosis

Signs You Have High-Functioning Depression

What is high-functioning depression? You might know someone who has it. Learn more about this misunderstood form of depression in our blog.

Signs You Have High-Functioning Depression

Table of Contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

March 30, 2023

The Edge Treatment Center

There has been a rise in the prevalence of high-functioning depression in the United States in recent years. However, because a lack of obvious symptoms of depression often characterizes high-functioning depression, identifying and diagnosing it may be more challenging.

The COVID-19 pandemic has also contributed to increased depression and anxiety in the United States, including high-functioning depression. In addition, the pandemic has caused social isolation, financial stress, and uncertainty about the future, all of which can exacerbate symptoms of depression. 

Other factors contributing to the rise of high-functioning depression in the United States include the pressure to succeed in a competitive society, the prevalence of social media and technology, and the increasing demands of work and family life. Additionally, mental health issues' stigma may prevent individuals from seeking help, leading to untreated depression. 

Anyone struggling with any form of depression, even high-functioning depression, should accept the assistance of a trained mental health professional. Symptoms can be alleviated and quality of life increased with the help of treatment.

By the Numbers:

According to data from the National Institute of Mental Health, an estimated 21.0 million adults in the United States had at least one major depressive episode. This number represented 8.4% of all U.S. adults.

What Is High-Functioning Depression?

High-functioning depression is defined as a subtype of depression that is characterized by individuals experiencing symptoms of depression but still being able to function relatively well in their daily lives. It can be difficult to recognize because people with high-functioning depression often appear successful and high-achieving on the outside, but they may struggle emotionally.

The symptoms of high-functioning depression are similar to those of major depressive disorder but are typically less severe and longer-lasting. Some common symptoms of depression include persistent sadness or feeling empty, decreased energy and fatigue, difficulty in concentrating, reduced self-esteem and feelings of worthlessness, irritability or agitation, difficulty sleeping or sleeping too much in previously enjoyed activities, appetite or weight changes, and physical symptoms such as stomachaches and headaches.

One of the key features of high-functioning depression is that individuals can continue with their daily activities, often at a high level of performance. They may succeed in their work or academic pursuits, maintain their social relationships, and appear to function well. However, this can cause disconnection and feeling emotionally drained or overwhelmed.

The causes of high-functioning depression are complex and varied, including genetic factors, environmental stressors, and psychological factors. Chronic stress is often a contributing factor, leading to changes in brain chemistry and functioning.

Treatment for high-functioning depression encompasses a combination of medication and psychotherapy. Cognitive-behavioral therapy (CBT) is often used to help individuals identify and change negative patterns of thinking and behavior contributing to depression. Antidepressant medications may also be prescribed to help regulate mood and improve symptoms.

What Are the Symptoms of High-Functioning Depression?

High-functioning depression is a form of depression in which individuals may still carry out everyday tasks while exhibiting depressive symptoms. The symptoms of high-functioning depression are similar to those of major depressive disorder but are often less severe and longer-lasting. Some common symptoms of high-functioning depression include:

Persistent Sadness or Feeling Empty

Individuals with high-functioning depression may experience a constant sense of sadness, emptiness, or hopelessness. They may feel like they cannot experience joy or pleasure.

Decreased Energy and Fatigue

People with high-functioning depression may feel chronically tired, even after getting enough sleep. They may struggle to complete daily tasks or activities they previously found easy.

Difficulty Concentrating or Making Decisions

High-functioning depression can make it difficult for individuals to focus or concentrate on tasks, impacting their work or academic performance. They may also struggle to make decisions or feel like they are constantly second-guessing themselves.

Decreased Self-Esteem and Feelings of Worthlessness

People with high-functioning depression may have a negative view of themselves and their abilities. They may feel like they are not good enough or do not deserve happiness or success.

Irritability or Agitation

High-functioning depression can cause individuals to feel irritable or easily frustrated, even over small things. They may also feel restless or agitated.

Difficulty Sleeping or Sleeping Too Much

Insomnia or difficulty sleeping is a common symptom of high-functioning depression, but some individuals may also experience hypersomnia or sleeping too much.

Lacking Interest in Previously Enjoyed Activities

People with high-functioning depression may lose interest in activities or hobbies they previously enjoyed. As a result, they may withdraw from social activities or spend less time with friends and family.

Appetite or Weight Changes

Appetite changes or weight can be a symptom of high-functioning depression. Some individuals may experience an increase in appetite and weight gain, while others may have a decreased appetite and lose weight.

Physical Symptoms Such as Headaches or Stomachaches

High-functioning depression can also cause physical symptoms, such as headaches, stomachaches, or other bodily pains.

What Are the Causes of High-Functioning Depression?

The causes of high-functioning depression include complex and multifactorial, involving genetic, psychological, and environmental factors. Here are some potential causes of high-functioning depression:


Depression can run in families, and specific genes may increase an individual's susceptibility to developing depression. However, genetics alone do not determine whether someone will develop depression, and environmental factors also play a role.

Environmental Stressors

Chronic stress, such as work-related stress, financial difficulties, or relationship problems, can contribute to depression. Individuals with high-functioning depression may be able to manage these stressors on the surface, but they may still be experiencing internal emotional turmoil.

Childhood Experiences

Childhood trauma, abuse, or neglect can increase an individual's risk of developing depression later in life. In addition, adverse childhood experiences can significantly impact an individual's emotional well-being and contribute to depression.

Brain Chemistry

Imbalances in brain chemicals such as serotonin, norepinephrine, and dopamine can contribute to the development of depression. High-functioning depression may be caused by changes in brain chemistry that are not severe enough to result in major depressive disorder.

Personality Traits

Certain personality traits, such as perfectionism, high self-expectations, and self-criticism, can increase an individual's risk of developing depression. People with high-functioning depression may be high-achievers who put a lot of pressure on themselves to succeed, leading to stress and burnout.

Medical Conditions

Certain medical conditions, such as chronic pain, thyroid disorders, or chronic illnesses, can contribute to depression. These conditions can cause physical discomfort and stress, affecting an individual's emotional well-being.

Substance Abuse

Substance abuse can be both a cause and a symptom of depression. Individuals with high-functioning depression may use drugs or alcohol to cope with their emotions, exacerbating their symptoms.

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Diagnosis of High-Functioning Depression

Diagnosing high-functioning depression could be difficult, as individuals with this subtype of depression often appear to be functioning normally on the surface. However, mental health professionals can use a combination of clinical interviews, questionnaires, and diagnostic criteria to diagnose high-functioning depression. Here are some of the key factors that may be considered in interpreting high-functioning depression:


Mental health professionals will assess an individual's symptoms to determine whether they meet the diagnostic criteria for depression. As discussed earlier, common symptoms of high-functioning depression include persistent sadness, decreased energy, difficulty concentrating, and reduced self-esteem in previously enjoyed activities.


To meet the diagnostic criteria for depression, an individual must experience symptoms for at least two weeks. However, individuals with high-functioning depression may have symptoms that persist for extended periods without significantly interfering with their daily functioning.

Functional Impairment

While individuals with high-functioning depression may be able to maintain their daily functioning, they may still experience some impairment in their personal or professional lives. Mental health professionals may assess an individual's ability to complete tasks, maintain relationships, or perform daily activities to determine whether their depression is causing functional impairment.


The severity of an individual's depression can also be a factor in diagnosis. While high-functioning depression may be less severe than major depressive disorder, individuals with this subtype of depression may still experience significant distress or impairment.

Other Diagnoses

Mental health professionals will also consider other diagnoses or underlying conditions contributing to an individual's symptoms. For example, anxiety, bipolar disorder, or a medical condition may also cause symptoms of depression.

To diagnose high-functioning depression, mental health professionals may use diagnostic criteria such as the DSM-5 or the ICD-11. These criteria include specific symptoms, duration, and functional impairment requirements that must be met for a diagnosis of depression. In addition, mental health professionals may use standardized questionnaires or assessments to help identify symptoms and severity of depression.

Treatment of High-Functioning Depression

The treatment of high-functioning depression typically involves a combination of psychotherapy, medication, and lifestyle changes. The specific treatment plan will depend on the severity of the symptoms and the individual's preferences and needs. Here are some of the most common treatments for high-functioning depression:


Psychotherapy, or talk therapy, is often the first-line treatment for depression. This therapy can help people recognize negative thought patterns and behaviors contributing to their depression and develop coping strategies to manage their symptoms. In addition, cognitive-behavioral therapy (CBT) is an effective type of psychotherapy in treating depression, as it focuses on changing negative thoughts and behaviors.


Antidepressant medication can be effective in treating depression by regulating brain chemicals that are involved in mood regulation. SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) are two types of antidepressants that are commonly prescribed for depression. However, medication is not always necessary for treating high-functioning depression, and some individuals may prefer to manage their symptoms without medication.

Lifestyle Changes

Lifestyle changes can also be effective in managing depression symptoms. Regular exercise, a healthy diet, and good sleep habits can help improve mood and reduce symptoms of depression. In addition, social support, hobbies, and relaxation techniques such as mindfulness or meditation can also be beneficial.

Support Groups

Support groups can provide a sense of community and understanding for people with depression. Joining a support group can offer the opportunity to connect with others who are experiencing similar challenges and can provide emotional support.


Practicing self-care can also help manage depression symptoms. This may include taking a relaxing bath, walking in nature, or engaging in a favorite hobby. Self-care activities can help individuals relax and reduce stress, improving mood.

Cognitive Behavioral Therapy (CBT)

CBT is a type of psychotherapy that focuses on identifying negative thought patterns and behaviors and replacing them with more positive, adaptive ones. This therapy can help individuals with high-functioning depression identify and change negative beliefs and thought patterns contributing to their symptoms.

Interpersonal Therapy (IPT)

IPT is a type of psychotherapy that focuses on improving interpersonal relationships and communication skills. This therapy can be helpful for those with high-functioning depression who may have difficulty maintaining relationships or expressing emotions.

Mindfulness-Based Therapies

Mindfulness-based therapies such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) can be effective in reducing symptoms of depression by increasing awareness and acceptance of thoughts and emotions. These therapies can help individuals develop coping skills to manage stress and negative emotions.

Psychodynamic Therapy

Psychodynamic therapy is a type of psychotherapy that focuses on exploring past experiences and relationships to gain insight into current patterns of behavior and emotions. This therapy can be helpful for people with high-functioning depression who may have unresolved emotional conflicts or difficulties with self-esteem.

Group Therapy

Group therapy can provide community support for people with high-functioning depression. Group therapy sessions can offer the opportunity to connect with others experiencing similar challenges and provide a safe space to share experiences and emotions.

It is essential to remember that the treatment of high-functioning depression may take time and may require a combination of different treatments. In addition, not all treatments work for everyone, so it may be necessary to try different approaches before finding the most effective treatment plan.

How Can The Edge Treatment Center Help With High-Functioning Depression?

At The Edge Treatment Center, we provide comprehensive and personalized treatment for high-functioning depression. Our center is staffed by a team of experienced mental health professionals committed to providing our patients with the highest quality care. 

At The Edge, we believe in a holistic approach to treating high-functioning depression, which involves a combination of psychotherapy, medication, and lifestyle changes. Our team will work with you to develop a personalized treatment plan that meets your unique needs and preferences. 

The Edge Treatment Center is committed to providing compassionate and effective care for high-functioning depression. We believe everyone deserves to live a whole and healthy life, and we are here to help you achieve that goal. To learn more, reach out to us today.

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