Even though it might not be obvious, getting through the day is exhausting.
It can be difficult to spot the signs of someone with high-functioning depression. That’s because, on the outside, they often appear completely fine. They go to work, accomplish their tasks, and keep up relationships. And as they’re going through the motions to maintain their day-to-day life, inside they’re screaming.
“Everyone talks about depression and anxiety, and it means different things to different people,” says Dr. Carol A. Bernstein, professor of psychiatry and neurology at NYU Langone Health.
“High-functioning depression isn’t a diagnostic category from a medical standpoint. People can feel depressed, but the question with depression is for how long, and how much does it interfere with our capacity to go on with [our] life?”
There’s no difference between depression and high-functioning depression. Depression ranges from mild to moderate to severe. In 2016, about 16.2 million Americans had at least one episode of major depression.
“Some people with depression can’t go to work or school, or their performance suffers significantly because of it,” says Ashley C. Smith, a licensed clinical social worker. “That’s not the case for people with high-functioning depression. They can still function in life, for the most part.”
But being able to get through the day doesn’t mean it’s easy. Here are what seven people had to say about what it’s like to live and work with high-functioning depression.
1. You feel like you’re constantly “faking it”
“We hear a lot now about imposter syndrome, where people feel that they are just ‘faking it’ and aren’t as together as people think. There’s a form of this for those who deal with major depression and other forms of mental illness. You become quite adept at ‘playing yourself,’ acting the role of the self that people around you expect to see and experience.”
— Daniel, publicist, Maryland
2. You have to prove that you’re struggling and need help
“Living with high-functioning depression is very hard. Even though you can go through work and life and mostly get things done, you’re not getting them done to your full potential.
“Beyond that, no one really believes you’re struggling because your life isn’t falling apart yet. I was suicidal and close to ending it all in university and no one would believe me because I wasn’t failing out of school or dressing like a complete mess. At work, it’s the same. We need to believe people when they ask for support.
“Lastly, a lot of mental health services have needs-based requirements, where you have to appear a certain amount of depressed to get support. Even if my mood is really low and I am constantly considering suicide, I have to lie about my functioning to be able to access services.”
— Alicia, mental health speaker/writer, Toronto
3. The good days are relatively “normal”
“A good day is me being able to get up before or right at my alarm, shower, and put on my face. I can push through being around people, as my job as a software trainer calls me to. I’m not crabby or anxiety-ridden. I can push through the evening and have conversations with co-workers without feeling total despair. On a good day, I have focus and mental clarity. I feel like a capable, productive person.”
— Christian, software trainer, Dallas
4. But the bad days are unbearable
“Now for a bad day… I fight with myself to wake up and have to truly shame myself into showering and getting myself together. I put on makeup [so I don’t] alert people about my internal issues. I don’t want to talk or be bothered by anyone. I fake being personable, as I have rent to pay and don’t want to complicate my life any more than it is.
“After work, I just want to go to my hotel room and mindlessly scroll on Instagram or YouTube. I’ll eat junk food, and feel like a loser and demean myself.
“I have more bad days than good, but I’ve gotten good at faking it so my clients think I’m a great employee. I’m often sent kudos for my performance. But inside, I know that I didn’t deliver at the level I know I could.”
5. Getting through the bad days requires an enormous amount of energy
“It’s extremely exhausting to get through a bad day. I do get work done, but it’s not my best. It takes much longer to accomplish tasks. There’s a lot of staring off into space, trying to regain control of my mind.
“I find myself getting easily frustrated with my co-workers, even though I know there’s no way they know I’m having a hard day. On bad days, I’m extremely self-critical and tend to not want to show my boss any of my work because I fear that he’ll think that I’m incompetent.
“One of the most helpful things I do on bad days is to prioritize my tasks. I know the harder I push myself, the more likely I am to crumble, so I make sure I do the harder things when I have the most energy.”
— Courtney, marketing specialist, North Carolina
6. You can struggle to focus, and feel like you’re not performing to the best of your ability
“Sometimes, nothing gets done. I can be in a long drawn out daze all day, or it takes all day to complete a few things. Since I’m in public relations and I work with individuals and companies that champion a great cause, which often pull at people’s heartstrings, my work can take me into an even deeper depression.
“I can be working on a story, and while I’m typing I have tears streaming down my face. That may actually work to the advantage of my client because I have so much heart and passion around meaningful stories, but it’s pretty scary because the emotions run so deep.
— Tonya, publicist, California
7. Living with high-functioning depression is exhausting
“In my experience, living with high-functioning depression is absolutely exhausting. It’s spending the day smiling and forcing laughter when you are plagued by the feeling that the people you interact with only just tolerate you and your existence in the world.
“It’s knowing that you’re useless and a waste of oxygen… and doing everything in your power to prove that wrong by being the best student, best daughter, best employee you can be. It’s going above and beyond all day every day in the hopes that you can actually make someone feel that you’re worth their time, because you don’t feel like you are.”
— Meaghan, law student, New York
8. Asking for help is the strongest thing you can do
“Asking for help does not make you a weak person. In fact, it makes you the exact opposite. My depression manifested itself through a serious uptake in drinking. So serious, in fact, I spent six weeks in rehab in 2017. I’m just shy of 17 months of sobriety.
“Everyone can have their own opinion, but all three sides of the triangle of my mental health — stopping drinking, talk therapy, and medication — have been crucial. Most specifically, the medication helps me maintain a level state on a daily basis and has been an intricate part of my getting better.”
— Kate, travel agent, New York
“If the depression is greatly impacting your quality of life, if you think that you should be feeling better, then seek out help. See your primary care doctor about it — many are trained in dealing with depression — and seek a referral for a therapist.
“While there’s still considerable stigma attached to having mental illness, I would say that we are starting, slowly, to see that stigma abate. There’s nothing wrong with admitting you have an issue and could use some help.”