High-Functioning Depression: Symptoms And Mental Health Treatment Options

Medically reviewed by Corey Pitts, MA, LCMHC, LCAS, CCS
Updated February 26th, 2025 by BetterHelp Editorial Team

Mental health conditions can present in various ways, and each form of depression may look different. Some individuals may experience persistent sadness and loss of energy that affects their ability to function in everyday life. However, other individuals may continue to fulfill responsibilities at work, maintain relationships at home, and perform daily activities, despite experiencing internal mental health challenges.

High-functioning depression, though not an official diagnosis, is a colloquial term used to describe a mental health condition in which individuals appear to be managing responsibilities effectively while experiencing unseen depression symptoms. High-functioning depression can be challenging to experience, impacting quality of life and emotional well-being. Therapy and lifestyle changes are often helpful for people with this type of depression.

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Recover from high-functioning depression

What is high-functioning depression?

Rather than a clinical diagnosis, high-functioning depression is a term used to describe a condition in which individuals experience depressive symptoms while continuing to function effectively in their daily lives. Since these individuals maintain their work performance, family obligations, and social responsibilities, their symptoms may go unnoticed by those around them.

Unlike major depression, which can severely impact daily function, high-functioning depression tends to be associated with persistent but manageable symptoms. However, this doesn’t mean symptoms shouldn’t be taken seriously. Long-term emotional distress can impact mental, physical, and emotional well-being, potentially contributing to the development of other mental health disorders over time.

Symptoms of high-functioning depression

Symptoms of high-functioning depression are similar to those experienced in persistent depressive disorder (PDD). Below are a few common symptoms:

  • Persistently feeling sad, hopeless, or helpless 
  • Sleeping too much or experiencing insomnia
  • Having difficulty concentrating or making decisions
  • Experiencing a lack of interest in activities that usually bring joy
  • Having negative thoughts and perceptions about oneself and others
  • Experiencing fatigue and a general lack of energy

These symptoms may go unnoticed because they don’t always prevent people from maintaining their day-to-day responsibilities. However, high-functioning depression can lead to worsening mental health symptoms over time.

The difference between high-functioning depression and persistent depressive disorder (PDD)

There is some symptom overlap between high-functioning depression and persistent depressive disorder (PDD). However, there are also some key differences. Unlike high-functioning depression, PDD is a clinically recognized diagnosis. PDD, otherwise known as dysthymia, involves persistent depressive symptoms that last for two or more years. Symptoms may come and go over this period but occur the majority of the time. Individuals with PDD often experience a consistently low mood, along with other symptoms that impair their mental and emotional well-being.

Symptoms of persistent depressive disorder (PDD)

Persistent depressive disorder often involves the following symptoms:

  • Persistent sadness, helplessness, or hopelessness
  • Low energy and persistent fatigue, even after a full night's rest
  • Difficulty experiencing joy and enthusiasm during activities once enjoyed
  • Frequent anger, frustration, or impatience
  • Avoidance of social interactions and activities
  • Criticism of oneself and others

While the term “high-functioning depression” is often used to describe people who appear to be successful despite internal challenges and symptoms, PDD is a diagnosable mental health condition that often requires professional assessment and treatment. If their symptoms persist, individuals with high-functioning depression may meet the criteria for PDD.

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The impact of high-functioning depression on everyday life

Even though people with high-functioning depression may continue to fulfill their responsibilities, maintain their relationships, and participate in daily activities, symptoms of emotional distress can impact their work and home lives. At work, individuals may push themselves harder to compensate for their emotional distress, potentially leading to fatigue and burnout. In addition, people experiencing emotional distress may withdraw from social interactions.

Social withdrawal tends to be associated with various mental health conditions, including high-functioning depression. Regardless of severity, people experiencing depressive symptoms may isolate themselves from friends and family members, which may lead them to experience a sense of being emotionally disconnected from others.

Depressive symptoms, even those that aren’t readily noticeable by others, can also impact relationships. People may form negative opinions and believe stereotypes about depression, which can lead those experiencing symptoms to believe they will be judged and misunderstood if they speak up about what they’re experiencing. 

Strategies for managing well-being and mental health

While high-functioning depression can be challenging to experience, there are practical strategies you can implement to foster mental health, physical well-being, and emotional resilience.

Lifestyle changes in conjunction with professional treatment

Prioritizing small, intentional self-care activities throughout the day may improve mood and energy levels. Eating nutritious meals, taking mindful work breaks, prioritizing sleep, spending time outdoors, and engaging in regular exercise can support mental, physical, and emotional health. When time is limited, combining these activities to support your well-being can be worthwhile. For example, exercising in natural environments can benefit emotional well-being, so swapping a treadmill workout for an outdoor walk or jog may be worthwhile.

Social support

Fostering a social support system may help individuals manage high-functioning depression, especially when symptoms flare up. Research shows that strong social relationships can reduce depressive symptoms. Friends, family members, and support groups can provide connection, compassion, and support during stressful life events.

Mindfulness practices

Mindfulness and self-awareness practices can help people shift negative thought patterns to be more constructive or accept difficult thoughts without judgment. Meditation can reduce symptoms of depressive disorders like clinical depression (major depressive disorder). Some mindfulness and cognitive approaches to try include the following:

  • Mindful observation: Paying attention to thoughts, feelings, and body sensations in the present moment without labeling or judging them can reduce their impact
  • Deep breathing: Slow, deep breathing can support mental and physiological health, stabilizing blood pressure and reducing stress, anxiety, and depression
  • Relaxation techniques: Visualizing peaceful scenarios or consciously releasing tension from different parts of the body can lead to a sense of calm

The impact of untreated high-functioning depression

Symptoms of high-functioning depression may be less intense than those associated with major depressive disorder (MDD) and persistent depressive disorder (PDD). However, when mild symptoms of depression are left untreated, they may worsen over time. Individuals may have difficulty coping with minor stressors and setbacks, experience emotional numbness or detachment, or begin relying on unhealthy coping mechanisms, such as overworking, isolating themselves, or engaging in substance misuse.

Hidden mental health challenges

A key challenge of high-functioning depression is that symptoms can be difficult to identify, particularly from the outside. Therefore, people may dismiss their feelings of sadness, fatigue, and frustration as normal responses to everyday life. This can prevent them from effectively treating high-functioning depression with the help of a healthcare provider.

Online treatment for high-functioning depression

Online therapy has become an increasingly accessible option for people with high-functioning depression. Platforms like BetterHelp allow individuals to connect with a specialized mental health professional who follows clinical practice guidelines from any location with an internet connection. Sometimes, depressive symptoms like fatigue and lack of motivation can make attending in-person sessions challenging. However, online therapy can remove these barriers to healthcare so people can receive the support they deserve from the comfort of their homes.

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Recover from high-functioning depression

What research says about online therapy

Individuals with high-functioning depression can attend cognitive behavioral therapy (CBT) sessions, guided self-help programs, and support groups online. Research shows that internet-based cognitive behavioral therapy (iCBT) can improve symptoms of mild to moderate depression. When combined with lifestyle changes and social support, online therapy may be especially effective for treating symptoms of high-functioning depression.

Takeaway

High-functioning depression can be difficult to recognize due to its subtle symptoms, but it can still have a significant impact on a person’s mental and emotional well-being. On the outside, individuals may appear to manage their responsibilities well, but they may be experiencing significant internal challenges. By incorporating lifestyle changes, social support, mindfulness practices, and professional treatment, individuals can address symptoms of high-functioning depression, enhance overall well-being, and live a more balanced and fulfilling life. Online therapy can be an especially accessible and convenient form of treatment for those with high-functioning depression.

Depression is treatable, and you're not alone
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