Depression affects millions, but it doesn’t always look the way we expect. Often, we imagine it as deep sadness or withdrawal from life, but it can also be something more hidden. High-functioning depression is one of those quieter forms. People with this type may seem to have it all together—excelling at work, maintaining social lives, even appearing upbeat—but inside, they’re struggling with persistent feelings of emptiness and low mood.
This type of depression can be especially hard to spot because the outward signs don’t match the internal battle. It’s easy to miss, both for the person experiencing it and those around them. In this article, we’ll dive into what high-functioning depression looks like, how to support those who are affected, and the treatment options available through Westwind Recovery® to help people find their way back to feeling better.
Understanding High-Functioning Depression
High-functioning depression, sometimes referred to as persistent depressive disorder with atypical features or “smiling depression,” is not a formal diagnostic term in the DSM-5. However, it effectively describes a pattern of depressive symptoms that don’t necessarily impede an individual’s ability to maintain their daily routine or achieve professional success. These individuals often excel in their careers, maintain active social lives, and appear to be coping well. This “mask” of normalcy can make it difficult for them to recognize their own suffering and for others to offer support.
The core of high-functioning depression lies in the disconnect between outward appearance and inner experience. Individuals may experience persistent feelings of sadness, hopelessness, and worthlessness, but they are adept at concealing these emotions. They might engage in “compensatory behaviors,” such as overworking, perfectionism, or excessive social engagement, to distract themselves from their internal pain and maintain the illusion of well-being.
Several factors can contribute to the development of high-functioning depression. Personality traits such as perfectionism and a strong need for control can make individuals more susceptible. Societal pressures to succeed and maintain a positive image can also contribute to the tendency to suppress negative emotions. Additionally, a history of trauma, chronic stress, or genetic predisposition can increase the risk.
The Signs and Symptoms of High-Functioning Depression
Identifying high-functioning depression can be challenging because individuals often downplay or deny their symptoms. However, certain signs and symptoms may indicate the presence of this condition:
- Persistent Low Mood: While individuals may not appear overtly sad, they often experience a persistent sense of gloom, emptiness, or dissatisfaction.
- Loss of Interest or Pleasure: Even in activities they once enjoyed, individuals may experience a diminished sense of pleasure or motivation.
- Changes in Appetite or Sleep: These can manifest as overeating or loss of appetite, insomnia, or excessive sleepiness.
- Fatigue and Low Energy: Despite maintaining a busy schedule, individuals may experience chronic fatigue and a lack of energy.
- Difficulty Concentrating: They may struggle with focus, memory, and decision-making.
- Feelings of Worthlessness or Guilt: Despite external success, individuals may harbor deep-seated feelings of inadequacy or self-blame.
- Irritability or Restlessness: They may experience increased irritability, agitation, or difficulty relaxing.
- Physical Symptoms: Unexplained aches, pains, or gastrointestinal issues can also be associated with depression.
- Social Withdrawal (Subtle): While maintaining a social presence, they may avoid deep connections or meaningful interactions.
- Perfectionism and Overworking: These can be coping mechanisms to avoid confronting underlying emotional pain.
- Thoughts of Death or Suicide: Even if they don’t appear outwardly distressed, individuals may experience recurring thoughts of death or suicide.
How to Help Others with High-Functioning Depression?
Supporting someone with high-functioning depression requires empathy, patience, and understanding. Here are some helpful strategies:
Being a good listener is one of the most valuable ways to support someone with high-functioning depression. Offer a safe and non-judgmental space for them to share their feelings. When they open up, avoid giving unsolicited advice and focus on listening and validating their emotions. Just knowing they’re heard can be incredibly comforting for someone dealing with high-functioning depression.
Patience is crucial when supporting someone with high-functioning depression. People with high-functioning depression may struggle even when they appear fine. Be patient and understand that their moods can fluctuate. Refrain from offering quick fixes or encouraging them to “snap out of it,” and instead provide a consistent, understanding presence, letting them know you’re there for them no matter what.
While offering emotional support is important, it’s equally vital to encourage seeking professional help. Therapy can provide effective tools for managing depression. You can offer support by researching therapists or helping them set up an appointment, but respect their pace in making that decision.
Sometimes, the smallest gestures of support can have the most significant impact. It could be as simple as checking in regularly with a text or phone call, offering to hang out without any expectations, or helping with tasks they find overwhelming, like grocery shopping or household chores. Sometimes, just being there to listen or share a quiet moment can ease the pressure they feel.
While it may seem like the last thing someone with high-functioning depression wants to do, self-care and maintaining healthy habits are key to improving mental well-being. Encouraging healthy habits like eating well, getting enough sleep, and staying active can be beneficial, though it’s important not to pressure them. Gently suggest these activities and offer to do them together, like going for a walk or cooking a healthy meal, to make self-care feel less like a task.
High-functioning depression often leads people to set impossibly high standards for themselves. Help them break tasks into smaller, manageable steps, and encourage them to focus on progress, not perfection. Celebrate their achievements, no matter how small. By being supportive and patient with their progress, you can help them feel less overwhelmed and more in control.
Supporting someone with depression can be emotionally taxing, so it’s important to maintain your well-being. Set boundaries when needed, and don’t be afraid to ask for help. This allows you to be a more effective support while protecting your own mental health. Remember, you’re not their therapist or caregiver but a supportive family member or friend, and it’s okay to ask for help when you need it, too.
It’s important to be aware of the warning signs that their depression may be worsening, such as increased withdrawal, a decline in functioning, or expressions of hopelessness or self-harm. If you notice any concerning behaviors, it’s essential to address them promptly. Be prepared to take action if necessary, including seeking emergency support if they express suicidal thoughts.
While you may have good intentions, sharing your own experiences with depression or offering advice like “I’ve been through this, and this is what helped me” can sometimes be counterproductive. Instead, try to focus on validating their feelings and experiences without minimizing or dismissing them. Every person’s journey with depression is different, and what worked for you may not work for them.
Everyone copes with depression in their own time and at their own pace, and it’s crucial to respect that. Don’t push them to talk or open up if they’re not ready, but make sure they know you’re there when they are. Sometimes, just showing that you’re consistently present, without trying to force a conversation, can provide them with the space they need while letting them know they’re not alone.
These strategies can help someone with high-functioning depression feel supported, understood, and less alone in their journey.
What Treatment Programs Does Westwind Recovery® Offer to Assist with High-Functioning Depression?
At Westwind Recovery®, we understand the unique challenges of high-functioning depression and offer comprehensive treatment programs designed to meet the specific needs of individuals struggling with this condition. Our holistic approach integrates evidence-based therapies with supportive services to help you achieve lasting recovery.
Experienced therapists offer individual therapy sessions to explore emotions, identify underlying issues, and develop coping strategies. Therapies like Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are highly effective in treating depression.
Group therapy provides a supportive space for individuals to connect with others facing similar struggles, reducing feelings of isolation and promoting healing through shared experiences.
For those with co-occurring substance use disorders, Westwind Recovery® offers dual diagnosis treatment, addressing both mental health and substance use issues simultaneously with an integrated approach.
Holistic therapies such as yoga, meditation, and mindfulness are incorporated to enhance well-being and reduce stress, supporting overall mental health.
Recognizing that each person’s experience is unique, Westwind Recovery® tailors mental health treatment plans to meet individual needs and goals.
Comprehensive aftercare planning ensures ongoing support after treatment and helps prevent relapse, offering a continued path to recovery.
Westwind Recovery® Can Help with High-Functioning Depression
High-functioning depression can deeply affect an individual’s quality of life. Westwind Recovery® offers compassionate, effective treatment through evidence-based therapies and personalized care. We provide the guidance and support to navigate high-functioning depression and achieve lasting recovery. Contact us today to learn more about our programs!
Dr. Deena is the Chief Clinical Officer of Westwind Recovery®, an award-winning outpatient treatment center in Los Angeles where she oversees the clinical and administrative program and treatment methods. Dr. Deena is a doctor of psychology and licensed clinical social worker since 1993. LCSW #20628. Originally from the East Coast, Dr. Deena has worked running treatment centers, worked as a therapist in psychiatric hospitals as well as school settings and currently has a thriving private practice in the LA area. Dr. Deena has appeared regularly on the Dr. Phil Show as an expert since 2003. She has also been featured on many other TV shows, podcasts and has contributed to written publications as well as podcasts.
