The Duality of Depression: High Functioning Depression Can be Difficult to Recognize

Can a depressed person be visually identified?  Do people who suffer with depression manifest certain mannerisms, expressions or behaviors?  Mainstream media has historically branded the face of depression as a person curled up in bed, sitting in a dark corner, crying themselves to sleep, or not having the energy to attend school or work.  Depression does not always manifest in this overt classically characterized depiction.  There are many people who struggle daily with depression, but their outward appearance and actions might not obviously show their struggle. 

High functioning depression is not an official subset of Major Depressive Disorder (MDD) but is used colloquially to refer to people who appear to be high achieving-- performing well at their workplaces, maintaining exercise regimens, and engaging in social activities-- but beneath this veneer of success they struggle to get through their days.

As the recent suicides of fashion designer Kate Spade and chef Anthony Bourdain remind us, when it appears outwardly that someone may "have it all," it might not actually be the case.  They may find it more difficult to seek help because of the internal and external pressures to maintain the facade of effortless success. A highly functioning person with depression may even downplay their own struggles because they are still able to engage in their daily lives and do not fit the "typical" image of a depressed person. They may also feel shame for being simultaneously successful and unhappy, causing them to worry about being perceived as spoiled or ungrateful, or not taken seriously if they were to reach out for help. Others who experience great success and are able to engage in activities might not even recognize the severity of their symptoms.

With depression, it is critical to keep an eye out for symptoms, which include:

  • Increasing reliance on self-medication such as alcohol or recreational drugs
  • Increased irritability
  • Masking depressive symptoms during social activities
  • Disrupted sleep patterns (sleeping too much or too little on days without work/social responsibilities)

It’s important to recognize changes in yourself and those around you, no matter how someone’s life appears to be going. Appearances can be deceiving, especially those that are carefully curated on social media.

If you or a loved one are experiencing depressive symptoms, we urge you to reach out for help.  Depression is a treatable condition and people do not have to suffer. There are a variety of ways to treat depression, including medication, talk therapy, and Transcranial Magnetic Stimulation (TMS) Therapy.  If you or a loved one are struggling with depression and find that medication and talk therapy are not enough, schedule a free consultation with Greenbrook TMS to learn how we can help.

If Covid-19 and social isolation are heightening your symptoms of depression, Greenbrook TMS therapy may be able to help. At Greenbrook, we specialize in TMS therapy — an FDA-cleared, non-invasive treatment for treatment-resistant depression and OCD without harmful side effects. See if TMS therapy is right for you by clicking here to take a brief assessment:

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