Is High-Functioning Depression A Real Diagnosis? - Everyday Health

Mental Health ConditionsDepressionExplore This TopicShare this articleShare on FacebookShare on XShare on PinterestCopy LinkDepression

Get the facts about depression, including its symptoms, causes, and many treatment options. Learn what experts say about talk therapy, antidepressants, and lifestyle changes that can help improve mood.

LEARN MORE

• 1What Is Depression?
• 2Depression Symptoms and Diagnosis: It Can Look Different in Men and Women and in Teenagers, Too
• 3Depression Treatment: The Options
• 4Depression Medication: Types, Side Effects, and More
• 58 Different Types of Depression
• 67 Great Exercises for Depression

SEE MOREIs High-Functioning Depression a Real Diagnosis?

Actually, it’s a buzzword used to describe real clinical diagnoses, such as persistent depressive disorder, also known as dysthymia. Here’s what these terms really mean.

ByMichelle PugleUpdated on May 23, 2024Medically Reviewed bySeth Gillihan, PhD

You may have heard other people use the term “high-functioning depression” — maybe on social media or in the news, for instance — and you might be wondering what that means.

Although “high-functioning depression” is not an official clinical diagnosis, it is a term commonly used to describe people whose depression is so well hidden that it does not affect their day-to-day functioning, says Jennie Marie Battistin, a licensed marriage and family therapist in Burbank, California.

For example, they may be socializing often with friends, meeting expectations at work, and not expressing hopelessness, yet inside they are struggling.

Next up video playing in 10 seconds

13 Surprising Facts About Major Depressive Disorder

Major depression is common around the globe, but there are still misunderstandings surrounding the diagnosis.

Why Is High-Functioning Depression So Hard to Recognize?

Persistent stereotypes about depression equate “real” depression with difficulty functioning. You can’t get out of bed, you’re always sad, and you can’t muster what it takes to do well at work.

Those stereotypes don’t apply to someone with “high-functioning depression.” The person doesn't appear “sick,” which makes it difficult for loved ones — and even the person with the condition — to identify the internal feelings of inadequacy, self-doubt, and anxiety as signs of depression, says Joanne Frederick, a national certified counselor based in Washington, DC, and the author of Copeology.

Furthermore, “high-functioning” implies (misleadingly) that since a person is able to function, there’s no clear need for intervention, says Mirela Loftus, MD, PhD, a psychiatrist and the medical director at Newport Academy, an evidence-based treatment center for teens and families dealing with mental health issues in Connecticut.

What Are the Common Symptoms of ‘High-Functioning’ Depression?

High-functioning depression can sometimes be related to a diagnosis called persistent depressive disorder (PDD) or dysthymia. It’s an often milder but long-lasting form of depression that can include bouts of major depression at certain points.

[1]

Although PDD usually is not as severe as major depressive disorder (MDD), those who have it can experience many of the same symptoms, ranging from mild to severe, at different times. These symptoms may include:

[2]

• Avoiding social activities
• Changes in appetite (increase or decrease)
• Difficulty concentrating or making decisions
• Excessive anger or irritability
• Fatigue and low energy
• Feeling hopeless
• Feeling empty, sad, or down
• Feeling guilty or worried about the past
• Low self-esteem
• Reduced productivity, activity, or effectiveness
• Self-criticism or feeling generally less capable
• Sleep issues

High-functioning depression can be hard to notice because it doesn’t set off the same external red flags as MDD does, says Anisha Patel-Dunn, DO, a psychiatrist and the chief medical officer at LifeStance Health in Bellevue, Washington.

For instance, someone with high-functioning depression may be showing up for work or school, but act more reserved than usual, says Amanda Stretcher, a licensed professional counselor in private practice in Dallas. Or they may seem fine when socializing but are not performing as well at work as usual.

Furthermore, for someone to be diagnosed with MDD, they need to have at least five symptoms of depression for at least two weeks. For someone to be diagnosed with PDD, they need to have at least two of the symptoms for more than two years.

If You’re ‘High-Functioning,’ Are You Sick Enough to Need Help?

People with high-functioning depression may assume they’re not sick enough to need help and therefore don’t seek it out. Nothing can be further from the truth, says Frederick, since depression, even if “high-functioning,” still impedes your quality of life.

“It’s important to remember that ‘high functioning’ does not mean fully functioning,” says Frederick. People with dysthymia still experience some level of impairment even if they’re able to perform most tasks on most days.

If your depression isn't comparable with extreme cases or stereotypical symptoms, that doesn’t mean you wouldn’t qualify for or benefit from professional help, Dr. Patel-Dunn adds.

And just as with physical illnesses, early intervention is important. Left untreated, any symptoms of depression can cause impaired functioning and lead to MDD or complications like substance use, chronic pain, and suicidal thoughts or behaviors.

[2]

“There is no symptom severity ‘limit’ for what you can and should seek help for,” Dr. Loftus says.

Is ‘High-Functioning Depression’ Treatable?

Yes. Although dysthymia may not appear to be as severe as major depression, it is very treatable, Frederick says. “There is no reason that anyone [has to] live with a constant low mood when effective treatments are readily available,” she adds.

“If you experience any of the aforementioned symptoms, the first step is to talk to your primary care physician or another healthcare provider,” Loftus notes.

Dysthymia is often treated with talk therapy, medication, or a combination of the two.

[3]

Cognitive behavioral therapy, one of the most common types of therapy used to treat depression, teaches people with dysthymia to turn unhelpful thinking and behavioral patterns into more adaptive ones.

The American Psychiatric Association and similar organizations offer directories to help you find a therapist in your area.

Self-care is another important way to manage dysthymia. Lifestyle changes to consider, says Loftus, include:

• Going to sleep and waking up around the same times every day
• Journaling, meditating, or making art
• Making time for physical activity each day
• Nourishing your body with a diet rich in fruits and vegetables
• Reaching out to loved ones for support and letting them know you’re struggling

If you have a family member, friend, or colleague with dysthymia and you want to offer support, Stretcher has this advice:

• Be an active listener. “They may not want or need solutions, just someone to hear them and validate their experience. So instead of offering a ‘fix,’ try asking ‘What can I do to support you?’” says Stretcher.
• Highlight any strengths you see in the person, and share what you see. “Help cultivate hope where they may be experiencing hopelessness,” Stretcher explains. But avoid directly telling someone with depression to “think positive” or naming the reasons why they shouldn’t be depressed.
• Know there will be ups and downs and continue to reach out even when they appear withdrawn. Just call or send a text to let them know you're thinking about them and that you’re there whenever they want to talk.

If you or a loved one is experiencing significant distress or having thoughts about suicide and need support, call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24/7. If you need immediate help, call 911.

The Takeaway

High-functioning depression may not be an official diagnosis, but it affects many people who appear to function well in daily life despite symptoms like persistent sadness and hopelessness, trouble concentrating, and low self-esteem. Long-term, mild depression symptoms may link to dysthymia, and the label “high-functioning” seems to imply that someone with dysthymia may not benefit from treatment because they can still go about daily tasks — which is misleading.

“High-functioning” is not the same as “fully functioning,” and self-care, talk therapy, and medications may help a person tackle the low mood, fatigue, hopelessness, and appetite changes that can come with dysthymia, even if these are not as severe as in major depressive disorder. Seeking professional support is crucial even if you feel you’re able to “handle it,” and getting treatment for dysthymia can prevent worsening symptoms further down the line.

EDITORIAL SOURCESEveryday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.SourcesResources

1. Dysthymia. Johns Hopkins Medicine.
2. Persistent Depressive Disorder: Symptoms & Causes. Mayo Clinic. December 2, 2022.
3. Persistent depressive disorder: Diagnosis & treatment. Mayo Clinic. December 2, 2022.

Sign up for our Mental Wellness Newsletter!Enter your emailSubscribeBy subscribing you agree to the Terms of Use and Privacy Policy. RELATED ARTICLESSee all in Depression6 Depression Symptoms You Shouldn’t Ignore

Depression6 Depression Symptoms You Shouldn’t IgnoreMedically Reviewed by Lee S. Cohen, MD | Jun 05, 20254 Ways Depression Affects Brain Health

Depression4 Ways Depression Affects Brain HealthMedically Reviewed by Michelle Riba, MD | May 13, 2025What Is Depression?

DepressionWhat Is Depression?Medically Reviewed by Angela D. Harper, MD | Feb 28, 2025What Is Treatment-Resistant Depression? Symptoms, Causes, Treatments, and More

DepressionWhat Is Treatment-Resistant Depression? Symptoms, Causes, Treatments, and MoreMedically Reviewed by Angela D. Harper, MD | Feb 17, 20256 Ways You Can Help Someone With Depression

Depression6 Ways You Can Help Someone With DepressionMedically Reviewed by Seth Gillihan, PhD | Aug 28, 20245 Ways to Cope With Depression During the Holiday Season

Depression5 Ways to Cope With Depression During the Holiday SeasonMedically Reviewed by Seth Gillihan, PhD | Aug 23, 2024Depression Treatment: The Options

DepressionDepression Treatment: The OptionsMedically Reviewed by Angela D. Harper, MD | Jul 22, 20247 Things Not to Say to Someone With Depression (and What to Say Instead)

Depression7 Things Not to Say to Someone With Depression (and What to Say Instead)Medically Reviewed by Seth Gillihan, PhD | Jul 12, 20245 Common Pitfalls That Make Major Depressive Disorder Worse

Depression5 Common Pitfalls That Make Major Depressive Disorder WorseMedically Reviewed by Seth Gillihan, PhD | Jun 18, 20248 Different Types of Depression

Depression8 Different Types of DepressionMedically Reviewed by Seth Gillihan, PhD | Oct 13, 2023Study Identifies 7 Ways to Cut Depression Risk in Half

DepressionStudy Identifies 7 Ways to Cut Depression Risk in HalfPublished on Sep 26, 20235 Ways to Stay Productive if Your Depression Is Getting in the Way

Depression5 Ways to Stay Productive if Your Depression Is Getting in the WayMedically Reviewed by Seth Gillihan, PhD | Sep 19, 2023Know a Senior With Depression? Here’s How You Can Help

DepressionKnow a Senior With Depression? Here’s How You Can HelpMedically Reviewed by Allison Young, MD | Aug 25, 2023Major Depression Is More Likely to Be Misdiagnosed if You’re Black — Here’s How to Advocate for Yourself

DepressionMajor Depression Is More Likely to Be Misdiagnosed if You’re Black — Here’s How to Advocate for YourselfMedically Reviewed by Patrice A. Harris, MD, MA, FAPA | Aug 23, 20238 Daily Habits to Help You Feel Better if You’re Struggling With Depression

Depression8 Daily Habits to Help You Feel Better if You’re Struggling With DepressionMedically Reviewed by Seth Gillihan, PhD | Jun 08, 20238 Common Triggers of Depression Relapse

Depression8 Common Triggers of Depression RelapseMedically Reviewed by Seth Gillihan, PhD | Jun 02, 2023Psychotic Depression: Causes, Symptoms, Diagnosis, and Treatment

DepressionPsychotic Depression: Causes, Symptoms, Diagnosis, and TreatmentMedically Reviewed by Chester Wu, MD | May 10, 2023Is It Depression or Sadness? Here's How to Tell the Difference

DepressionIs It Depression or Sadness? Here's How to Tell the DifferenceMedically Reviewed by Allison Young, MD | Sep 22, 2022FDA Approves A New Medication for Clinical Depression

DepressionFDA Approves A New Medication for Clinical DepressionPublished on Aug 23, 2022What a Psychiatrist Says Cheslie Kryst's High-Functioning Depression Can Teach Us About This Invisible Illness

DepressionWhat a Psychiatrist Says Cheslie Kryst's High-Functioning Depression Can Teach Us About This Invisible IllnessPublished on Feb 09, 2022