In keeping with this month's theme for National Depression Awareness Month, this week I’d like to address a topic that is often misunderstood: high-functioning depression.
How depression is often portrayed
There is a classic picture, often perpetuated by ads from drug companies and movie portrayals of mental hospitals, of what depression looks like. It goes something like this: A person, dressed in drab colored clothes with messy unkempt hair, who is either laying in bed with the covers pulled over their head or sitting on the couch looking out at the world they cannot engage in. Sometimes the person is crying. Sometimes there is a grey cloud depicted over their head. But almost always the picture is one of incapability and withdrawal from the world.
Where this portrait falls short
Yes, this might be an accurate portrayal of what depression looks and feels like for some people, but certainly not for everyone. There are millions of depressed people soldiering on, going about their daily routines. From the outside they might look “normal“ and people assume that they couldn’t possibly be depressed. But their inner experience might be closer to the grey cloud portrayal we see in commercials and movies. These people are living with what is known as high-functioning depression. Just because they go about their daily lives does not mean they are not suffering mightily on the inside.
What High-Functioning Depression really looks like
Everyone’s experience of depression is a little different. Many people slide into it slowly, and don’t realize what is happening until things get really bad. If they come from a background that values hard work and downplays emotions, they might be inclined to just put their head down and power through. Or at least to hide these difficult emotions from the world. Or perhaps, there is just enough anxiety or perfectionism bundled up with their depression (and fueled by our culture), that it keeps them going for fear of “failure”.
On the surface, people with high-functioning depression often look like everyone else. They get out of bed, they go to work, they might even spend time with friends, or exercise. But their inner experience is very different from the outward image that they portray. And it is partly for this reason that they often don’t get the help that could get them on the road to feeling better.
Myths About Depression
I would like to debunk some of the myths about depression that keep high-functioning people from seeking the treatment they need and could benefit from. Studies show that depression treatment is effective...but also that more than half of people don’t reach out for the help they need.
Myth 1: If I have good days then I’m not clinically depressed
Wrong! Many people believe that when someone is depressed, they are mopey and sad and lethargic all of the time. But that simply isn’t true. Like anything in life, it also comes with ups and downs. Just because some is suffering from clinical depression doesn’t mean they can’t go out with friends and actually enjoy themselves once in a while. It doesn’t mean they can’t laugh at a joke, or feel any joy at all ever. It just means that those moments are likely less frequent, more draining, and take more energy to get to or recover from. Being depressed doesn’t mean you are sad 100% of the time. Most of the time? Yeah, probably. But not 100%. Even in the darkest times, a little light still gets through.
“It can’t rain all the time.”
~ Eric Draven, The Crow
Myth 2: If I can work then I must not have major depression
Also false. Many people with major depression are still able to keep jobs (and in some cases, it’s the jobs that are causing the depression, but I digress). I have known so many people, friends, co-workers, clients, who have soldiered on through their depression to go to work every day. Some of them take antidepressant medication to help them push through, some of them collapse when they get home at the end of the day because work took all of the energy they had, some of them sneak off during the work day to cry in the restroom. You never know what’s happening in private or outside of work unless you ask.
Myth 3: I still exercise, so I can’t be depressed
[insert sound of loud buzzer here] Just because a person continues their exercise routine doesn’t mean they can’t be depressed. It might take every ounce of energy they have to go for a walk or hit the gym for 30 minutes. And they still do it, because maybe that’s what they’ve always done, or they think they’re “supposed to” do. But all of the joy might be gone out of it. Fatigue is a common symptom of depression, and it makes many people feel like they don’t want to exercise anymore. But that doesn’t mean it never happens, that they don’t still go to that volleyball league on Wednesday nights, or play a round of golf with their buddies now and then. And every time they do, it helps. Exercise is one of the most basic strategies for helping someone dig their way out of depression (along with sleep and diet). We often underestimate how much impact these everyday activities have, but I assure you, they’re important.
Myth 4: I’m not actively suicidal so it’s not major depressive disorder
Nope! Not everyone who fits the criteria for major depressive disorder is suicidal. Some people are actively suicidal, some people have passive thoughts of dying or just not wanting to be here anymore, and to others it never even occurs as an option. Every person is different, and just because someone isn’t thinking of suicide doesn’t mean they can’t still be depressed. If this is you, please do not wait until you start feeling suicidal to seek help. And if you are already having thoughts of suicide, please reach out to a professional immediately. We can help. And the world is always better with you here. Always.
Note: if you need help right away, please contact the 24-hour National Suicide Prevention Hotline: 1-800-273-8255
Myth 5: This is just how life is and I need to suck it up
I wish I could smash this one with a sledgehammer. I have seen so many people push themselves harder and harder, until they show signs of what they think is “real clinical depression” because they believe any one of a number of lies that Western society feeds us. Lies like: Depression is a sign of weakness. Or: Everyone else here [at work, school, etc.] is miserable too, that’s just how it is, quit complaining! Or my personal favorite: Life is just hard, you need to suck it up and keep moving. When we push ourselves too hard and don’t seek help, we only make things worse. Please, treat your mind and body like you would your vehicle: get regular check-ups and keep up on your maintenance. Don’t ignore the warning lights until you break down on the side of the road and need a tow truck.
Depression Treatment Can Help
Oftentimes we can manage to muster just enough energy to get by...but is that what you want your life to be? Just getting by? What if you could flourish? What if you could reconnect to a sense of joy and meaning again? Feel inspired and excited about the possibilities in your life again? Have hope for the future again? Wouldn’t that be nice? I want that for you.
If you think you might have high-functioning depression and would like to get a professional opinion, let’s chat. I find that depression counseling is the most effective when you still have enough energy to get through a day, to get to therapy, to try some small new things, even if you’re struggling. Will I work with you if your car is broken down on the side of the road? Yes, of course I will still be there for you. But might I invite you to reach out for help before it gets that far?
For more information on the symptoms of depression and what depression therapy looks like, visit the Depression Treatment page.