Pasithea Clinics

Get a free assessment now: +1 (888) 803-3375

What are the symptoms of high functioning depression?

When you think about depression, what do you picture? Do you picture emotions that are hidden away or out in the open?

While depression can be any of these things, it’s important to realize that it’s not always outwardly recognized. There are many individuals who struggle with feelings of sadness or hopelessness on a daily basis. However, they may be considered “high functioning” with their depression, and so their symptoms are not easily seen or recognized by people around them because they’re still able to complete, and even excel, at their everyday responsibilities.

If you want to better understand the symptoms of high-functioning depression, read on to figure out what this looks like.


What Is the Difference Between High Functioning Depression and Classic Depression?


Did you know that one in every six adults struggles with depression? Six million American adults are impacted every year.

There are different forms of depression and several things that differentiate between high functioning depression and major depression (the “standard” type of depression).

When someone experiences major depression, some of the signs can be a little more easily recognizable:

  • Reduced interest in activities
  • Withdrawal from society and social interactions
  • Frequently tired, lethargic, and unmotivated
  • Feeling sad, down, hopeless, or even guilty

However, high functioning depression presents differently. This type of depression was previously known as dysthymic disorder. Many of the symptoms are the same as major depression but are less noticeable by others and not as intrusive to an individual’s ability to function in everyday life.

The symptoms for high functioning depression are said to be diagnosed after going on for a minimum of two years in comparison to major depression, which is diagnosed after two weeks. In addition, high functioning depression is diagnosed when there is a combination of less intense times of sadness where symptoms are fairly more manageableas well as times of more intense sadness where symptoms become less manageable.

What Does High Functioning Depression Look Like?


Those with high functioning depression are often silent sufferers who may hide their feelings, put on a happy face for those around them, and may not seek or ask for help, professionally or otherwise.

It is common for these people to appear to live normal lives. They go to work, participate in social events, and generally take care of themselves. They generally appear content and happy on the outside even though they may be struggling in private.

In fact, those with high functioning depression are often high achievers in life.

Some of the signs of high functioning depressive episodes can be seen as frequent changes in eating patterns, an inability to sleep or a dramatic increase in the amount they sleep, decreased levels of energy regardless of sleep hours, difficulty when it comes to making choices or concentrating, having decreased self-esteem, and experiencing sadness or hopelessness. The thing with high functioning depression is that despite these symptoms, many of these individuals find ways to cope, healthy or unhealthy, to continue on with their day-to-day.

Changes in Eating Patterns


Some people experience changes in how they would typically eat, such as constantly craving comfort foods such as chips, ice cream, candy, or alcohol. Some people stop eating altogether.

This change in eating pattern could go either way and affects each person differently. As a result, the individual might find that they lose or gain a significant amount of weight unintentionally.

If this is you, look into what you are eating, and try to identify and keep track of what triggers you to overeat or restrict your eating.

The Inability To Sleep or a Dramatic Increase in Sleep


Just as with eating patterns, this symptom could go either way. Depression and stress can cause some people to sleep a dramatic amount because of how tired their other symptoms make them, or sometimes just to avoid having to deal with symptoms in the first place. For others, symptoms may actually keep them from falling and/or staying asleep.

Either way this is problematic, as oversleeping can interfere with daily activities, work, and social relationships. On the flip side, under-sleeping could lead to an inability to concentrate during the day, decreased work performance, and not having enough energy to interact with others.

Decreased Levels of Energy and Lack of Interest in Hobbies and Leisure Activities


This decrease in energy could be from the depression itself or it could be caused by other symptoms. Decreased levels of energy take away your ability to be fully present, whether for your significant other, children, siblings, or friends.

In addition, this decreased energy could cause or exacerbate feelings of anhedonia, which essentially refers to a lack of joy and excitement when it comes to activities that an individual previously enjoyed doing.

If you or someone you know suddenly loses interest in something that once excited you, this could be a sign of depression. For example, you may have previously loved dancing, but now you can’t find the energy or enthusiasm to dance, without any real reason.

Difficulty in Making Choices or Concentrating


Just as with a reduction in overall energy, this difficulty in making choices or concentrating could be its own symptom of depression or it could be linked with other symptoms such as under-sleeping or disinterest.

Depending on your job, having a difficult time making decisions could affect your overall work performance.

Having Feelings of Low Self-Esteem or Low Self-Worth


Those with high functioning depression may appear confident on the outside while inwardly they are experiencing feelings of insecurity or low self-esteem.

Experiencing Sadness or Hopelessness


As mentioned above, those with high functioning depression generally have coping mechanisms that allow them to still complete their day to day tasks and responsibilities. They are often high achievers who are not only good at taking care of their own needs, work requirements, and family needs, but also go above and beyond in these things.

However, internally, there is often a relatively strong degree of feelings of sadness and hopelessness that they struggle with continuously. They may have a difficult time verbalizing these feelings to others, or simply may not have the want to do so, which in turn can create an added layer of isolation and loneliness.

The Stigma Around Mental Health


If you’re afraid of seeking treatment due to the stigma behind having a mental health disorder, you aren’t alone in feeling that way.

Although the stigma has declined over the years, some people are still afraid to seek help because of what others may think of them or how others will view them.

One suggestion to overcome this stigma is to accept what you’re going through and be patient and kind to yourself. Acceptance is the first step to healing. Without admitting that something is wrong, there can be no healthy path to figuring out how to get back to feeling like yourself again.

Treatments could include a variety of things ranging from personal or group therapy, to journaling, to increasing your exercise routine, to finding a support group, to trying at-home administered ketamine… or maybe your treatment will involve a combination of these things.

Regardless of what you choose to seek for treatment, admitting and accepting your situation is the first step in the healing process.

In addition to this, those who have never experienced depression may not understand the extent to which it can affect you. Some common sayings are often heard such as “what’s so bad in your life that you’re depressed?” or “why don’t you just focus on the good thing?”

When it comes to depression of all types, it’s not something that someone can just “snap out” of. It’s an internal battle that even the strongest person can have a difficult time overcoming. More times than not, depression is a mixture of chemical, biological, environmental, or genetic factors, and it’s a medical condition that needs to be taken seriously to be properly treated.

What Part Can Ketamine Play in my Treatment Plan?


Pasithea Therapeutics is a biotech company at the forefront of research in mental health and brain disorders worldwide, and one service we’re beginning to introduce in the U.S. is at-home, professionally-administered intravenous ketamine.

Ketamine treatment can help those with treatment-resistant depression, and it has been shown to be safe and effective in many studies. IV treatments done in the home by an anesthesiologist or CRNA present the safest option as you’re monitored by a medical professional, plus there is less risk of abuse, which is associated with other forms of ketamine like oral and IM-administered options.

Since depression tends to reduce your energy levels and motivation, having an in-home treatment helps relieve some of the pressure and anxiety it may take to leave your home during a particularly tough episode.

Summing It Up


People with high functioning depression often lead seemingly normal, happy lives. They are usually high achievers, invested in their families, and even sociable. However, inwardly, they may be experiencing decreased self-esteem, sadness, anxiety, and an internal battle they keep to themselves. They may have any combination of depression symptoms, including their sleep being affected or their eating patterns being abnormal.

If you or someone you love are experiencing symptoms of depression, it’s  important to seek professional help so you can work out a treatment plan that may include prescription medication, therapy, lifestyle changes, or newer interventions like IV ketamine therapy.

It’s important to realize the stigma that still surrounds mental health and be understanding and empathetic towards those experiencing this, and that includes being kind to yourself if you’re the one going through this.



Suffering in Silence with High-functioning Depression – University Health Partners of Hawaii

High-Functioning Depression: An Invisible Illness with Unique Risks

Mental Health Conditions: Depression and Anxiety | Overviews of Diseases/Conditions | Tips From Former Smokers