What you should know if you love someone with “high-functioning depression” (yes, this is real)

In Mind & Body
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To the people who know her, Amanda Leventhal appears to be living a happy life. She’s a college student at the University of Missouri, has a good group of friends and gets perfect grades. She sings in her campus choir group.

She’s not someone that people would characterize as being “depressed”. Yet she is.

It wasn’t until Leventhal put together an essay on her struggles with depression that her friends even knew that something was wrong.

We’re becoming more aware of how widespread depression is. But the image we received of depressed people is one of being withdrawn socially, moping around, being unmotivated to do anything and having trouble sleeping. While these are certainly symptoms experienced by many people with depression, the reality is that it’s much more nuanced than this.

Depression also looks like your colleague who just got promoted. Your friend who’s having a drink with you and laughing at your jokes. Your girlfriend who’s meeting you for a morning coffee.

These people experiencing depression but still getting on with life are part of a growing contingent of people who are now being labelled as suffering “high-functioning depression”. Because a stigma is still attached to depression, they try to keep their sadness hidden and fit in with others. No-one knows they are suffering from depression until it’s too late.

High-functioning vs low-functioning depression

High-functioning depression happens when someone is experiencing depression on the inside but externally appears like they have everything together.

Carol Landau is a clinical professor of psychiatry and human behavior and medicine at Brown University. She says she sees high-functioning depression predominantly in women who have a tendency for perfectionism. These are the people who are being promoted, the girlfriends meeting their boyfriends for coffee and your friend joining you for a drink.

Here’s what Landau has to say:

“People often say being ‘high-functioning’ is better than being ‘low-functioning,’ but that’s not really true because the most important thing is for a depressed person to get help – which a high-functioning person is limiting herself from.”

Many people are struggling right in front of us

Leventhal struggled for years before putting her feelings of depression into words. “It was something I had been thinking about for a while,” she says. “I was up late one night, not sleeping, and decided to put into words everything I had been reflecting on over the years.”

After her post went live, her friends were shocked. Now, she’s much more comfortable sharing her experience with depression with those around her, although she sometimes feels hesitation bringing it up as it does make some people feel uncomfortable.

Landau says this is a common experience for women:

“We’re still striving to be caregivers, and part of that is not admitting we need help. But it’s a huge problem. Depression is actually the leading cause of disability worldwide, according to the World Health Organization, which takes into account things like days lost from work, not being up to doing daily activities, and other illnesses like diabetes. So the minute someone opens up to their friend about it, they’ll find out that their friend will say, ‘Me too,’ or, ‘My sister feels that way too,’ or, ‘So does my mom,’ or, ‘So does our other best friend.’”

There are other ways to identify depression

Leventhal says she doesn’t identify with the usual symptoms of depression. For her, it comes in the form of irritability, she says.

This is normal. People experience depression in their own unique ways.

It’s important to understand that people experience high-functioning depression as it gets rid of the myth that you need to be moping around or shutting yourself away from others to be depressed.

It could be that people in your life who you don’t suspect as being sad or depressed are having a tough time. When there’s more understanding that high-functioning depression is a reality, then these sufferers of depression are more likely to open up and seek help.