What is high-functioning depression?  

High-functioning depression isn’t an official clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it’s a term often used to describe people who experience symptoms of depression but are able to function relatively well in their daily lives, such as going to work, maintaining relationships, and meeting other responsibilities.  

Externally, people with high-functioning depression may give the impression of "managing" or "coping" with their symptoms and seem to be “fine,” even successful. Internally, they may be struggling with feelings of sadness, hopelessness, fatigue, or low motivation. Although they may appear to carry on with their daily routines, they can still be dealing with significant emotional distress and struggle to complete tasks.  

Is it another term for mild depression?  

Although the term is often associated with mild to moderate depression, it doesn’t necessarily mean that the symptoms are limited to a moderate level of severity. Some people with major depressive disorder (MDD) may also appear to function relatively well externally, even though they experience more severe depressive symptoms internally.  

Characteristics of high-functioning depression may include:  

• Chronic low mood  
• Mild to moderate depressive symptoms  
• Inability or struggle to keep up with daily tasks  

Is using the term “high functioning” harmful in any way and if so, how?  

Describing someone as having high-functioning depression:  

• Minimizes the seriousness of depression.  
• Overlooks the impact of the chronic symptoms.  
• Perpetuates the idea that depression must be visibly disabling.  
• Inflicts unintended shame on people who don’t experience typical depressive symptoms.  

Calling someone "high functioning" with depression can make the condition seem less serious, which might lead to missed diagnoses, delayed treatment, and less support. It can also perpetuate harmful ideas about what depression "should" look like, making it more difficult for people with chronic, low-severity symptoms to feel validated in their experiences. It's important to recognize that depression, whether high-functioning or not, can still have serious effects on a person’s mental and physical health.  

What are the signs of depression?  

Depression can manifest in various ways, and the symptoms can vary. However, there are some common signs to indicate someone may be struggling with depression.  

Emotional and psychological signs can include:  

• Persistent sadness or “empty” mood  
• Irritability or frustration  
• Loss of interest or pleasure  
• Feelings of worthlessness or guilt  
• Difficulty concentrating or making decisions  
• Frequent thoughts of death or suicide  

Behavioral signs can include:  

• Withdrawal from social activities  
• Decrease productivity or performance  
• Changes in sleep patterns  
• Loss of interest in self-care  
• Avoidance  
• Substance use  

Physical signs can include:  

• Fatigue or low energy  
• Changes in appetite or weight  

How can someone support a loved one with high-functioning depression?  

Supporting someone with high-functioning depression can be challenging. Here are six recommendations:  

1. Acknowledge and validate their experience – be mindful of language (be empathetic and non-judgmental).  
2. Offer practical support and assistance with daily tasks, encouraging self-care.  
3. Respect their space while offering support.  
4. Don’t try to “fix” everything and reinforce that “it’s okay to not be okay.”  
5. Encourage social connection.  
6.  Advocate for seeking professional help.  

People with high-functioning depression may feel like their struggles aren’t as serious or worthy of attention, but they still deserve support. Many people worry about being a burden or feeling like they shouldn't need help. Let them know that it’s okay to seek support, regardless of how well they appear to be handling things. Depression is still an illness, even if it’s not overtly disabling.  

Is there hope for someone struggling with it?  

Yes, there is hope! Treatment can help in many ways such as addressing the root cause, developing coping skills, assisting in rebuilding a support system, and improving emotional awareness and expression.  

This blog was written in collaboration with Rogers Behavioral Health, an ADAA partner.