A Break-Down of High-Functioning Depression

High Functioning Depression

What is High-Functioning Depression?

High-functioning depression, also known as persistent depressive disorder (PDD) or dysthymia, refers to a form of depression where individuals experience depressive symptoms but are still able to maintain a relatively high level of functioning in their daily lives. Unlike major depressive disorder, high-functioning depression involves persistent, chronic symptoms that may last for years.

People with high-functioning depression may be able to fulfil their responsibilities at work or in their personal lives. Still, they often struggle with a constant low mood, feelings of hopelessness, fatigue, and a lack of interest or pleasure in activities. The symptoms may be milder compared to major depression, but they are still significant and can have a long-term impact on an individual’s well-being.

It’s important to note that high-functioning depression can be challenging to recognise because those affected may mask their symptoms well and may not appear visibly distressed to others. This ability to maintain a facade of normalcy can make it difficult for individuals to seek help or for others to realise the extent of their emotional struggles.

If you or someone you know is experiencing symptoms of depression, it is crucial to seek professional help. A mental health professional can provide an accurate diagnosis and recommend appropriate treatment, which may include therapy, medication, or a combination of both.

Depression - High Functioning

What are the Symptoms of High-Functioning Depression?

High-functioning depression can manifest in various ways, and the symptoms may be subtle or easily overlooked. Individuals with high-functioning depression may outwardly appear to be coping well with their daily responsibilities, but they still experience persistent emotional distress. Some common symptoms of high-functioning depression include:

Persistent Low Mood

Individuals may experience a consistently low mood, sadness, or a sense of emptiness, which may last for an extended period (typically at least two years for a diagnosis of persistent depressive disorder).


Even with sufficient rest, individuals with high-functioning depression may feel tired and lack energy, making it challenging to engage in daily activities.

Difficulty Concentrating

A reduced ability to concentrate and make decisions is a common symptom. This can impact work or academic performance.

Changes in Appetite or Weight

Changes in eating habits, including overeating or loss of appetite, can be indicative of high-functioning depression.

Sleep Disturbances

Individuals may experience difficulty falling asleep, staying asleep or may sleep excessively.

Feelings of Hopelessness or Pessimism

Persistent negative thoughts about the future, a sense of hopelessness, or a pessimistic outlook are everyday emotional experiences.

Loss of Interest or Pleasure

Reduced interest or pleasure in once enjoyable activities can be a significant symptom. Hobbies, social activities, and personal relationships may be affected.

Social Withdrawal

People with high-functioning depression may withdraw from social interactions, even though they may still maintain a façade of normalcy in public.

Physical Symptoms

Some individuals may experience symptoms such as headaches, stomachaches, or other unexplained pains.

It’s important to note that everyone’s experience with high-functioning depression may vary, and not all symptoms may be present. Additionally, these symptoms can overlap with other mental health conditions, making it crucial to seek professional help for an accurate diagnosis and appropriate treatment.

Depression - Dr Clem Bonney

How is High-Functioning Depression Treated?

The treatment for high-functioning depression typically involves a combination of psychotherapy, medication, and lifestyle changes. Here are some common approaches:

Psychotherapy (Counseling or Talk Therapy)

Various forms of psychotherapy, such as cognitive-behavioral therapy (CBT) or interpersonal therapy, can be effective in treating high-functioning depression. These therapies help individuals identify and change negative thought patterns, develop coping mechanisms, and improve interpersonal relationships.


In some cases, medication may be prescribed to help manage the symptoms of high-functioning depression. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), are commonly prescribed. Working closely with a healthcare provider to find the most suitable medication and dosage is essential.

Lifestyle Changes

Healthy lifestyle habits can contribute to overall well-being and complement other treatment approaches. This includes regular exercise, a balanced diet, getting enough sleep, and reducing stress.

Support Groups

Participating in support groups or group therapy sessions can give individuals a sense of connection and understanding. Sharing experiences with others who are going through similar challenges can be beneficial.

Mindfulness and Relaxation Techniques

Mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help manage stress and improve emotional well-being.


Encouraging individuals to prioritise self-care activities, such as engaging in hobbies, spending time with loved ones, and taking breaks when needed, is essential to treatment.

Regular Monitoring and Follow-Up

Continuous monitoring of symptoms and regular follow-up appointments with mental health professionals is crucial to assess progress and make adjustments to the treatment plan as needed.

It’s important to note that the specific treatment plan may vary for each individual, and what works for one person may not be as effective for another. Therefore, personalised and collaborative care, involving open communication between the individual and their healthcare provider, is essential to determine the most appropriate treatment approach for high-functioning depression. If you or someone you know is experiencing symptoms of depression, seeking professional help is highly recommended.

Dr Clem Bonney & High-Functioning Depression

Dr Clem Bonney, as both a General Practitioner and Occupational Physician, assists people with high-functioning depression. He assists them in engaging with the right therapy early, monitoring outcomes and supporting individuals on their journey.  High-functioning depression can be managed.