What Is High-Functioning Depression? Signs, Symptoms, and When to Seek Help
.jpg)
Some people with depression experience symptoms like fatigue, lack of motivation, and low mood to the point where it makes managing depression while working, maintaining relationships, and participating in things that they once enjoyed difficult.
Other people are able to keep up with their daily responsibilities, but still face symptoms of persistent sadness and loss of interest. This second example is what is known as high-functioning depression.
Although high-functioning depression might not seem as severe as other types of depression, it can take a tremendous amount of energy to mask your symptoms and keep up with the demands of daily life. Learning about high-functioning depression can help you understand how high-functioning depression might be impacting you or a loved one and why high-functioning depression deserves treatment as much as any other form of depression.
What is High-Functioning Depression?
High-functioning depression isn’t a specific diagnosis. Instead, it is one way that depression can manifest. People with high-functioning depression can usually manage their daily activities, but they still face challenges. They may feel tired, have trouble focusing or being productive at work, and experience guilt. Restlessness, sleep issues, maintaining healthy relationships, and a lack of interest in things they used to enjoy are also common.
While it might look like they’re able to get through their daily activities with ease, the reality is that it might require a lot of effort on their part to do so – or they might be suffering in other domains of their life.
For example, they might be managing depression while working okay, but then feel too drained to do other things that they once enjoyed. The emotional and cognitive fatigue that high-functioning depression causes can even lead to physical symptoms, like headaches and stomachaches.
High-Functioning Depression and Persistent Depressive Disorder
Some individuals with high-functioning depression may be diagnosed with persistent depressive disorder (PDD). PDD is a type of clinical depression, but symptoms tend to be milder and longer-lasting than major depressive disorder (MDD). While you might not have heard of PDD, it’s fairly common: researchers estimate that 2.5% of adults in the United States have experienced PDD at some point in their lives.
In order to be diagnosed, individuals with PDD must experience their symptoms on most days for at least two years. Symptoms include:
- Feelings of sadness or emptiness
- Low self-worth
- Eating too much or eating too little
- Difficulty sleeping or sleeping too much
- Fatigue or lack of energy
- Low motivation
- Difficulty concentrating and making decisions
- Withdrawal from social situations
- Feelings of hopelessness
Why High-Functioning Depression Can Go Undiagnosed
High-functioning depression can go undiagnosed for many reasons. Some people think depression is just sadness. They might miss other signs, like being tired or having trouble focusing. Some people might also believe that, because their symptoms are less severe, they don’t need to seek treatment.
There are many stigmas associated with mental health issues. Some people think asking for help with depression is a sign of weakness. They worry they will burden others by sharing their feelings. But the truth is that asking for help is a brave decision, and that you’ll be better able to be there for your loved ones when you take care of yourself first.
When you’re able to cope well, you can sometimes convince yourself that things aren’t bad enough to seek help. You might hide your symptoms. This makes you look “fine” to others, but inside, you may feel disconnected and uninterested.
Even if it looks like you’re okay, the internal struggles of high-functioning depression can take a toll on you. Seeking support early can help you understand why you’re feeling the way you do and how to best help yourself.
Signs of High-Functioning Depression
If you have high-functioning depression, you might be outwardly successful. But, internally, you could be dealing with persistent fatigue, low motivation, and a loss of interest.
Isolating From Friends and Family Despite Maintaining Social Obligations
If you have high-functioning depression, you might be able to maintain your social obligations but are still isolating yourself from others. This might mean that you are attending social functions, but not connecting with your loved ones on a deeper level. For example, you might have difficulty sharing your personal thoughts and feelings. You might also feel disconnected, meaning that you’re not as interested in or enjoying social activities as you once were.
Loss of Joy in Previously Loved Activities
Depression doesn’t always look like sadness. Sometimes, it might mean that you don’t enjoy the activities that you once did.
Because it can take more energy for you to keep up with the demands of the day, you might feel too tired to do things that you used to enjoy, such as meeting friends for coffee or reading a book.
You might also feel that hobbies that you once loved, like cooking or hiking, feel uninspiring and more like a chore rather than time for yourself. Some people even find that they’re not able to enjoy music or television shows as they once did.
Persistent Fatigue and Low Energy that Doesn’t Improve
While we can all get tired from time to time, fatigue and low energy associated with depression don’t get better after a good night’s sleep. This can make it difficult to concentrate, like you’re in a mental fog or thinking more slowly than usual.
You might even feel as though you are talking or moving more slowly than usual. If medical causes have been ruled out, it might be a good idea to look into high-functioning depression as a potential cause.
How High-Functioning Depression Affects Daily Life
While individuals with high-functioning depression might appear “fine”, they’re often experiencing deeper emotions and feelings under the surface. High-functioning depression signs include:
- Low mood that makes it difficult to enjoy activities previously enjoyed or be emotionally available to loved ones
- Persistent fatigue that makes it difficult to keep up with daily tasks
- Trouble concentrating that makes it difficult to focus at work or school
- Difficulty making decisions or feeling in a mental fog
- Feelings of self-doubt, such as attributing success to luck, that can lead to low self-esteem
- Loss of interest in self-care
- Feeling as though social activities are an obligation rather than an enjoyable activity
- Feelings of guilt and shame for feeling disinterested or sad despite things going well
- Avoiding new situations due to fatigue or lack of interest
- Feeling flat or emotionally distant, making it difficult to connect with others or enjoy creative activities
- Trouble eating or overeating
- Difficulty sleeping or sleeping too much
- A feeling of dread or emptiness
Treatment Options and Management Strategies
Therapy and medication, or a combination of both, can help to improve the symptoms of high-functioning depression. This can help you feel more energized and connected with the world around you. It can also help you understand how high-functioning depression can affect you, allowing you to show more compassion towards yourself.
Cognitive-Behavioral Therapy
Cognitive-behavioural therapy (CBT) focuses on the connection between thoughts, feelings, and behaviours. It’s an evidence-based practice that has been shown to be as effective as medication in treating PDD.
In CBT, you’ll work to identify negative thought patterns and challenge these thoughts. You’ll also learn coping methods, such as breaking down tasks into smaller, more manageable steps.
Because high-functioning depression can mean that you’re not enjoying things as you once were, a CBT therapist can help you schedule small activities to help you get involved in your life again. Over time, this can help to improve your mood and break the cycle of negativity that depression can cause.
Dialectical Behavior Therapy for High-Functioning Depression
Dialectical behavior therapy is a type of therapy that is used to help manage strong emotions. It focuses on emotional regulation, mindfulness, interpersonal effectiveness, and distress tolerance. DBT can help you learn how to observe the thoughts and feelings associated with high-functioning depression without judgment.
This can be especially helpful for individuals who are experiencing strong emotions like guilt, shame, or hopelessness, as DBT can teach you to better regulate your emotions. DBT can also help you develop better relationships through advocating for yourself and saying no without guilt.
Medication
A range of medications that are used to treat depression can be used to help treat high-functioning depression. Most medications take 4-6 weeks to work. Also, there may be some trial and error to find the best one for you.
During this time, working with a therapist or joining a support group can help introduce you to coping strategies and helpful habits.
Possible medications used to treat high-functioning depression include:
- Selective-serotonin reuptake inhibitors (SSRIs): SSRIs work to increase the levels of serotonin in the brain, an important neurotransmitter linked to mood. These are usually the first line of treatment because they have fewer side effects.
- Serotonin norepinephrine reuptake inhibitors (SNRIs): SNRIs increase the levels of serotonin and norepinephrine in the brain, both of which play a role in mood. These medications are usually tried if SSRIs are not helpful. They can be especially helpful for people struggling with concentration, energy, chronic pain, or motivation. This is because norepinephrine is more connected to energy levels than serotonin.
- Atypical antidepressants: Atypical antidepressants may also be used. For example, bupropion (Wellbutrin) might be prescribed if fatigue is an issue, as it tends to be more helpful in improving energy levels and concentration.
When to Seek Professional Help for High-Functioning Depression
Because you might be functioning fine, it can make you feel like you don’t need to seek professional help. But, high-functioning depression can cause hidden depression symptoms like low mood, lack of energy, and a lack of enjoyment in doing things you’ve previously loved. If you’re experiencing any of these symptoms, seeking help can help validate what you’re feeling and improve your quality of life. Seeking help early can also help prevent any mental health issues that you might be experiencing from becoming worse.
Bottom Line
High-functioning depression can mean that you’re able to fulfill your obligations, but are dealing with symptoms like low mood, low energy, and lack of enjoyment beneath the surface. You might wonder if you need treatment since things aren't too bad. However, high-functioning depression is still a form of depression.
Remember, all types of depression deserve care. Therapy or medication, or a combination of both, can help to improve your quality of life by improving your energy and helping you find joy in the things that you love.
Even if you appear as if you’re coping, you’re still deserving of compassion and support.
References
Bupropion (Wellbutrin) | NAMI. (n.d.). Www.nami.org. https://www.nami.org/about-mental-illness/treatments/mental-health-medications/types-of-medication/bupropion-wellbutrin/
Chu, A., & Wadhwa, R. (2023, February 15 [updated]). Selective serotonin reuptake inhibitors. In StatPearls (Internet). Treasure Island, FL: StatPearls Publishing. Retrieved August 21, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK554406/
Cleveland Clinic. (2021, March 8). Persistent Depressive Disorder (PDD): Symptoms, Causes & Management. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9292-persistent-depressive-disorder-pdd
Drugs.com. (2024, July 15). SSRIs vs SNRIs – What’s the difference between them? Medical Answers. Medically reviewed by Carmen Pope. Retrieved August 21, 2025, from https://www.drugs.com/medical-answers/difference-between-ssris-snris-3504539/
Dispelling Misconceptions About High-Functioning Depression. (2025, March 27). Dispelling Misconceptions About High-Functioning Depression. Adaa.org. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/misconceptions-high-functioning-depression
Lamm, D. (2023, October 13). The Reality of High-Functioning Depression. NAMI. https://www.nami.org/depression-disorders/the-reality-of-high-functioning-depression/
Machmutow, K., Meister, R., Jansen, A., Kriston, L., Watzke, B., Härter, M. C., & Liebherz, S. (2019). Comparative effectiveness of continuation and maintenance treatments for persistent depressive disorder in adults. Cochrane Database of Systematic Reviews, 5. https://doi.org/10.1002/14651858.cd012855.pub2