Identifying High Functioning Depression: Know the Signs

February 15, 2018
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One glance at the front page of Washington Post’s October 26, 2017 edition was enough to cause stomach aches, high blood pressure, and panic, if not reinforcement for existing depression. Headlines addressed How to Adult: Shopping for Groceries, the Democratic National Committee’s frame-up of President Trump in the Russian Dossier created, used and abused by Hillary Clinton’s campaign, economic woes, healthcare miseries, the US government’s befuddlement regarding US soldiers and their alleged well-being after being ambushed in Nigeria, a long-lasting Hepatitis-A outbreak despite focused medical interventions to reign it in, and other political plus life-endangering problems. Let’s not forget about North Korea, ISIS and global terrorism, either. The topics could upset and depress anyone, particularly the people involved and their loved ones. They, and the rest of us, get through each day as best we can, though some of us are suffering High Functioning Depression while we interact with, or shy from, the world and our place within it. Let’s figure who has HFD and what to do about that.

Who has HFD? What Does it Look Like?

High Functioning Depression affects a wide number of people from children psychologically hurt by parental strife including divorce, to adults who struggle to finesse any of the vicissitudes of life. People with HFD often fulfill their responsibilities though they experience lingering sadness, a persistent struggle to simply rise from bed each morning and every time they waken from naps, to vacate a chair, to enter or to exit their vehicle, and almost anything that their bodies and thoughts should occupy. Wistfulness for life to be more fulfilling and satisfying is a round-the-clock reality for HFD sufferers.

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Though someone with HFD appears to be fulfilling their goals and responsibilities, it can be hard for most of us to realize that those accomplishments come with an emotional cost. High Functioning Depression comes with the following signs:

  • A sense of futility, and that nothing will matter in the end. Forcing oneself to take necessary actions is a challenge all on its own.
  • A lack of joy, enthusiasm or optimism.
  • Emotional numbness that is a mixture of physical and emotional fatigue.
  • A lack of physical energy and most likely a dysfunctional sleep cycle that leaves the person with difficulty in concentrating on tasks or in thinking clearly about anything. It’s sometimes called “brain fog. “
  • A sense of masking the depression so that it can’t be detected. HFDers are at a loss to know how to resolve their problem. They do not welcome suggestions from people who fail to understand the issue and then to offer naïve, misguided advice. They certainly don’t have the patience or desire to listen to lectures about why they should feel happy. If anyone is likely to break though the psychological barrier sensed by HFD sufferers, it is empathetic people with the ability to console, to accept someone else’s reality and to be compassionate about it.

About the naiveté referenced above: An invisible illness, HFD leaves observers wondering what an HFDer is complaining about. As far as critics are concerned, the person is fully functional. But the fact is that appearances are deceiving. Many laymen who are not educated in mental health matters believe that depression equals inability to function. That’s not always true. And the irony of High Functioning Depression is that its impact is hard to identify. That’s because the sufferer struggles not to be incapacitated by their depression.

High Functioning Depression also comes with the following signs:

  • Self-criticism. People with High Functioning Depression tend to demand much of themselves. They lack a tolerance for perceived failings. Eventually, they can crack under their self-imposed strain.
  • Loss of appetite. Interest in food comes with optimism and a sense of anticipation. They’re not part of a High Functioning Depression life.
  • Suicidal ideation. Some people with High Functioning Depression do consider killing themselves instead of living with deadened emotions forever.


Caveat: If you suspect that someone will try to end their life, speak with a counselor about how best to intercede. Calm conversation might work, a need to remove weapons from their hands or environment might be necessary and it might be necessary to summon help. Advance preparation can make all the difference in saving someone’s life. If emergencies happen, call 911.

Okay, now you know the common features of High Functioning Depression. Think back to the opening paragraph of this article. Imagine how many movers and shakers of the world experience the problem. Though it would be a challenge to find statistics about politicians or people in any specific profession with the problem, it’s no challenge to think of people you know who seem to function like mindless robots. They perform their duties but seem to lack vivaciousness or a concern about their effects on people. They don’t anticipate a better future for themselves or anyone. Mentally numb, they’re not enjoying life and they certainly don’t know why anyone would. Joie de vivre, joy, is absent from their lives. Does your cold-hearted professor, doctor, law enforcement professional, gas station attendant, plumber, sales clerk, neighbor or someone else come to mind? Consider what you’ve read above, and reconsider the person’s behavior. They might have High Functioning Depression.

Diagnosing HFD

Sometimes called “Dysthymia” or “Dysphoria,” High Functioning Depression is a matter of feeling unhappy or emotionally unwell. HFD can be a bit tricky to identify. The second half of the This Is What High-Functioning Depression Looks Like  article addresses the problem. A quick Google search for “Videos about High Functioning Depression” can yield this group of educational materials.

Mental health professionals have a body of science to rely on that’s far more sophisticated than Google searches. If and when someone seeks out such a diagnosis, let the professionals make the final decision, not laymen uneducated in the subtleties involved.

Here’s What to Do if Someone You Know has HFD

When you wonder how best to respond to someone with HFD, focus on easing stress for the affected person Do tasks that they’d appreciate. Make upbeat comments, and lighten the atmosphere with humor. In brief, do not make demands. Instead, offer comfort, build trust, and simply be a reliable source of comfort. Keep the relationship confidential, too. Mutual trust is important for any relationship and especially in one with a fragile mindset.

Do not insist that the person get therapy. It is the depressed person who must decide if therapy will become a part of their life, not you. Don’t make judgment calls about that because your behavior can alienate the person in need of help.

Simply be a sounding board that lets the unhappy person think aloud with you. Let them come to their own decisions. And if they ask you “Should I be in therapy? Should I take homeopathic medicine to feel better? Do I need medication?” “Should I do this/that/the other?” reply “What would you like to do?” and/or “If it can make you feel and be better off, why not? Give it a try!” Use your own words to convey those messages. And let the person know that one form of therapy might be appropriate over another. It’s a matter of research and personal comfort.

You can share the responsibility for helping the person with HFD to find a suitable form of therapy if he or she requests the favor from you. And keep remembering: They will decide which therapy to pursue, and which one works for them, not you.

Yocheved Golani is a popular writer whose byline has appeared worldwide in print and online. A certified Health Information Management professional, she is a member of Get Help Israel. Certified in Spiritual Chaplaincy (End of Life issues) and in counseling skills, her life coaching for ill people puts a healthy perspective into a clients’ success plan for achieving desired goals.