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What is High-function Depression, and How do I Know if I Have it?

Mar 28, 2024
What is High-function Depression, and How do I Know if I Have it?

Are you the last person anyone would guess is depressed? Do you follow the rules, get the job done, and show the world a happy face? Yet, once alone, you feel exhausted, down, and disinterested? If so, you may be suffering from high-functioning depression.

It’s not always obvious when someone is suffering from depression.

Many people who are depressed manage their responsibilities at work, school, or home successfully. But inside, they feel empty, lonely, or that they aren’t good enough.

Mental health professionals call this high-functioning depression. It’s not a medical term but does aptly describe a person who meets the criteria for a clinical diagnosis of depression yet still functions well day-to-day, masking their mental illness from the outside world. 

Up to 3% of the U.S. population experiences high-functioning depression, clinically known as persistent depressive disorder, at some point in their lives. Likely, the number is higher because people with high-functioning depression are often used to feeling low and don’t assume they’re sick and seek professional care.

That’s unfortunate. No one should settle for living in a constant state of meh. Happy Apple’s experienced therapists provide personalized, evidence-based treatment for patients struggling with many mental health conditions, including high-functioning depression. 

In this month’s blog, they break down the common yet depleting illness of high-functioning depression. 

High-functioning depression vs. major depressive disorder

The key differences between major depressive disorder (MDD) and high-functioning depression are the severity and duration of symptoms. 

High-functioning depression

Typically, high-functioning depression involves fewer, less intense symptoms. But they last longer, at least two years in adults and at least one year in children and teens.

That doesn’t mean you should wait for two years before getting help. Treatment is available and effective, even if you’ve been symptomatic for less time.

Major depressive disorder

With MDD, patients have five or more symptoms that last at least two weeks. However, symptoms usually persist much longer — months or even years. Most people with PDD also have an episode of major depression at least once in their lives. 

Symptoms of high-functioning depression

High-functioning and MDD share many symptoms. These include:

  • Avoiding social activities
  • An increase or decrease in appetite
  • Trouble concentrating or making decisions
  • Excessive anger or irritability
  • Fatigue or a lack of energy
  • Diminished pleasure
  • Low self-esteem and self-criticism
  • Difficulty sleeping or sleeping too much

Other mental health conditions, such as anxiety, also have overlapping symptoms, so it’s important to get a professional diagnosis.

Who is at risk for high-functioning depression?

Children, adolescents, and adults can all suffer from high-functioning depression. As with many mood disorders, it’s more common among women, who are twice as likely to develop high-functioning depression than men

Other risk factors include:

  • Genetics and a family history of depression
  • Chronic stress
  • Unresolved grief
  • History of trauma
  • Medication or substance misuse

Like MDDS, the cause may be a combination of factors. 


Depression isn’t a sign of weakness, and it can’t just be snapped away. Recovery requires treatment.

The team at Happy Apple specializes in helping patients with all types of depression. Cognitive behavioral therapy (CBT) is among the most effective treatments for high-functioning depression. Lifestyle changes and, sometimes, medication are recommended in addition.

If you’re ready to reclaim joy in your life, the team at Happy Apple can help. Call 646-351-6418 to reach our office in New York City or request an appointment online