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Have You Heard of ʻHigh-Functioning Depressionʻ?

One of my best friends has been in my life for almost 10 years. We met as middle school students, and now as adults we’re closer than ever before. The entire time I’ve known her, she’s struggled with mental illness. Depression and anxiety were only a fraction of all the suffering that middle school entails. As if middle school isn’t hard enough, awkwardly trying to figure out the world and yourself, add onto that the struggle of depression and anxiety. I was in the same boat. Part of our friendship was the mutual understanding that as much as we could be there for each other, it was still difficult. Debilitating bouts of depression kept her out of school a lot of days. At some points, even the administration had to step in. This struggle carried on into high school. While she was able to receive treatment, it’s safe to say she’s felt remorse for all the opportunities lost, for the childhood she was robbed of.

Now that we’re older, and now that we have more frequent discussions about how we treat ourselves and our mental health, we talk about middle school a lot. Recently, she told me that she never understood what happened to me in middle school. She knew that I had been struggling with the same mental health issues as her, even had some of the same unhealthy coping mechanisms, but I had never had to talk to so many school administrators and counselors as she did. I had thought that we were in the same boat, but she had thought that my mental health wasn’t being treated the same way hers was. She couldn’t figure out exactly why my mental health was supposedly flying under the radar. Until I reminded her that, academically, I was really smart.

As a preteen, I excelled at math in comparison to my peers, going as far as to win certificates of recognition. I held good grades in the rest of my subjects as well. I was involved in clubs and sports. I hardly ever missed a day of school. By all standards, I was a great student. Isn’t that all that matters? There can’t really be something wrong with me, especially mentally, if I’m doing so outstanding. Right? So, my check-ins with administrators and counselors were standard and brief. I built a reputation in my family as the one with the 4.0 GPA. Whenever they asked me, “How’s school going?”, I knew that they expected me to respond with “It’s going great! I got an A on my test!”. Or at least something along those lines. And when I told my friend this, she was saddened for me. She felt that I had been disregarded unfairly.

This conversation was only a few days ago, but I can’t help but be overwhelmed with the truth of it. For a long time, not only was my mental health disregarded by both my school and family alike, but I discredited my own struggle. I knew what she was going through and how tough it was for her, and for some reason, I felt as if my own depression and anxiety was nothing compared to hers. I was still getting good grades and participating in extracurriculars. I was still getting out of bed every morning (albeit, reluctantly). Why couldn’t I have taken my own mental health as seriously as I took hers; as seriously as she took mine?

I hadn’t heard of the phrase “high functioning depression” until this past year. (Tik Tok therapists fit an absurd amount of information into a 60 second video.) Essentially, high functioning depression, medically referred to as dysthymia, occurs when someone experiences the symptoms of depression without “looking depressed”. High functioning depression became a popular term, especially with rising rates of depression in individuals over the course of the pandemic. Everyone was trying so hard to be “normal”, to push through those feelings of isolation and sadness by continuing the routines they had established in the best way they could – working from home, working in person for some, having to take care of their kids all day, schooling through a computer. They manage all these tasks, feel a sense of accomplishment for a moment, but at the end of the day, have to confront the heaviness still inside of them.

Picture a depressed person. Do you think of someone laid up in bed for hours a day? So down that it’s difficult for them to hold a job or maintain relationships? Do you think of someone so sad they cry for long periods of time or even someone who considers harming themselves? This image is a stereotype. Real for many people, but a stereotype, nonetheless.

This more commonly known depression is medically referred to as major depressive disorder. It shares symptoms with high functioning depression: having low energy or appetite; being extremely critical of oneself or others; difficulty managing emotions like anger, sadness, and guilt; feeling increased irritability; feeling more emotionally affected by small things that wouldn’t usually cause such a reaction; a difficulty experiencing joy. Where high functioning depression differs from major depressive disorder is the capacity to “function”, as in being able to maintain a demanding job, pursuing romantic relationships, making time to hang out with friends and family, and staying active on social media. The point is that someone with high functioning depression is struggling with something not as easy to spot.

There are some obvious problems with this supposedly “invisible” illness. Not only is it harder for other people to notice your symptoms, it's harder to notice them yourself. It’s harder to see yourself as depressed because you’re trying to compare your own mental health to others, asking yourself if what you’re struggling with is legit. Maybe you think that all you need to do to get over your feelings of sadness is to work harder or somehow have a better attitude. This just isn’t true! Just because you don’t look depressed, just because you get good grades, just because you don’t cry yourself to sleep every night doesn’t mean you don’t deserve to have your mental health taken seriously. High functioning depression has the reputation of being less “severe” than more common depressive disorders, but there are still biological and psychological effects. It should be treated as such. You deserve to live well.

This is why it’s important to destigmatize mental illness, and to spread awareness of its different forms. Depression can look like this. It can be quiet, it can be loud, depression can be ugly, it can be violent. If you’re dealing with depression in any of these forms, I hope you feel the courage to express that to someone so that they can be there for you. And if someone expresses that to you, I hope you’re able to provide them the support they need. In this month dedicated to Mental Health Awareness, I hope we can expand our perceptions of mental health, while simultaneously destigmatizing it, to allow those who need help to get the support they need, so that they can live freely, carrying less of the burden on their own when they know they can rely on others to help them along.

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