- Depression affects everyone differently — you may have no trouble at work or in your relationships.
- Your symptoms are valid, even if no one notices them and you can manage the things you need to do.
- If coping strategies and support from loved ones don’t make a difference, therapy can help.
Depression has many faces. People with this mental health condition may find it difficult to keep up with self-care and everyday tasks, for instance.
But if you have no trouble performing at work, caring for kids, and maintaining relationships, despite other symptoms of depression, you may have what some people call “high-functioning depression.”
High-functioning depression isn’t a clinical diagnosis, and you won’t find it in the Diagnostic and Statistical Manual of Mental Disorders.
According to Peggy Loo, a licensed psychologist and founding director of Manhattan Therapy Collective, someone with high-functioning depression may have a diagnosis of:
People with PDD experience longer-lasting symptoms, but Loo says they tend to have fewer and less severe symptoms, compared to people with MDD.
Below, five people share their experiences living with high-functioning depression.
1. “I had thoughts of no longer existing.”
As a licensed clinical mental health counselor with experience in both treating and dealing with high-functioning depression, Michelle F. Moseley has a unique perspective on the condition.
When Moseley first began experiencing symptoms of depression as a teen in the mid-90s, she didn’t know a term to describe how she felt. In addition to overwhelming sadness, irritability, and sleep difficulties, she also sometimes had “thoughts of no longer existing.”
Moseley realized she could have high-functioning depression in her late 20s, after reading about and hearing other people’s experiences with this condition. She says only a few people noticed her symptoms, due to her consistently excellent job performance and ability to accomplish daily tasks.
Moseley says her depression has affected her relationships in the past — after using all her energy up for school work or her job, she often found herself too fatigued to answer the phone or respond to a text.
But her psychotherapy training helped her become more aware of the signs of depression so she knows when to reach out for support. She says antidepressants have also helped reduce the severity of her symptoms in the past.
“I’ve found a few safe people who I trust and can be honest with about what I’m feeling or thinking, and it makes it somewhat less of a burden for me to be able to share,” she says.
“For me, having things to look forward to, being honest with my partner about how I’m doing, and being open to utilizing therapy and medication as needed are all helpful in dealing with depression,” Moseley says.
2. “I never knew a life that was any other way.”
From a young age, author Sam Thomas recalls feeling emotionally numb and withdrawn and at times — he felt much safer and happier in his own company than around other people.
Then, at the age of 13, he began experiencing relentless homophobic bullying, which led him to feel even more isolated. He also believes the bullying drove his eating disorder and alcohol addiction.
Thomas calls his symptoms “invisible” to others around him. Despite his depression, he’s managed to achieve many of his goals — including running a national charity for a decade, speaking at major conferences, and going to the gym daily.
According to Thomas, his high-functioning depression includes what might appear like contradictions:
- He often avoids social situations because he doesn’t want to be noticed by anyone. But he can act confident, charismatic, and engaging when needed — like when speaking to 100 or more delegates at a conference.
- He generally manages to get to the gym early in the morning, even when he doesn’t want to get out of bed.
Because Thomas was able to function well at work and other areas of life, he didn’t always recognize his symptoms as depression.
“I never knew a life that was any other way,” he says.
Thomas notes that trauma therapy played a pivotal role in helping him to understand the roots of his depression: instability and an absent mother during childhood.
“Working through my traumas one by one during the lockdowns — which turned out to be the perfect time to focus on this work — enabled me to process and make sense of my history,” Thomas says.
In therapy, he also learned productive ways to cope with his emotions, like writing about his experiences — which he documented in his first memoir, “Smashed Not Wasted,” out in 2023.
3. “Confronting what makes me scared or sad and dealing with the discomfort helps me heal.”
At the age of 13, Carmen Cusido began showing signs of depression as well as an eating disorder. She often asked to stay home from school to avoid the bullying she experienced, and she frequently cried in her room — although she says she tried to hide it from her parents so as not to worry them.
She recalls a general feeling of hopelessness and believing life would never get better.
Eventually, her concerned parents found her a therapist.
“Through therapy, I learned my feelings are valid but may not accurately represent what’s going on,” Cusido says.
“I’ve also learned that situations aren’t permanent. By slowing things down and giving myself the grace to feel sad about certain things but now dwell on them, I’ve realized these sometimes-overwhelming feelings don’t have to control my life,” Cusido says.
In school, good grades came easily to Cusido — and she even maintained a full-time job while getting a master’s degree, despite her depression.
It wasn’t until her parents died 16 months apart in 2019 and 2020 that she felt her depression had the potential to derail her everyday life. Cusido says her recent therapist helped her release stored trauma related to these losses.
“Trying to find ways to avoid or escape feeling terrible made me feel worse — but confronting what makes me scared or sad and dealing with the discomfort helps me heal,” Cusido says.
When Cusido goes through significant life changes — like her parents’ death or ending a seven-year relationship — her depression tends to worsen. Now she knows that during difficult transitions, she may need extra therapy sessions.
Cusido says taking time for self-care — including journaling, reading, and playing with pets — is crucial for managing her symptoms. Staying connected to friends and family also ensures she has the emotional support she needs.
4. “My chronic depression allows me to function, but it’s always there.”
Some people may not be able to identify when a loved one has depression because they’re still able to accomplish many things. Although 58-year-old Lynn Jones has had depression since age 16, it went unnoticed by many people in her life — perhaps because she:
- Has co-founded a successful firm now in its 22nd year
- Started a successful child welfare nonprofit
- Led a team to raise over $1 million for an adoption agency
- Is married with two grown children
“My chronic depression allows me to function, but it’s always there,” Jones says.
When her symptoms started as a teen, Jones frequently wanted to go to sleep as soon as she came home from school.
She also occasionally canceled plans with friends or came home early from social events — even though she considers herself a generally high-energy person.
Working with a psychiatrist helped Jones better understand her depression and find ways to cope. For instance, exercise provides a positive distraction, though she says it’s not a “cure-all.”
Jones also tried a range of medications over the years, and found serotonin-norepinephrine reuptake inhibitors (SNRIs) make a big difference in how she feels day to day.
Learning to be realistic about her capabilities and prioritize her responsibilities is another key element in managing her high-functioning depression.
“I can make it through the work day, but then I must make a choice: Do I fix dinner or work out — make it to my mom’s or work on a few things around the house? I won’t have the energy to do it all,” Jones says.
5. “I can take a lunch break at noon, have a good 15-minute cry at 12:15, and then hop on a call with a client at 12:30.”
At age 22, while graduating from college with no job prospects in sight, Tori Bentkover felt exhausted, unmotivated, and generally low. Watching her father die of cancer while she also coped with the painful symptoms of ulcerative colitis didn’t help.
“I more or less had to be near a bathroom at most times. It took me away from my friends, traveling, exercising, enjoying eating and drinking, and a lot of other things, Bentkover says.
Several months after graduating college, Bentkover’s parents encouraged her to find a therapist. Through cognitive behavioral therapy (CBT) she’s discovered some problematic thought patterns that may contribute to her depression.
“I tend to catastrophize, meaning I assume the worst possible outcome in most situations. An obsessive need to make sure people aren’t upset with me occupies a lot of my headspace,” Bentkover says.
Bentkover occasionally takes breaks from therapy when she and her therapist decide she’s ready, but she’s learned to identify the signs that it’s time to start talking to a mental health professional again. For example, she knows to reach out for support when she feels more inclined to stay in bed and isolate herself so she doesn’t have to talk with people.
While dealing with her depression is an ongoing journey, she says it hasn’t really impacted her job performance.
“I can take a lunch break at noon, have a good 15-minute cry at 12:15, and then hop on a call with a client at 12:30. This doesn’t mean that all of a sudden I’m no longer depressed, it just means I know how to manage it,” Bentkover says.
How to get support for depression
Therapy offers a valuable tool for treating depression, since it can help you:
- Recognize and change unproductive thought patterns that may cause or worsen depression
- Learn and practice helpful strategies for dealing with life stressors and challenges
That said, according to Moseley, you do have options for managing milder depression symptoms on your own — as long as you have a strong support network.
Mosely suggests these strategies:
- Reaching out to friends and family members for support as needed.
- Practicing self-care, whether that means taking walks in nature, reading, journaling, or meditating.
- Allowing plenty of time for rest and recovery in between activities and obligations.
- Staying aware of your symptoms and their severity so you know when your depression improves or worsens.
Moseley recommends reaching out to a therapist if:
- You don’t have a solid support system
- Your symptoms take a toll on your ability to care for yourself, maintain relationships, or handle everyday tasks
- You’re experiencing thoughts of self-harm or suicide
According to Brian Yu, a licensed psychologist and founder of Prevail Performance, these types of therapy may prove most helpful for depression:
- Cognitive behavioral therapy (CBT): This type helps you recognize and change unhelpful thought patterns that may trigger depression.
- Interpersonal therapy: This modality involves examining and shifting relationship habits and patterns that may contribute to your depression. It also entails helping you foster better social support.
- Psychodynamic therapy: This approach focuses on unpacking and resolving traumatic experiences, especially from childhood, that may contribute to depression.
Loo, Moseley, and Yu all say antidepressants may help lessen the severity of depression symptoms. They don’t work for everyone, however. Moseley suggests talking with your psychiatrist or primary care doctor to ask if you might benefit from these medications.
If there’s one thing Moseley wants others with high-functioning depression to know, it’s this:
“Your experience is valid — even if it doesn’t look like what others perceive as depression.”
Also, she says it takes immense strength to “wade through the waters of depression,” while still attempting to manage day-to-day life responsibilities.
High-functioning depression may be challenging, but remember: you don’t have to deal with it alone. Having support — whether from your primary care doctor, a licensed therapist, or just a trusted friend or family member — can help as you learn to manage your symptoms.