The Silent Struggle: Functional Depression

When someone says they are suffering from depression, we are likely to imagine them feeling very low, spending long hours crying, avoiding family and friends, and not enjoying anything in their lives. Now, what if I told you, your best friend who jokes around with you suffers from depression? Your dad, who goes to his office in the morning and drinks chai while reading the newspaper, suffers from depression. Your mother, who watches her favorite television serial at 6pm, suffers from depression.

You may assume that this is absurd. These people who live around you, laugh, eat, and have normal conversations with you, cannot have depression. Why? Because they don’t demonstrate the classic symptoms of depression. However, let’s look deeper into a very prevalent, but often ignored type of depression—Functional Depression.

Functional depression, also known as high-functioning depression, refers to a condition in which the individual experiences depressive symptoms while still managing daily responsibilities and appearing well-put together. It is often linked to persistent depressive disorder (dysthymia), a chronic but milder form of Major Depressive Disorder (MDD).

High-functioning depression is not a formal clinical diagnosis; however, it is something that deserves a lot of attention in today’s time. It describes individuals who mask depressive symptoms and maintain productivity, relationships, and routines despite deep internal emotional struggles. Though symptoms are less severe than those of Major Depressive Disorder, they are persistent, which allows them to get through life seemingly pleasantly and smoothly while feeling empty or exhausted inside. These individuals may not realize that their concerns are worth discussing because they assume they can move on with their lives without any trouble.

Symptoms of Functional Depression

The symptoms of functional depression are like those seen in MDD and PDD. But these symptoms manifest with less intensity, develop gradually, and are often hidden.

• Persistent sadness

• Hopelessness

• Feelings of guilt or worthlessness

• Low self-esteem

• Fatigue

• Irritability

• Increased sensitivity to stress and criticism

• Loss of interest in hobbies

• Social withdrawal

• Difficulty in concentration and focus

• Changes in appetite or sleep

Why High-Functioning People Suffer Silently?

High-functioning depression creates emotional exhaustion in the person. They feel low, become irritable, and find it very difficult to have fun or connect with the people around them. It feels never-ending, something they can’t escape. On the other hand, the person appears to be doing well, with a smile plastered on their face and effectively handling work responsibilities while maintaining social connections (even if they don’t want to). They typically look content and pleasant to outside observers. However, they constantly struggle with emotional fatigue and negative self-talk.

There are several reasons why they suffer silently:

• They use perfectionism and workaholism as an emotional escape, to remind themselves that they are fine. They dedicate more than the required hours to work and aim to achieve perfection in almost every task.

• They engage in people-pleasing behavior to distract themselves from their inner emptiness by prioritizing others’ needs above their own.

• They are likely to emotionally detach from their loved ones and friends as a way of self-protection. They might not want others to know about their struggles.

• The fear of appearing weak or incapable, the stigma around mental health, and societal expectations to seem strong and have it all together prevent them from looking deep within themselves. Especially if they are highly successful individuals or the financial pillar of their households, they are likely to ignore any such feelings to keep themselves together to support their careers and families. They compare themselves to those with more visible struggles, to downplay their issues as stress, or even normalize chronic low mood as the way they are- a personality trait.

Is Functional Depression serious?

Though functional depression initially presents with low-intensity symptoms, over time these symptoms may develop into a more severe depression. High-functioning depression impairs your productivity and daily functioning. It impairs your work performance through fatigue, trouble with decision-making and planning, and decreased quality of work performance. It takes a toll on your relationships via emotional withdrawal, lack of communication, and irritability, leading to isolation. Sleep disruptions like insomnia, hypersomnia, or poor quality and appetite changes can exacerbate exhaustion and physical health issues.

Treatment of Functional Depression

The symptoms of functional depression are often hard to recognize for the person and those around them. The first step towards healing is understanding the hidden symptoms. Like MDD and PDD, treatment is usually a combination of therapy, medication, and lifestyle changes.

1. Therapy- Cognitive behavioral therapy (CBT) is highly effective in dealing with functional depression. CBT helps in identifying the negative thought patterns, reframing them, building healthy coping skills, and addressing factors like perfectionism and workaholism. Group therapy and family therapy are also beneficial in helping treat functional depression by reducing isolation and creating a sense of belongingness.

   
   

2. Medications- Antidepressants are provided to help balance the neurotransmitters in the brain. It is important to note that medications alone will not lead to lasting changes; medication combined with therapy fosters long-term healing.

   
   

3. Lifestyle changes- Regular healthy activity, nutritional diet, sleep hygiene, practicing mindfulness techniques, deep breathing, progressive muscle relaxation, guided imagery to reduce stress, and behavioral activation to schedule rewarding activities, enhance the progress made in therapy.

If I function, it's not real depression.

This is what most people who feel empty and emotionally exhausted think.

But Koott wants to tell you today, “You don’t have to go through this alone. You don’t have to feel the way you feel. Koott is with you.”

Book your session today.