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High-Functioning Depression: How a Debilitating Illness Gets Overlooked
More than half of the women who responded to a recent national survey reported depressive symptoms. So it’s time we had a real talk about depression. Because it’s a broad term and encompasses many different challenges and experiences. Among them: appearing well but silently dealing with “high-functioning depression.”
That term became a popular one this year after Miss USA 2019 Cheslie Kryst, who was also an attorney and social justice advocate, died by suicide in January. Kryst’s mom said that her daughter hid her high-functioning depression "from everyone — including me, her closest confidant — until very shortly before her death.”
Depression can be an invisible illness. So we called up licensed counselor Amanda E. White to discuss it out loud. She told us what high-functioning depression is, how to know if you have it, and when to seek help.
What is high-functioning depression?
It’s actually not a clinical diagnosis. Aka not something you’ll find in the DSM-5, a manual that mental health professionals use to make diagnoses. And some medical professionals disagree on the meaning of high-functioning depression. But according to White, sometimes it makes sense to use the term.
“Although it's not an official diagnosis, I think it can be helpful because we sometimes think depression looks very specific,” White said. Think: being unable to get out of bed, missing work. But that’s not always how depression manifests. And the term “high-functioning depression” acknowledges that, she said.
What are signs and symptoms of high-functioning depression?
They’re the same as any kind of depressive symptoms. But saying “high-functioning” implies that the person is seen outwardly as totally “fine”…or even super successful, productive, and potentially a perfectionist. Here are some examples of what someone might be dealing with on the inside:
Loss of interest in things you used to enjoy...Like a hobby you loved or a sports team you rooted for.
Feelings of emptiness or hopelessness...And maybe you’re quick to cry.
Fatigue...You might be going through the motions of your job and home life, but have no energy.
Sleep disturbances...Which could mean insomnia or sleeping too much.
Change of appetite...Whether it’s significantly increased or reduced.
Ruminating on past mistakes...Something that also comes up with anxiety. Keep in mind: Depression and anxiety can go hand in hand.
When is it time to seek help for depression?
The biggest red flag, according to White, is suicidal thoughts. But instead of trying to push dark ideas aside, it’s important to talk them out. She said there’s this “unfortunate belief” that if you talk about suicide, it makes you more likely to attempt suicide. “And that’s completely false.” Instead, sharing with a psychiatrist or a therapist — who may be trained to evaluate risk — can be much more helpful for working through those feelings. Rather than staying quiet and feeling shame about your thoughts, White said.
And if you regularly experience any of the other symptoms above for a while — maybe about a month — it could be time to get some help, she added.
According to White, “the weird thing about depression” is that it can be hard to recognize. “Like a frog in boiling water, it happens slowly.” And although TikTok and other forms of social media have started to help normalize conditions like ADHD and autism, stigma around depression remains. Which can make it harder to talk about, identify, and treat, especially when the person experiencing it seems fine from the outside.
How can you get help for — and manage — depression?
Regardless of how outwardly obvious or disruptive your depression is, you deserve to get help and feel better. Ideally, you’d want to talk to a therapist or counselor (like White) or a psychiatrist (particularly if you think medication could be helpful) to get started on a path to recovery. If you need some assistance with finding the right person to talk to, ask your PCP to refer you. But if you can’t talk to a professional right away — whether that’s because finding the right one is inaccessible or you’re just not up for it — opening up to a loved one can be a good first step, White said.
And she offered this advice for managing your depressive symptoms: Remember that your mental health and physical health are connected.
“I tell my clients that when they're having hard mental health days to really treat themselves like they're physically sick,” White said. That could mean taking breaks during the day, making sure you’re eating enough food, drinking plenty of water, going to bed early, wearing cozy clothing, putting on a comfort TV show, etc. Overall, “be kind to yourself,” she said.
注释：
Function: v
表示“运行；起作用 ”，means " work, operate “，如：Start running,functioning,or operating,as of lights or power. 开始机能运转或者运行，关于光或者能量。
同义词辨析：
1. function指物体自身的作用。
2. action和agency指一物〔事〕对另一物〔事〕的作用;
action常着眼于结果。
agency常着眼于原因：by〔through〕 the agency of
Debilitate: V
表示“使 ... 衰弱”，means" make weak",如：Partisan politics is often an obstruction to good government. Office politics are often debilitating and counterproductive. 党羽的政治阴谋经常是良好政府的妨碍。公务上的政治争斗经常是带削弱性质和招致反效果的.
Encompass: v
表示“ 围绕；包围；包括；”，means "include in scope; include as part of something broader; have as one's sphere or territory; “，如：The prison is encompassed by high walls. 监狱被高墙围绕着。
Confidant: adj
表示“ 心腹朋友；知己 ”，means "someone to whom private matters are confided “，如：The artless woman had made a confidant of the boy.这个心地单纯的女人把孩子当作心腹朋友。
DSM：abbr.
表示“ 精神疾病诊断与统计手册 ”，means " the Diagnostic and Statistical Manual of Mental Disorders“
Manifest: v
表示“ 显示；证实；表露 ”，means " show clearly; give signs of, come to light“，如：Opportunities will manifest in ways you never even dreamed of.机会的到来出乎你的意料。
Outwardly：adv.
表示“表面上 ”，means "with respect to the outside “，如：Though badly frightened, she appeared outwardly calm.她虽然非常害怕，但表面上还是显得很镇静。
Insomnia: n
表示“ 失眠；失眠症 ”，means " inability to sleep “，如：Lately he has been moaning about his insomnia and headache. 他近来一直诉说自己患了失眠和头痛症。
Ruminate: v
1. 表示“ 深思；沉思 ”，means "reflect deeply on a subject “，如：The discovery provides pabulum for the scientific community to ruminate on for decades to come.这项发现为科学界对未来十年的深思提供了精神食粮。
2. 表示“反刍 ”，means "chew the cuds “，如：The cow began to ruminate after eating up grass.牛吃完草后开始反刍。
Normalize: v
表示“使正常；使标准化；”，means " become normal or return to its normal state“，如：Our relationship has been normalized. 我们的关系正常了。
Red flag：n
表示“危险信号 ”，means "a flag that serves as a warning signal “，如：If I were advising him, I would say that the elation of his party's progressive wing is a red flag. 如果让我给他提建议，我会说，民主党中进步派的洋洋得意是一个危险信号。
ADHD: abbr.
表示“ [医]注意力不足过动症；多动症 ”，means " Attention Deficit Hyperactivity Disorder“
Autism: n
表示“ 自闭症 ”，means "(psychiatry) an abnormal absorption with the self; “，如：The overall risk for autism is said to be small. 得自闭症的总体概率据说是比较小的。
Stigma: n
表示“ 耻辱；污名 ”，means " mark of shame or disgrace “，如：There should be no stigma attached to being poor.贫穷不应该与耻辱扯上任何关系。
Disruptive: adj
表示“破坏性的 ”，means "characterized by unrest or disorder or insubordination; “，如：We should be alert to the potentially disruptive elements in society. 我们应该警惕社会上潜在的破坏分子。
PCP:
表示“护理医师 ”，means " primary care provider ,a person who helps in identifying or preventing or treating illness or disability “，如：Referring physicians were categorized as a primary care provider (PCP) or specialist (internist, ob/gyn). 研究人员将咨询医生分成两类：初级护理医师(PCP)和专业医师（内科医师：产科医师/妇科医师）。
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