7 Signs of High-Functioning Depression

Posted on August 22, 2022

man with high functioning depression staring out a window

The Centers for Disease Control and Prevention (CDC) report that 4.7% of adults 18 and up have regular feelings of depression. According to the Cleveland Clinic, about 3% of the U.S. population experiences PDD at some point in their lives.

High-functioning depression is not a diagnosis or a clinical disorder, and many mental health professionals do not support using the term. The clinical diagnosis people refer to when they say high-functioning depression is a condition known as persistent depressive disorder (PDD) or dysthymia.

Types of Depression

Feeling down or sad occasionally is normal. However, when those feelings are persistent, the person is likely dealing with the more serious issue of depression. However, depression is not one size fits all. Depression comes in several forms and displays different symptoms.

Major depression is when someone feels depressed most days of the week. Typically, someone diagnosed with this form of depression exhibits five or more of these symptoms:

  • Loss of interest or pleasure in activities
  • Weight loss or gain
  • Trouble falling asleep or feeling sleepy during the day
  • Feeling physically or mentally restless, agitated, sluggish, or slow
  • Being tired and without energy
  • Feeling worthless or guilty
  • Difficulty concentrating or making decisions
  • Thoughts of suicide

Bipolar disorder, formerly referred to as manic depression, is depression that is marked by wide emotional swings, from being very up to feeling very low.

Seasonal Affective Disorder (SAD) occurs during the winter for most people and is linked to shorter days and less sunlight. Psychotic depression occurs when someone displays symptoms of major depression, as well as psychotic symptoms such as hallucinations, delusions, and paranoia.

Additionally, there are forms of depression associated with the hormonal fluctuations women experience around their menstrual cycles and childbirth. These are known as Peripartum or Postpartum Depression (after childbirth) and Premenstrual Dysphoric Disorder (PMDD).

It’s important for an individual with any form of depression to discuss their symptoms with a healthcare professional who can help them determine what type of depression they have and how best to treat it.

Signs of Persistent Depressive Disorder

Another type of depression is persistent depressive disorder. This term is now used to describe what was formally known as dysthymia — a persistent low-grade form of depression — and chronic major depression. Someone with PDD experiences depression for two years or more.

The seven signs someone may have PDD include:

  • Change in appetite (not eating enough or overeating)
  • Sleeping too much or too little
  • Lack of energy or fatigue
  • Low self-esteem
  • Trouble concentrating or making decisions
  • Feeling hopeless
  • Irritability or excessive anger

No test exists to diagnose PDD; the person must discuss their symptoms with a health care provider. Some questions the provider may ask include:

  • Do you feel sad a lot?
  • Are there particular reasons you feel down?
  • Do you have trouble sleeping?
  • Do you have difficulty concentrating?
  • Are you taking any medications?
  • How long have you had these symptoms?
  • Are the symptoms always there, or do they come and go?

Blood or urine tests may be administered to rule out other causes. The health care provider will likely recommend the person speak to a psychologist or psychiatrist about their mental health.

Causes of Persistent Depressive Disorder

No one thing causes PDD. It can be linked to various factors, including biological differences, brain chemistry, inherited traits, or life events. Often, several of these combine to cause a person to experience this type of depression.

  • A person’s risk of developing PDD increases if they have the following risk factors:
  • A first-degree family member who has a depressive disorder
  • A history of traumatic or stressful life events, for instance, the loss of a loved one
  • Personality traits such as negativity, low self-esteem, being too self-critical or pessimistic
  • A history of other mental health disorders, like a personality disorder

Preventing Persistent Depressive Disorder

While it isn’t possible to prevent persistent depressive disorder, someone can take specific steps to mitigate symptoms. For instance, individuals may work to limit stress in their life and find ways to increase their resilience and boost their self-esteem.

The person should seek treatment at the first sign of any issue to help prevent their symptoms from worsening. Other steps to take include reaching out to family and friends, especially during any crisis. Finally, the individual would be advised to consider long-term maintenance treatment to try and prevent any relapse of symptoms.

Treatment of PDD

Someone diagnosed with PDD will typically be treated with a combination of talk therapy and medication. Several factors will help shape the treatment approach. These include:

  • The severity of the symptoms
  • The person’s desire to address emotional or situational issues affecting their life
  • The individual’s personal preferences
  • Previous treatment methods
  • Someone’s ability to tolerate medications
  • Other emotional problems the person may have

One type of talk therapy that has been successful in helping those with PDD is cognitive behavioral therapy or CBT. CBT helps people examine their thoughts and emotions and how they affect the person’s actions. A therapist or psychologist provides this therapy, which also works with the individual to help them unlearn negative thoughts and develop more positive thinking.

The most common medications used to treat PDD are selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

It can take a month or more for these medications to take effect and begin to counteract the person’s PDD symptoms. It is essential to take these medications as prescribed, even if it doesn’t seem to be helping initially. Do not stop taking the medication without talking to a healthcare provider. Suddenly stopping these medications may cause withdrawal symptoms or even worsening depression symptoms. Finally, it’s important to understand that finding the best medication takes patience. A person may have to try several medications or combinations before finding the best solution.

A licensed mental health and substance abuse intensive outpatient program (IOP) in Scottsdale, Arizona, Rising Phoenix was created to offer a safe, welcoming, and nurturing environment where clients are not judged, but embraced, throughout their recovery process.

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