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MENTAL HEALTH

Depression And

High-Functioning Depression

- An Invisible Illness (1/2)

Written by Dr Malek

16—MAR—2021 16:40 GMT
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he incident of mental health conditions is increasing globally. Depression is one of the most common mental health conditions. Worldwide, more than 264 million people of all ages suffer from depression. According to WHO study it was predicted to be the second most important cause of disability worldwide. [1]

If symptoms are moderate or severe in intensity, depression may become a serious health condition. At its worst, depression can lead to suicide. Around 800 000 people die due to suicide every year. More women are affected by depression than men. [3]

 

You may have also heard of a new term called ‘high functioning depression.’ There is no difference between depression and high functioning depression. 

First, let’s understand what depression is:

Depression is a mood disorder. Mood disorders include Bipolar disorders and Depressive disorders. They are highly prevalent, and are associated with high mortality, morbidity and suicide.  Anyone can feel sad at any point in their life. However, depressive mood disorders are when this sadness is sustained for a long period of time, constantly throughout the day. [1]

Symptoms of depression: [2]

  • Loss of interest in hobbies/normal activities/sports/sex

  • Low mood 

  • Feeling sad/tearful -which means you feel like crying all the time 

  • Hopelessness about life/future 

  • Worthlessness/low self-esteem 

  • Guilt for past failures/self-blame

  • Loss of energy

  • Sleep changes: too much sleep or too little

  • Poor concentration/memory 

  • Fluctuations in weight: eat too much or too little 

  • Headaches/back-aches 

  • Anxiety/agitation 

  • Psychomotor retardation-slowed body movements/speaking 

  • Thoughts of suicide/death/attempts of suicide 

These symptoms may last for two or more weeks. They are usually markedly different from how you normally feel/function.

 

Depression can often be masked by other complaints e.g. insomnia, fatigue. Which can further complicate the differential diagnosis. Thus clinicians are given very specific criteria in order to diagnose it. Many different factors in one’s life could lead to a depressive episode e.g. bereavement, loss of job, serious medical illness or disability, financial ruin.  It can be one or a combination of things. [2] 

 

Depression can come in different severities: mild, moderate, and severe. It can reach a point where it causes clear disruption in all aspects of one’s life: social, work and home.  It would naturally be a difficult time in someone’s life. You may not even know you are depressed.

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There is always light at the end of the tunnel.
Image by Fernando @cferdo

So, what is high-functioning depression?

High-functioning depression is not a medical diagnosis. It is a term used to describe one’s depression that has not evidently affected their work and activities of daily living etc.  People with high-functioning depression can go about their lives as normal because they are good at hiding it, but this doesn’t make life easy for them. [5] 

What are some characteristics of high functioning depression? [5]

1. Feeling like you’re faking it

2. Good days are normal 

3. But bad days are really bad 

4. You struggle to prove that you’re actually going through something and feeling invalidated 

5. Exhaustion

References

1. Black, D., & Grant, J. (2014). DSM-5 Guidebook The Essential Companion to the Diagnostic and Statistical Manual of Mental Disorders (5th ed., pp. 89-96). American Psychiatric Publishing.

2. Brown, A. (2017). Depression (major depressive disorder) - Diagnosis and treatment - Mayo Clinic. Mayoclinic.org. Retrieved 17 January 2021, from https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013.

3. Depression. Who.int. (2020). Retrieved 17 January 2021, from https://www.who.int/news-room/fact-sheets/detail/depression.

4. Kastrup, M. (2011). Cultural aspects of depression as a diagnostic entity: historical perspective - Medicographia. Medicographia. Retrieved 17 January 2021, from https://www.medicographia.com/2011/10/cultural-aspects-of-depression-as-a-diagnostic-entity-historical-perspective/.

5. Shannon-Karasik, C. (2017). This Is What High-Functioning Depression Looks Like. Healthline. Retrieved 17 January 2021, from https://www.healthline.com/health/depression/this-is-what-high-functioning-depression-looks-like#High-functioning-people-need-treatment-for-depression-too.