June 20, 2023

What is High Functioning Depression?

Man sitting down with head in hands to represent woman looking out at a sunset to represent adderall withdrawal symptoms

High functioning depression, or functioning depression, refers to individuals who exhibit symptoms similar to those of depression (major depressive disorder) but are able to maintain their daily lives with less impairment. Despite struggling internally, a functioning depressive is able to perform relatively well in most areas of life.

Today, you will learn:


      • What does high functioning depression look like?

      • What are the symptoms of functional depression?

      • What is the best way of treating this form of depression?

    Symptoms of High Functioning Depression

    People diagnosed with high-functioning depression, clinically described as PDD (persistent depressive disorder), exhibit symptoms like persistent fatigue and lack of energy. PDD is typically diagnosed when these symptoms persist for a minimum of two years.

    Previously referred to as dysthymia, PDD requires professional evaluation from a psychiatrist or mental health expert. Diagnostic criteria outlined in DSM-5-TR serve as a guideline or test for high-functioning depression. While many symptoms of functional depression overlap with those of major depression, they are generally less severe.

    To meet the criteria for PDD, an individual must experience a depressed mood for most of the day, nearly every day, over a period of two years or more. This depressed mood must be accompanied by at least two of the following functional depression symptoms:


        1. Changes in appetite, either decreased or increased.

        1. Sleep disturbances, including insomnia and excessive sleepiness.

        1. Persistent lack of energy and fatigue.

        1. Lowered self-esteem.

        1. Difficulty concentrating and making decisions.

        1. Feelings of sadness and hopelessness.

      In addition to the above high-functioning depression symptoms causing a persistent depressed mood, several other criteria must be met for a clinical diagnosis of high-functioning depression:


          • The depressed mood, along with the associated symptoms, must occur on most days for at least two years, with no relief from depression lasting longer than two months during this period.

          • The individual must not have experienced a manic or hypomanic episode, which involves an abnormally elevated and energetic mood.

          • The symptoms of depression cannot be better explained by another mental illness, a medical condition, or substance abuse.

          • The symptoms and depressed mood must result in impairment in one or more areas of normal functioning and cause significant distress to the individual.

        It is possible for an individual diagnosed with PDD to also meet the criteria for major depression.

        A woman looks out of a window to represent functioning depression.

        Do I Have High Functioning Depression?

        If you resonate with the above signs of functional depression and suspect you may have high-functioning depression, keep in mind that only a qualified mental health professional can provide an accurate diagnosis. That said, self-awareness and recognizing the signs can be an essential step in seeking help and support. Here are some questions to consider:


            • Are you frequently experiencing a persistent low mood that affects your daily life?

            • Do you often find it challenging to experience long-lasting happiness or joy?

            • Are you consistently feeling fatigued and lacking energy, despite getting adequate rest?

            • Do you find yourself becoming emotional or tearful without a clear reason?

            • Are you able to fulfill your responsibilities, but feel an overwhelming sense of effort and struggle?

            • Do you have negative self-perceptions, feeling unworthy or like an imposter?

            • Are you highly self-critical and find it difficult to accept compliments?

            • Do you attend social activities but feel as though you’re forcing yourself to be there?

            • Have you turned to substances like alcohol or drugs to cope with your emotions?

            • Have you noticed a gradual emergence of these symptoms without any specific triggers?

          If you responded positively to several of these questions, it may be worth discussing your concerns with a mental health professional. They can provide a comprehensive evaluation and determine whether high-functioning depression or another mental health condition is present. Remember, seeking support is a positive step towards understanding and improving your mental well-being.

          Signs of Functional Depression

          The indications of high-functioning depression can be subtle. In your everyday life, you may experience the following:


              • Frequently feeling down, with fleeting moments of happiness.

              • Maintaining a generally pessimistic outlook on the world.

              • Persistent tiredness, even if you feel that you are getting enough sleep.

              • Experiencing unexplained crying or emotional episodes.

              • Fulfilling your personal and professional responsibilities but finding them incredibly challenging.

              • Feeling unworthy or like an imposter in life, believing that you don’t deserve happiness.

              • Engaging in self-criticism and struggling to accept compliments.

              • Attending social events but feeling like you’re forcing yourself to be there.

              • Resorting to alcohol or drugs as an attempt to alleviate your emotions.

            Your constant low mood and seemingly mild symptoms may lead others to perceive your high-functioning depression as normal behavior or attribute it to your personality. They may view you as lazy, miserable, or unable relax, rather than recognizing it as a mental health condition that requires treatment. This is why it can be tricky to identify high-functioning depression. Beyond this, unlike sudden onset depression or depression triggered by specific events or stressors, the signs of high-functioning depression may emerge gradually without clear triggers or limited triggers.

            Treatment for High Functioning Depression

            High functioning depression, like any form of depression, can be effectively managed with appropriate treatment. Begin by consulting with a mental health professional to receive an accurate diagnosis and create a personalized treatment plan.

            Here are some common approaches to treating high-functioning depression:


                • Therapy: Psychotherapies like CBT (cognitive-behavioral therapy) or IPT (interpersonal therapy), can be highly beneficial for the treatment of PDD. These therapies help individuals identify and modify negative thought patterns, develop healthier coping mechanisms, improve relationships, and enhance overall emotional well-being.

                • Medication: In some cases, antidepressant medication may be prescribed to alleviate symptoms of high functioning depression. Antidepressants work by balancing brain chemicals that are associated with mood regulation. Consult with a psychiatrist who can assess your specific needs and guide you through the medication options.

                • Lifestyle changes: Adopting healthy lifestyle habits can have a positive impact on mental well-being. This includes getting regular exercise, eating a balanced diet, getting sufficient sleep, and avoiding the use of addictive substances. Additionally, incorporating stress management techniques like meditation, mindfulness, and relaxation exercises can help reduce symptoms.

                • Support network: Building a support network is a key component of managing high functioning depression. Seek support from trusted friends, family members, or support groups. Sharing your experiences and emotions with others who understand can provide validation, empathy, and encouragement.

                • Self-care: Prioritize self-care activities that bring you joy and relaxation. This could include engaging in hobbies, practicing self-compassion, setting boundaries, and allowing yourself time for rest and rejuvenation.

                • Regular check-ins: Attend regular follow-up appointments with your mental health professional to monitor progress, discuss any challenges, and adjust the treatment plan as needed. Open communication and honest feedback are vital for optimizing your treatment outcomes.

              Remember, treatment for high functioning depression is highly individualized, and what works for one person may not work for another. Be patient with yourself throughout the process and celebrate small victories along the way. With the right support and treatment, it is possible to effectively manage high functioning depression and improve your overall quality of life.

              A man sits in front of an open window to represent the signs of high-functioning depression

              Addiction and Depression

              The relationship between addiction and depression is complex. While they are separate conditions, they can often co-occur and impact each other. According to NAMI (National Alliance on Mental Illness), one-third of U.S. adults with mental illnesses and half of those with SMIs (severe mental illnesses) also have substance abuse issues.

              Here are some key points to consider regarding the connection between addiction and depression:


                  • Dual diagnosis: When someone is diagnosed with both depression and a substance use disorder, this is clinically described as a dual diagnosis or co-occurring disorder. These individuals require specialized treatment that addresses both conditions simultaneously. Tackling both the addiction and the underlying depression is proven more effective than treating both conditions in isolation.

                  • Shared vulnerability: Addiction and depression can share common risk factors and vulnerabilities. Genetic predisposition, environmental factors, traumatic experiences, and imbalances in brain chemistry can contribute to the development of both conditions. Understanding these shared vulnerabilities can inform treatment approaches.

                  • Vicious cycle: Addiction and depression can create a vicious cycle where each condition worsens the other. The consequences of addiction like relationship problems, financial issues, or legal troubles can intensify feelings of depression. Similarly, the presence of depression can contribute to cravings, relapses, and difficulty sustaining recovery.

                  • Integrated treatment: Treating addiction and depression together is essential for successful recovery. Integrated treatment approaches involve addressing both conditions simultaneously, often through a combination of therapy, medication, support groups, and lifestyle changes. This comprehensive approach helps individuals develop healthier coping mechanisms and manage both their addiction and depressive symptoms effectively.

                  • Recovery support: Building a strong support network can include participation in support groups, seeking help from mental health professionals, involving loved ones in the recovery process, and exploring resources specific to dual diagnosis treatment.

                If you or a loved one is struggling with both addiction and depression, it is essential to seek professional help. Mental health professionals, addiction specialists, and treatment centers are equipped to provide the necessary support, guidance, and treatment options to address these intertwined conditions. Recovery is possible with the right support and a comprehensive approach that addresses both addiction and depression.


                What does it mean to be functionally depressed?

                Being functionally depressed means experiencing symptoms of depression while still being able to perform daily tasks and responsibilities, even though it may require extra effort and energy to do so.

                What is the difference between high-functioning depression and regular depression?

                High-functioning clinical depression refers to individuals who can maintain a seemingly normal level of functioning and productivity despite experiencing depressive symptoms, whereas regular depression may significantly impact a person’s ability to function in various aspects of their life.

                What does high-functioning mean in mental illness?

                In the context of mental illness, high-functioning typically means that a person can outwardly appear successful, competent, and productive despite experiencing significant mental health challenges internally.

                A group of people stand with their arms around each other to represent Gratitude Lodge's high-functioning depression treatment program in California.

                Get Treatment for Addiction and Depression at Gratitude Lodge

                If you have been struggling with addiction and depression or high-functioning depression and anxiety, we offer integrated dual diagnosis treatment at Gratitude Lodge in Southern California. Our unwavering commitment to combatting addictions and nurturing mental well-being led us to establish pet-friendly rehab centers in two serene locations in Newport Beach and Long Beach, CA.

                Embark on your recovery with confidence as our dedicated team guides you through a supervised medical detox program, ensuring your safety and comfort throughout the process. Once your system is cleansed from the grips of addictive substances, seamlessly transition into our comprehensive 30-day inpatient program, designed to empower you on your path to lasting recovery.

                At Gratitude Lodge, we draw upon a diverse range of evidence-based interventions to tailor treatment programs that suit your unique needs. Our multidimensional approach encompasses the following modalities:


                    • Medication-assisted treatment

                    • Psychotherapy

                    • Group therapy

                    • Individual counseling

                    • Family therapy

                    • Holistic therapies

                    • Aftercare

                  Choose to embark on this transformative journey of healing and recovery. Place your trust in Gratitude Lodge, where compassionate care and a personalized approach converge. Take the first step towards a brighter tomorrow by calling our admissions team at 800-994-2184.

                  Want to learn more?

                  Recent Articles

                  Begin your journey
                  to recovery.

                  Get evidence-based treatment in a peaceful location, with a
                  team of dedicated, expert staff. 
                  Share on Facebook
                  Share on Twitter
                  Share on Linkedin
                  Share on Email
                  Joe Gilmore

                  Joseph Gilmore

                  Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.
                  Jenni Bussi

                  Jenni Busse MS, LPCC

                  Jenni Busse MS, LPSS is the Clinical Director at Gratitude Lodge. Jenni oversees the clinical program and the clinical team at Gratitude Lodge as a whole. Jenni has worked in treatment for almost 14 years. Her background as a licensed therapist and her passion for helping others intersected with addiction recovery when she started working primarily in detox residential treatment.

                  Drug detox can vary according to the patient’s addiction factors, including the substance abused, how long the addiction has lasted, the patient’s medical condition, if any other disorders are present, and more. Our skilled and credentialed team at Gratitude Lodge work closely with every patient going through drug detox, facilitating the beginnings of a successful recovery at our rehab addiction centers in Orange County, CA.

                  Drug detox can vary according to the patient’s addiction factors, including the substance abused, how long the addiction has lasted, the patient’s medical condition, if any other disorders are present, and more. Our skilled and credentialed team at Gratitude Lodge work closely with every patient going through drug detox.

                  Many patients don’t realize the toxicity of prolonged alcohol abuse and how it affects the body. Alcohol detox at the luxurious rehab addiction centers at Gratitude Lodge leeches your body of these toxins in preparation for successful treatment for drugs and alcohol abuse. Alcohol detox may not take as long or produce severe withdrawal symptoms, but it is still an essential beginning to your recovery.

                  Many patients don’t realize the toxicity of prolonged alcohol abuse and how it affects the body. Alcohol detox at the luxurious rehab addiction centers at Gratitude Lodge leeches your body of these toxins in preparation for successful treatment for drugs and alcohol abuse.
                  an image of clients representing drug detox california

                  Holistic Therapy

                  Our holistic therapy treatments offer a full-scope approach to recovery, addressing your mind, body, and emotions as part of a comprehensive treatment plan. This therapy is designed to help address underlying issues and integrate alternative therapies to promote overall health and well-being.
                  Gratitude Lodge clients laughing, representing drug detox california


                  An essential part of your treatment experience, we offer individual (CBT and DBT talk therapy) and group addiction treatment counseling to help you explore and address the emotional component of addiction, providing you with the tools, self-awareness, and empowerment you need to maintain recovery.
                  woman at beach representing drug detox in california

                  Dual Diagnosis

                  Dual Diagnosis is a highly effective addiction treatment that addresses substance use and mental health disorders simultaneously. Often co-occurring, these disorders are best managed when treated together with specific and targeted therapy.
                  an image of a client and therapist at Gratitude Lodge's Long Beach addiction treatment center

                  Medication-Assisted Treatment (MAT)

                  Medication-Assisted Treatment provides you with FDA-approved medications to help ease the symptoms of withdrawal while you’re in treatment. This makes the detox process easier and safer, as well as increasing the chances of a successful recovery.
                  an image of clients outside after getting help at Gratitude Lodge's rehab in Long Beach, California

                  Sober Living

                  Sober living provides a supportive and substance-free living environment for your ongoing recovery. We partner with a number of upscale and carefully vetted sober living homes that are available to our clients after inpatient alcohol and drug addiction treatment.
                  an image of clients at Gratitude Lodge's drug rehab program

                  Outpatient Treatment

                  Once detox and inpatient are complete, we provide an easy transition to outpatient care through our hand-selected partners. This program offers a more flexible approach, allowing you to ease back in to daily life while still receiving frequent & effective care.
                  An image of clients going through inpatient substance abuse treatment


                  Inpatient treatment provides an intensive and comprehensive addiction treatment program in a structured environment. You will receive 24/7 expert care, therapy, and support as you build your foundation for long-term recovery.
                  an image of clients at clients at Gratitude Lodge's representing fear in recovery

                  Drug & Alcohol Detox

                  A crucial first step in the recovery process, our detox program provides a comfortable, medically supervised environment that addresses the physical aspect of addiction and eliminates substances from your body.

                  Use Our 24 Hour text line. You can ask questions about our program, the admissions process, and more.