High-Functioning Mental Illness Doesn't Mean Your Struggles Are Invalid - Why And How To Reach Out For Help

Mental illness is far from uncommon. According to the National Alliance of Mental Health, as of 2021,  almost 59 million adults in the U.S. were living with a mental disorder. The prevalence of mental illness in our society, especially anxiety and depression, is so common that even if you've never struggled with it personally, there's a good chance someone you love has.

But when it comes to mental disorders, they don't always look the same. Not everyone who has depression is stuck in bed for weeks on end when they have a particularly difficult episode, nor does everyone with anxiety pop Xanax every day just to make it through the week. For some, especially if they're unaware that they have a disorder, go about their day struggling in silence. This is especially the case for those who have a high-functioning mental illness. "Generally, individuals are able to function at work and social environments," Dr. Lorenzo Norris told U.S. News. "These people are able to function quite well and even overachieve in some areas, and they themselves are probably not aware of their symptoms."

It's this ability to get by day after day that, if one with high-functioning depression or anxiety were to tell someone about their eroding mental health and the internal struggles they're dealing with, they might hear something like, "Well, you don't look depressed or anxious." And that's exactly the problem: assuming all mental illnesses look the same way, when nothing could be further from the truth.

What is a high-functioning mental illness

For those with high-functioning anxiety and depression, despite the suffering they're experiencing inside — fear, feelings of hopelessness, constant worrying, exhaustion, and even overall misery — they push through it. These people have trained themselves, either consciously or subconsciously, to function at all costs. It's a coping mechanism for them to get through the day in one piece and put on a brave face in the process.

But just because these people can smile all day long and often be considered people pleasers, it doesn't mean that when they go home at night that they don't engage in self-harm or self-medicating with drugs and/or alcohol. Because high-functioning doesn't fit the stereotype of what a mental illness "should" look like, at least according to our culture, these people have to grapple with the fact that their disorder might not be taken seriously which, in turn, makes their illness feel invalid, further stigmatizing mental disorders, per Mental Health Center.

What high-functioning mental illness looks like (and why it's overlooked)

While mental health problems look different for different people, someone who has high-functioning anxiety, for example, may look like a perfectionist or a go-getter, someone who doesn't fail because inside, they have an intense fear of failure. To fail, would be devastating and contribute to the suffering that they're already always feeling. That's why these people appear so driven in every aspect of their life. So much so that no one, in their wildest dreams, would suspect that this person is struggling every day.

"High-functioning individuals tend to forge ahead in an effort to succeed with goals," psychotherapist Mayra Mendez, Ph.D. told Healthline. "The drive to accomplish often sustains action and moves high-functioning individuals towards getting things done."

It's this veil that hides the suffering that makes high-functioning mental illnesses so often overlooked, per Mental Health Center. The anxiety and depression are so internalized and suppressed, that friends, family, and coworkers don't suspect there's a problem. So, no one addresses it, questions it, or suggests that the person who's high-functioning gets the help they absolutely need. Turning a blind eye or simply not recognizing the disorder can exacerbate the mental illness to a point where these individuals just burn out from the exhaustion that essentially comes with living two lives.

The struggles of those with high-functioning mental illness

When it comes to being high-functioning, there can be an overwhelming feeling of isolation. Whereas those with depression and anxiety that aren't high-functioning receive the attention they deserve, those who are able to function every day don't get the attention they desperately need. In fact, of the 33 million studies published in the National Library of Medicine, there's only one research paper on the topic and it's about the need for more studies about high-functioning mental illness, per Inverse.

So in addition to struggling with all the symptoms of depression and anxiety internally — the hopelessness, the loss of interest, the constant concern for things out of your control, low self-esteem, as well as the physical toll of depression and anxiety — there is a serious lack of research on the topic. But this may be because the "high-functioning" label is a modifier to explain where on the spectrum your mental health condition falls. High-functioning anxiety is anxiety. It may not be so severe that it inhibits you from going about your daily tasks, but that doesn't mean you aren't suffering. And high-functioning depression can still destroy your quality of life if not addressed and managed, even though you may still be able to get out of bed and take care of your responsibilities. 

Where to seek help

Because these high-functioning disorders are essentially invisible, getting friends and family to provide a support network may not be easy. Finding help can be doubly difficult when the people in your life still fight to understand mental illness in general. But you know yourself. You know what you're feeling and you shouldn't ignore it.

"I advocate for therapy," co-founder of Viva Wellness, Jor-El Caraballo, LMHC told Popsugar. "I definitely think that's the best option just because it offers you the possibility of a mirror. To have someone who can see you without being you is incredibly helpful... These are obviously going to be ways to cope but they aren't going to 'fix the problem,' but it can help you get to a better place, definitely." The first step in gaining control is to research therapists in your area, their specialties, and what they charge. Some insurances cover mental health, while others only cover a fraction. There are also programs like Mental Health Care America for those who can't afford therapy. 

There is no definitive cure for mental illnesses. Even on days when you're feeling good, it's still there. What's important to realize is what you're experiencing is real and while the psychology community may not officially use the term "high-functioning," they know it's something with which people battle. Therapy will help you develop tools to manage your disorder so you can begin to feel like less of a prisoner of your mind.