Why We Need to Talk About High-Functioning Depression
Because "depression" is so much more than isolation.
When the Bubble of Normality Pops
To any onlooker, Amanda Leventhal, a college student at the University of Missouri, seems to have it all: perfect grades, a large network of friends, and social activities to take up her time. She's not someone one would typically identify as "depressed".
Her classmates at the University of Missouri would never have suspected that she had depression. Yet, her struggles with anxiety became clear when she wrote this essay, opening up about the truth of her life.
Distancing oneself from friends and family, not finding pleasure in former hobbies, having trouble sleeping and frequent crying are what multiple ads picture as depression symptoms. While those are signs of the disease, it doesn’t show us the whole spectrum that it can assume.
You’d never guess your recently promoted colleague, your friend who seems to have a dream job or your neighbor who just got married would be fighting such an intense struggle.
The reason this group of brilliant yet severely sad people won’t call for help is the stigmatized image of depression. Often, no one even knows something is wrong... until it's too late.
A Struggle Hiding in Plain Sight
It took me a long time and thought before making my private struggle public, says Leventhal. After her post was published, her friends told her it was shocking to find out.
“It was something I had been thinking about for a while, I was up late one night, not sleeping, and decided to put into words everything I had been reflecting on over the years.”
Now, she can talk about her depression more easily and mention that an appointment with a therapist should be as common as an appointment with a dentist. However, she still doesn’t include her anxiety as a topic for all conversations, fearing some people would not be willing to listen.
Carol-Landau, PhD, a clinical professor of psychiatry and human behavior and medicine at Brown University, reveals this issue is more characteristic among women.
“We’re still striving to be caregivers, and part of that is not admitting we need help. Depression is actually the leading cause of disability worldwide, according to the World Health Organization, which takes into account things like days lost from work, not being up to doing daily activities, and [possibly leading to] other illnesses like diabetes,” she says.
So when a woman speaks out, she can make it easier for another woman to share her emotional difficulties and their stories can help their close friends, spreading awareness and moreover, empathy.
Different Ways to Spot Depression
“You might have a friend who is cranky all the time, or who people think of as a ‘bitch,’ but inwardly that person is really struggling. Other subtle signs to look for: ironic or ill-humored jokes—if they are out of character—or often seeming 'out of it'.
Leventhal doesn’t identify herself with the women in antidepressant commercials either. Her symptoms manifest themselves in a different way. “For me, it was irritability,” she explains, which is a very typical manifestation of the disease, states Landau.
High-Functioning is Not Better Than Low-Functioning
High-functioning depression occurs when someone's list of accomplishments covers a profound sadness inside. Landau says she often notices it in perfectionist women.
Achieving goals and becoming successful is not always a correlation of balance and satisfaction in life.
By being harder to diagnose and less likely to seek help, a ‘high-functioning’ individual face even more adversities than a person with 'Low-Funtioning depression' does, adds Landau.
How do we talk to a friend who is masking high-functioning depression?
If you believe your friend is not opening up about her real emotional status, Landau suggests to simply ask if she is doing ok, telling her she has not been herself lately. Leventhal agrees that little things like asking “How are you doing?” and paying attention to the answer can be incredibly helpful.
“Just be there to listen and ask them what they need. Different people will need different things.” It can be compelling to prepare some suggestions beforehand, as information about a qualified therapist nearby or online options for meditation.
There’s an immense range of treatments, therapies and even internet resources such as apps and tools that can be used to alleviate anxiety, adds Carol Landau. “That’s why it is tragic that so many people don’t seek help.”
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