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Do You Know What High-Functioning Depression Is?

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Do You Know What High-Functioning Depression Is?

You’re tired, experience bouts of sadness or mild depression, and have unexplained weight gain or loss – all the while being rewarded as a high achiever personally and professionally. You may be suffering from a condition known as high-functioning depression or dysthymia, often treatable with medicine, counseling, or ketamine therapy.

Are You Depressed?

Depression can be characterized by five or more of the following happening often:

  • Depressed moods
  • Loss of interest or pleasure
  • Weight gain or loss
  • Insomnia/hypersomnia
  • Slowed thoughts or physical movements
  • Fatigue
  • Feelings of worthlessness, extreme guilt
  • Poor concentration
  • Thoughts of suicide or death

Your symptoms interfere with daily life, aren’t the physiological effects of substance abuse or a medical condition, aren’t explained by other psychotic disorders, and there’s no history of manic or hypomanic episodes.

What is Dysthymia?

According to Johns Hopkins Medicine, “Dysthymia is a milder, but long-lasting form of depression. It’s also called a persistent depressive disorder. People with this condition may also have bouts of major depression at times.”

It’s the only kind of depression where symptoms happen for at least two years or even longer. Women experience it more than men, which a chemical imbalance may cause in the brain or biological, environmental, genetic, or psychological factors.

What is High-Functioning Depression?

High-functioning depression is a milder form of depression but can still have severe consequences for people who suffer from it. Therapist Sherry Amatenstein says, “High-functioning depression or dysthymia may be harder to detect than a major depressive disorder because the people living with it are often high achievers who make you think everything is all right all the time.”

One of the characteristics of people who suffer from high-functioning depression is chronic overachievement, pushing themselves to their limits. Unfortunately, they also buy into the myth that if their depression isn’t severe and persistent, it’s not a problem.

It May Be Chronic, Low-Level Depression

Depression, which lasts most of the day, could indicate dysthymia, even if you function relatively normally. You’re able to handle daily obligations but without much enthusiasm for life. Depressed moods lasting for longer than two months and combined with two or more of the following may indicate high-functioning depression:

  • Overeating or little appetite
  • Sleep too little or too much
  • Tiredness or low energy
  • Low self-esteem
  • Problems making decisions or concentrating
  • You feel hopeless


High-function depression can be diagnosed by:

  • A physical examination is needed to learn what might be causing the condition
  • Analysis of lab results, which could rule out specific causes or discover the presence of thyroid problems, for instance
  • A psychological evaluation, where a therapist will consult with depression criteria in the DSM-5

Key Points About High-Functioning Depression

One of the worst things you can do about depression or mental illness is to minimize it or let someone else control your narrative. In the age of gaslighting, there’s nothing more serious than having your words and emotions twisted and the facts of your mental illness downplayed. Key points to remember about high-functioning depression, dysthymia, or low-level depression are:

  • Dysthymia may be mild, but it’s a more chronic form of depression. You may also experience significant depression concurrently.
  • There is no definitive cause, but experts believe it’s a byproduct of chemical imbalances in the brain. While depression can run in families, no genes have definitively been linked to depression.
  • It’s not unusual for depression to be accompanied by persistent feelings of sadness, helplessness, hopelessness, and irritability. Without treatment, symptoms can persist for several years.

Treating the illness involves psychological counseling, ketamine therapy, or a combination of both.


Treatment Phases

  • Acute phase to relieve symptoms, about four to eight weeks, but possibly longer depending on responsiveness to initial therapy.
  • Continuation phase to maximize improvements you’ve made. This phase may last about five months and require treatment adjustments, like modifying medication dosages.
  • The maintenance phase has the goal of preventing depression reemergence.

Ketamine for Depression

In all cases of mental illness, a doctor or mental health professional will only arrive at a diagnosis of high-functioning depression after you’ve undergone a thorough physical and psychological exam and after comparing your symptoms to criteria in the DSM-5. Your doctor may recommend psychological counseling or refer you to a clinic to receive ketamine therapy. Ketamine was once used only for anesthesia and is known to treat symptoms of mental illness.

Final Thoughts

Depression is widely regarded as the leading cause of disability worldwide but isn’t embarrassed by or ashamed of. It affects millions of adults, often with devastating consequences. By recognizing its symptoms and seeking treatment, you’re now on a meaningful personal journey of regaining control of your life.

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