Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: February 9, 2026
Fact checked
Quick Summary
  • You behave naturally to the world surrounding you doesn't mean you are not suffering.
  • If you are anxious, depressive, and going through some mental health issues but performing well in your daily life, you are a high-functioning individual.
  • In other words, high functioning means you are better at hiding your depression and mental issues from people and living a normal life than others with the same mental condition.

Do you feel depressed despite doing well in your life? You behave naturally to the world surrounding you doesn’t mean you are not suffering. Have may you ever hear this phrase? “Are you really depressed, but you look quite normal.”  If yes! You are a high-functioning individual. Let’s understand this first. What does high functioning mean? If you are anxious, depressive, and going through some mental health issues but performing well in your daily life, you are a high-functioning individual. In other words, high functioning means you are better at hiding your depression and mental issues from people and living a normal life than others with the same mental condition.

The term high function depression is argued by mental health experts as this is neither a clinical disorder nor have a diagnosis. Professionals think this is an ambiguous terminology encircling ongoing forms of depression such as persistent depressive disorder and dysthymia. Moreover, the people living with high function depression make you feel like everything is great around you. In high functioning individuals, depression exists but in a less severe form than the other depressed individuals.

Normally, mental ailments are diagnosed based on a specific criterion of health impairment. Impairment refers to loss of normal functioning in one or more fields of life. Either he or she may not be able to perform well in their academics, jobs or unable to manage their relationships. But some people act normally all the time but still experience depression symptoms and signs are high functioning. One thing that should be considered is that high functioning differs from fully functioning. So, there must be some mental impairment.

Situational Depression Symptoms and Treatment (source: WHO, 2023)

We know, depression is real and a very common mental health problem worldwide. World Health Organization (WHO) claims that over 264 million people of all age groups go through depression globally.

Among these millions, many people face mental health problems like others but present themselves “ok” in front of others. Similarly, high function depression (HFD) exists when a person experiences the same symptoms and challenges as any other depressive person, but his struggles are mostly obscure from the outside world.It is a persistent type of depression previously known as dysthymia and is currently called persistent depressive disorder (PDD). PDD differs from severe depression that is called a major depressive disorder.

Signs and symptoms of high function depression are common with other forms of depression but less severe. If you are familiar with symptoms of other depression types, then you know the high functioning depression symptoms. In HFD, the depression symptoms are persistent and last for an extended period. The person may have a depressed mood most of the time each day. (source: NIMH, n.d.-a)

Many other symptoms may include:

  • Change in eating habits
  • Lack of concentration
  • Low mood or sadness
  • Indecisiveness
  • Despair
  • Low self-esteem
  • Feeling guilty all the time
  • Lack of energy
  • Feeling like “you are faking it” upon accomplishment, also called imposter syndrome.
  • Feeling incapable of doing more than what you are already doing or being lazy
  • Tiredness/ Fatigue
  • Feeling worthless
  • Insomnia (sleeplessness) or oversleeping
  • Desire to avoid social life

Due to the commonness between depression symptoms, people usually ponder and ask, “is high functioning depression real?” Yes, it is. But it is only challenging to identify because, unlike other depressed individuals, who are fully incapacitated by depression signs and symptoms, high functioning people can get along with it. They push themselves and try to use their strategies to cope with depression instead ofgetting the help they desperately need.

High functioning depression is difficult to diagnose. However, if an individual feels depression signs and symptoms, he or she should seek a mental health professional. Most people have less intense symptoms and are sometimes unaware that they are suffering from depression. Therefore, HFD diagnosis is a challenging process. (source: NIMH, n.d.-b)

Doctors or mental health experts usually go for a clinical interview for the diagnosis of high-function depression. For persistent depressive disorder or PDD, a person must have depression for a minimum of two years and possess some other symptoms. 

Horse Therapy to Treat Depression and Anxiety

  • The person must have a depressed mood on most days for a minimum of two years without any break from depression episodes for more than two months.
  • Depress mood and depression symptoms must result in any impairment in normal functioning in one or more areas of life.
  • Depression is accompanied by mental illness, anxiety disorder, substance abuse, and a medical condition.

To tackle a high-functioning depressed person, we should understand his feelings and thought process. We should know “what high functioning depression feels like?”. [4]

The person experiencing high functioning depression may feel sad and low all day but still manages to do what is necessary. He or she carries his daily routine in a normal but in an undelightful way. High-functioning depressed people think like, “I can do this.” I must. People are relying on me. I will do what is to be done”. As HFD is not a distinctive clinical manifestation of depression. However, people feeling depressed mood or depression-like symptoms must seek medical help.

Friends and loved ones can help a person come out of high functioning depression. If you have any high-functioning depressed friends or anyone in your circle, you can help them. You can listen to them. Your friend may be unaware of his depressive condition. You can find medical support for them. And if, at some point, they get disappointed or desire to leave their treatment,encourage them to continue their therapy. As this can help them overcome depression.

High-functioning depression can be treated by psychotherapy or talk therapy as well as medication. Mental health experts may take some time to understand the condition and adequately devise a suitable combination of therapies to treat HFD. (source: MedlinePlus, n.d.)

TMS Therapy to Treat Depression

Besides medication, a high-functioning depressed individual is also advised to adapt the followings habits such as

  • Exercise daily to get your blood pumping
  • Share your problems with a sincere friend
  • Limit your screen time
  • Spare time for healthy activities that please you
  •  Get time to socialize
  • Go for a walk, hike, or run
  • Limit or avoid alcohol use
  • Do mediation, yoga and relax your mind and body
  • Join community serving activities
  • Sleep enough

These habits can slowly help a high-functioning depressed person get out of depression and increase his productivity. This leads a depressed one to the path of healthy mental life.

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