High Functioning Depression at Work

Feelings of despair, loss of appetite, difficulty concentrating, trouble sleeping. Small tasks that were once carried out automatically now require tremendous effort. We might assume that a person who has depression always has trouble making it into work and fulfilling their obligations. On the other hand, someone who carries out all of their day-to day tasks, and even performs well at work is not always depression free.

Dysthymia is a long lasting, mild form of depression (Mayo Clinic Staff, 2015).  It is not what we would expect from depression because people with dysthymia often carry out all their daily productive tasks. As such, it has been dubbed “high-functioning depression”.

What does high-functioning depression look like?

Some of the characteristics may include:

  • "hopelessness
  • tiredness and lack of energy
  • irritability or excessive anger
  • avoidance of social activities
  • sleep problems
  • poor appetite or overeating" (Mayo Clinic Staff, 2015)

 Yet, the person may still come into work on time, get all their work done in a timely manner, and even socialize in the staffroom. Meanwhile, they are fighting an internal battle we we have no idea about. Harvard Medical School (2012) helps us characterize dysthymia by asking us to “Think of dysthymia as a dim gray compared to depression's blackness.(…)You carry out your daily responsibilities, but without much zest for life.”

At least it’s not major depression, right?

Scientists note that although dysthymia does appear to be mild, “the cumulative burden of persistent depressive symptoms and impaired functioning is substantial and probably greater than most episodic major depressions” (Klein & Santiago, 2003).  Among the adult population, it can last up to five years on average (Harvard Health Publications, 2012).

Suffering in Silence

Dysthymia and major depression fall under the same diagnostic umbrella, but they cannot be equated.  People with high-functioning depression who are “getting things done” are probably less likely to receive the same attention as someone whose illness has a more visible impact on their productivity at work.  Our predetermined picture of depression could be a factor in preventing people from getting the help they need.

How to help

We cannot go around our workplaces suspecting that everyone who is getting their work done without enthusiasm to be depressed. Sometimes just being aware of the different faces of mental illness is already a big step in helping those around us who may be suffering. When we acknowledge that depression does not always have a “typical” presentation, we effectively minimize the stigma by validating the feelings of those who feel depressed but may hold back from getting help because they “do not fit the mold” of depression.


Mayo Clinic Staff (2015). Persistent depressive disorder (dysthymia). Retrieved from http://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/home/ovc-20166590

Klein, D. N. & Santiago, N. J. (2003). Dysthymia and chronic depression: Introduction, classification, risk factors, and course. Journal of Clinical Psychology/In Session, 59(8), 807-816. doi: 10.1002/jclp.10174

Harvard Health Publications (2012). Feeling down? It could be low level depression. Retrieved from http://www.health.harvard.edu/healthbeat/feeling-down-it-could-be-low-level-depression

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