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REGISTER Representing the interest of 14 IPA’s, throughout South Africa

High Functioning Depression

Depression exists on a spectrum with varying degrees of severity. At the lowest end of the depression spectrum, the condition is debilitating and makes daily living extremely challenging. The definition of high-functioning depression is apparent in the term itself, implying that although some symptoms of depression may be present, an individual is still able to function – often with great success – in areas of work, family, and relationships. This type of depression is also referred to as chronic depressiondysthymia, and persistent depressive disorder. But whatever the label, the important thing to note is that treatment for depression on the higher end of the spectrum is available, and people don’t have to suffer in silence anymore.

Are you a High-Functioning Depressive?

High-functioning depression doesn’t conform to the stereotypical image of what depression is supposed to look like. This has two very significant consequences: firstly, it makes it difficult to diagnose, and second, people often don’t realize they have it. However, as with any mental illness, there are great risks involved if left untreated. So even though a person might seem like they have it all together – successful at work, grounded family, healthy social life – there are signs to look out for that can help you identify high-functioning depression for what it is, so you can seek the necessary help.

Tiredness becomes fatigue and exhaustion. It takes a lot of effort to get through a day when you feel like you’re barely holding on, but you also feel a strong need to give the impression that you are in total control. Getting home from a day of work feeling physically, emotionally, and mentally depleted to the point where you can’t do anything but curl up in bed, is a sign that something is wrong.

Your inner-critic never sleeps. High-functioning depressives are consistently self-critical. This is usually linked with increased self-doubt and a low self-esteem. You work really hard and perform well at work, but it’s driven by an internal narrative that you’re a failure and that everyone else thinks so too.

Anxiety is your default setting. The constant worry of past, present, and future consumes every waking moment, and keeps you out of sleep as well. Striving for perfection in everything, not being able to rest or slow down for fear of unwanted thoughts and feelings that come in moments of stillness… This kind of anxiety is one of the prime symptoms of high-functioning depression.

Minor annoyances end your world. Your friend has canceled a lunch date, or your favorite show’s been preempted due to sport. When mildly annoying things cause a great stress reaction that is not in proportion to the situation, it’s usually a sign of high-functioning depression. It is also related to excessive anger and irritability that leave you feeling like a bomb waiting to explode at the drop of a hat.

Getting Help for Depression

The high-functioning depressive deals with many symptoms that overlap with ‘typical’ depression. But because these symptoms are usually less severe, it makes them easy to hide and therefore not noticeable to anyone looking in from the outside. This type of depressive still manages to get out of bed every day, do well at their job, and maintain relationships. Private depression clinics often see patients who started out thinking they could live with their high- functioning depression because they were ‘getting by’ and it wasn’t affecting their day-to-day life all that much. But symptoms become worse over time if left untreated, and the condition that you were managing to push through will suddenly begin impacting your quality of life in a negative way. It is this invisible characteristic of high-functioning depression that poses a unique risk and makes it a rather dangerous condition, given that it receives free reign to fester and grow into major depression when it is ignored.

Another risk involves the stigma surrounding depression and mental illness. For people suffering from high-functioning depression, fear of being stereotypedand singled out is a reality. This could lead to them choosing to try and deal with it on their own, instead of seeking the professional help they need. More often than not – since they may not be equipped to deal with their condition in a healthy way – this leads to the development of other conditions, like substance abuseandeating disorders. The point is to seek out clinical intervention as soon as possible, because depression is treatable and nobody needs to go through it alone.

There are various screening tools used by mental health professionals to diagnose high- functioning depression, and if you suspect you might be at risk, speak to your GP for a referral. Psychiatric hospitals in Pretoria and around the country in general, are well-versed in specializing in depression treatment, and will be able to provide the help you need to better manage your condition. Often a combination of psychotherapy (talk therapy) and medication is advised, to help deal with acute symptoms and to establish a solid foundation for living with high-functioning depression in a healthy way.

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