Yes, You Can Have Both ‘High-Functioning’ and ‘Severe’ Depression

As someone who has studied in and now works in the mental health field, I believe that everyone has some degree of mental health issues. The extent to which we’re affected by mental illness depends on brain chemistry, genetics, past trauma, support systems and other variables. In our society, I think mental illness, depression especially, is seen in a dichotomous way of either being so severe that one can’t get out of bed, or mild enough that one doesn’t need any help.

This is not true.

I’ve been struggling lately with the thought that I’m somewhere in the middle of this mental illness spectrum, and it can be very difficult to explain this. On one end, I consider myself to have “high-functioning depression,” meaning that I’m still able to carry on my daily activities. I recently graduated from college with honors, I lived in the dorms, and I was part of a sorority. I am currently a graduate student as well as a social worker, and I do very well at my job. Most of my friends are surprised to hear about my mental health struggles.

On the other end, I also have severe depression, in addition to anxiety and obsessive-compulsive disorder (OCD). I have gone to weekly therapy for the last five years, I currently take six psychiatric medications, and I’ve been admitted into an inpatient psychiatric hospital multiple times in the last several years.

Even while going to school and working, I have called the suicide hotline and I still text the crisis hotline often. However, I’m still able to do my job and schoolwork well, have close positive relationships with my family and friends, and live independently.

Every therapist I have had, after I explain the severity of my depression, has said: “Well, it seems like you function very well.” To me, this almost makes it seem like they are implying that being high-functioning negates the severity of my depression. On the contrary, when I have opened up to coworkers or teachers about my mental illness, I’m often met with a response like, “are you sure you’re able to continue on with your job/school work?” This makes it seem like they’re implying that I can’t be high-functioning if I have severe depression.

So, one thing I want my peers and the mental health community to know is that it is possible to have what I’ve coined as “high-functioning but severe depression.” Being able to function well does not necessarily negate the severity of your mental illness, nor does the severity of your mental illness prohibit your ability to be high-functioning.

Now, I want to make clear that in many cases, mild depression does correlate with being high-functioning, as does having severe depression often yield to having difficulties carrying out everyday activities. However, what I want people to be aware of is that depression doesn’t only come in these two varieties. “High-functioning but severe depression” does exist, and it is very valid.