Join the Conversation on
933K people
0 stories
129K posts
  • About Depression
  • Note: The hashtags you follow are publicly viewable on your profile; you can change this at any time.
  • Explore Our Newsletters
  • What's New in Depression
    Good to see you today 👋

    The Mighty offers a safe, supportive community for people who talk about mental health with compassion and without judgment. All we're missing is you.

    Join The Conversation Today
    Laura Bower

    5 (False) Things People Assume About Depression

    Depression is often misunderstood and unless you have lived with this horrible monster, it’s hard to grasp the reality of this unfortunate condition. Here are five things people often assume about depression. 1. Everyone who has depression is in bed all day. Someone you know may be battling depression and you may not even know it. People with depression aren’t always noticeable — they may not be sleeping all day or even seem sad. The truth is, many people can learn to hide their depression quite well and sometimes the happiest people are the ones battling demons within themselves. 2. It’s easy to just be happy. “Just be happy!” If I had a dollar for every time I heard this, then I’d be on my way to owning my own private island.When you battle depression, it’s not as easy as “just being happy.” We would love to be happy — to feel “normal” —but for some reason, we just can’t. 3. Being outside and exercising will “cure” depression. There’s this meme floating around on the internet about going outside if you are depressed and how it will help your mood. People without depression often assume a quick fix to getting rid of said depression is to just get outside or simply exercise. It’s not that easy. While those things are great for the mind, when I was in my darkest days of depression, the last thing I wanted to do was to move my body or even leave my house. And I wanted to… very badly. 4. People with depression are “crazy.” If you live with depression or any form of mental illness, you probably know the stigma surrounding it. There’s a big misconception that people with depression are “crazy.” Not true. We can be some of the most normal and well-rounded individuals with successful careers and can be the best parents. We have an illness. We aren’t crazy. 5. People with depression just want attention. I can assure you this couldn’t be further from the truth. When you battle depression and you are reaching out to someone for help, that is the most vulnerable thing you can do. People with depression don’t seek attention… they seek help. Comfort. A friend. Before I battled my own depression, I had no idea how misinformed I was about it. I hope I was able to shed some light on things that are often assumed about depression.

    Sponsored By

    7 Ways Parents Can Recognize Clinical Depression in Their Kids

    When I speak with parents who are considering mental health treatment for their teenagers, the primary question they ask me is how to tell the difference between “typical” teen behavior and behavior that indicates there’s something more serious going on. A year ago, I would have been able to answer without hesitation: While some ups and downs are totally expected, watch out for social withdrawal, declining grades and high levels of anxiety or irritability. But, since March 2020, all of that has become more commonplace for teens around the country and the world. In the midst of a pandemic, with adolescents bearing the brunt of the mental health repercussions, it has become even more difficult to discern the tipping point when the stress and uneasiness we’re all feeling becomes a diagnosable disorder. That said, parents do not need to sound the alarm every time a teenager has a mood swing, but they do need to pay very close attention to what’s happening. Given the physical changes and emotional turbulence that can be a part of the teenage experience, “teen angst” — which manifests as moodiness, irritability and anxiety — is part of the process of evolving and maturing into a healthy adult. Although it is not always comfortable to experience tension and frustration, it is actually a critical developmental process that helps teens learn more about how to navigate and understand their emotions. However, major depressive disorder is a potentially life-threatening mental health condition, so it is essential not to downplay or overlook behaviors that might be symptoms of depression in teenagers. Research shows that 50 percent of all lifetime mental illnesses begin by the age of 14, and when left untreated, adolescent mental health issues become adult mental health issues. According to a study published in the American Journal of Psychiatry, 75 percent of teenagers who experience a depressive episode during adolescence later struggle with depression, other mood disorders, and/or substance use disorder as adults.   learn more   If you are a parent who’s having trouble understanding what your teen is going through, you are not alone. Forty percent of parents have a hard time distinguishing between changing moods and teen depression, according to a national poll conducted by the Mott Children’s Hospital. A good place to start is to look for these seven behaviors. Any one of these could indicate the presence of an underlying mental health condition, which can be assessed by a mental health professional. Your teen has stopped reaching out. Parents often notice during the teen years that their child doesn’t want to spend as much time with them as they used to. This is the age when adolescents do tend to move away from parents as their primary source of connection; although it can feel like a big loss for parents, this type of differentiation is critical for adolescents to go through. However, if teens are not connecting with peers, rarely coming out of their room unless forced to and not turning to parents for support, even though they seem to be struggling, these are warning signs. We are all isolating to some degree right now, but if a teen is isolating from everyone, even close friends and family members, that is a cause for concern. They are abusing drugs or alcohol or engaging in risky behaviors. Curiosity about drugs and alcohol is to be expected during adolescence, and even mild experimentation with substances can still fall within the range of normal teenage behavior (although it is not ideal). However, when teens are drinking or using substances to the point where their behavior and decisions are being negatively impacted, that can be a sign that intervention is needed. Drug paraphernalia in their room, binge drinking, lying about the amount of substance use, significant changes in appearance, or hanging out with a new friend group may all be indicators that a teen is self-medicating with substances. A family history of substance use is also a significant risk factor. Similarly, although it is typical for teens to experiment with their boundaries around sexuality and new interests, if parents notice that teens are engaging in dangerous sexual activities, this would be cause for concern. Childhood trauma is resurfacing. Our brains are wired to be hypervigilant for signs of distress or trauma, particularly for those who have a preexisting history of traumatic experiences. Throughout the pandemic, we have been experiencing a collective trauma of sorts, which has led to uncomfortable triggers for individuals who have experienced trauma in the past. Parents of teens who have survived abuse or other traumatic events should listen to their teen when they express concerns over nightmares, flashbacks and dissociative symptoms. It’s also important to remember that your teen’s past trauma may be related to family dynamics in some way. If they aren’t comfortable talking to you, offer them resources where they can feel safe speaking openly. They are self-harming and/or talking about suicide. Curiosity about suicide in the abstract is normal for teens, and parents do not need to shy away from those conversations. However, if teens start to talk about making a suicide attempt themselves, or use language like “No one would miss me,” “I’m a burden” or “The world is better off without me,” parents should take action immediately. While self-harm is not necessarily a suicidal behavior, it does also indicate an urgent need for assessment and possible support from a mental health professional. You can find mental health professional resources here. Their academic performance has drastically declined. Throughout the pandemic, we have seen that teens who used to enjoy school and excel academically may be less motivated and not as engaged in remote or hybrid schooling. But a steep decline in grades or a complete loss of interest in school is worth further investigation. There is a family history of trauma or other mental health conditions. There is a genetic component to many mental health conditions, and the ramifications of significant trauma can be transmitted over generations, so adolescents with this history are particularly vulnerable. Parents with this family history may need additional support as well, so they can create a stable foundation from which to support their teen. And as stated above, it’s always important to provide resources to your teen, should they not feel comfortable discussing trauma, particularly family-related trauma, with you. Your teen’s personality has changed significantly. Moodiness, grumpiness and a tendency to challenge authority can be expected during adolescence. Teens are balancing complex hormonal shifts and an increasing need for independence — not to mention a global pandemic and a heightened political climate. However, if your teen, who has recently been outgoing and communicative, becomes sullen and withdrawn, that can be cause for concern. Even for teens who tend to challenge authority, if parents notice a rise in violent or aggressive behavior, it would be helpful to seek assessment or treatment. If parents notice feelings of worthlessness, intense sadness or irritability that last more than two weeks, I would recommend reaching out for support from a professional. Finally, just because many teens are going through similar emotions and adjustments doesn’t mean it’s okay to dismiss troubling behaviors. Depression shows up in different ways for different people. If parents recognize potential warning signs of depression in a teenager, the best course of action is to access professional help and make sure your teen has a comprehensive mental health assessment. I will always err on the side of advising a parent or caregiver to have their child screened; early diagnosis and treatment of depression, as well as any co-occurring disorders, dramatically improves treatment outcomes. The sooner parents learn how to distinguish if their teen is living with depression and take the appropriate action, the sooner that child — and the whole family — can be on a path toward healing.   Find resources now

    Do your future self a favor!

    Get The Mighty's best mental health articles. Directly in your inbox. Twice every week. Future You will say thank you.

    Subscribe to Mental Health Matters
    Treatment Resistant Depression (TRD) is a brutal lifelong fight and that fight is even harder alone. That's where our new TRD Support group can help. Join up and connect with people who truly get it.
    Sarah Schuster

    Using a 'Wheel of Emotions' to Help Identify What You're Feeling

    I’ve always described myself as an “after-reactor,” meaning I don’t typically react to things as they’re happening. I intellectually process what’s happening, whether it be bad news, an overwhelming task or a hard situation, but can often have a hard time feeling it. I can’t lie, this has served me well. I can be pretty great at handling stress, compartmentalizing and temporarily putting away feelings I’ve deemed unhelpful. It’s easy for me to “leave things at the door” when I go to work, because you can’t be distracted by things you’re not processing, right? This is how I learned to function in high school. This is how I juggled so much in college. This is largely still how I function now. Avoid bad feelings. Suppress and move on. Emotions can’t hurt you when you don’t feel them… It doesn’t take a psychologist to guess where this is going. Because of course, feelings you don’t feel don’t simply go away. They don’t seep into the ground never to return again. In fact, it’s more like the water cycle. Whatever the earth absorbs eventually comes back as rain. Except in this version of the water cycle, the more water that goes unused and unprocessed, the bigger the storm. Water you ignore comes back with fury, demanding your attention, raining big, angry drops on your head. For me, this rain can manifest physically through stomachaches and back pain no amount of stretching relieves. It comes out in bad thoughts, like, “I want to kill myself,” a sentence that sometimes (although, thankfully, not recently) runs through my mind, a placeholder for whatever negative emotions I didn’t process that day. Then, it comes out in bursts of emotion, triggered by seemingly “little” things. A change in dinner plans leaves me sobbing on my bed. One off-hand comment from a friend (combined with too many drinks), and I’m fighting self-harm urges in a public bathroom. Something happens in a TV show, and I cry as if it’s happening to me, suddenly unable to breathe by a fictional plot that is vaguely related to something personal. But yet, as things are actually happening, it’s still hard for me to feel. It’s as if my brain is trying to protect itself, working in overdrive so I can still function. It makes it hard for me to identify how I really feel about things. It makes it hard for me to process emotions in real time. During a fight with my boyfriend, he begged me to tell him how I was feeling. “Nothing,” I responded. And I meant it. “I feel nothing.” Later, while we were in the car, I screamed. I talk about this in therapy, but only after my wonderful therapist called me out. Even in her office, I tend to recount stories as if they didn’t happen to me, intellectually analyzing events and avoiding discussions about how things actually made me feel. My therapist isn’t big on worksheets or homework, so I was surprised when after one session, she excused herself to get something for me. What she handed me was a piece of paper I didn’t know I needed: a Wheel of Emotions. It’s a simple chart, with different levels of color-coded emotions, meant to help those who possess it identify how they’re feeling. I stared at it, and was hooked. My “Wheel of Emotions,” crinkled up from being in my purse. Maybe it’s because I’m a writer, or maybe it’s because the colors are nice, but I’ve found this to be one of the more helpful tools I’ve been given for my mental health. For me, what makes the Wheel of Emotions so great is that it starts out relatively vague, and then moves on to more specific, intense emotions. Now when I, for example, reference this tool when talking to my boyfriend (yes, this has happened), I start by looking at the emotions in the middle. Even if I think I feel nothing about what we’re talking about, I can usually at least choose an emotion to start. My options are: Bad, Fearful, Angry, Disgusted, Sad, Happy, Surprised. If I can’t pinpoint exactly how I’m feeling, but know, at the very least, I feel “bad,” I can then move on to the next layer. ( Do I feel Bored, Busy, Stressed or Tired?) Then, I can even go one step deeper. If I feel Stressed, do I also feel Overwhelmed or Out of Control? Do I feel both? Even if there isn’t one “perfect” label  to sum up how I’m feeling, it sets me in the right direction. It gives me some language to talk about how I feel. It’s better than “nothing.” According to American psychologist Dr. Robert Plutchik, humans can experience 34,000 distinguishable emotions. He developed a wheel of emotions that looks a little different than mine, which you can find here. As stated in the resource about navigating Plutchik’s Wheel of Emotions, the “deeper” you get on the wheel, the more intense the emotional response. No matter what your Wheel of Emotions looks like, the concept is still the same — humans are capable of so many vast and complicated emotions. Identifying them is a practice. Dealing with them can be a strength. I included a bigger (and hopefully easier to read) version of my Wheel of Emotions below so you can take a look: Click here to view full size version. Image via Even before I was given my new favorite piece of paper, slowly but surely I’ve been getting better at feeling my feels. Anger has gotten a little easier to process. I’m trying to take away shame from feelings I think are “illogical” or “wrong.” I’m trying to own myself as an emotional person, and remind myself that while burying “bad” emotions is tempting, and even “helps me” in the short-term, it always bites me in the end. It inhibits my growth, rather than helping it, and just because I can push through bad feelings doesn’t mean I have to. The magic thing about processing and identifying emotions while they’re happening is that afterwards, I often feel lighter. I can deal with what I’m going through without giving the storm festering inside of me more fuel. Identifying my emotions, with the aid of my dear wheel, has been a big help on my own mental health journey. If you’re someone who struggles with identifying emotions, I hope it’s a tool that can help you too.

    Erica Chau
    I know what it’s like to live and interact with illness, whether physical or mental ... I want to use my words and my story to help create a safer and more open world.
    Juliette V.

    15 Things People Said That Were Code for 'I'm Struggling Today'

    Oftentimes, when someone is struggling with their mental health, they won’t come right out and say it. Some may hint at what they are feeling, hoping others pick up on the clues. Others may use language that means “I need help” without actually saying the words — because saying them can sometimes make it feel too real, or you might be afraid of how others will react. No matter what reason someone has for using “code words,” it’s important we talk about what kinds of phrases to look out for. Talking about these phrases can help us identify loved ones who are struggling and get them to the resources and support they need. To find out what people said when they were having a hard time with their mental health, we asked members of our Mighty community to share one thing they said that was really code for “I’m struggling today.” Here’s what our community shared with us: 1. “I’m not feeling well.” “It’s not untrue and I don’t have to explain myself. People automatically assume I have a cold or something.” — Mackenzie C. “It’s true. Majority of the time, depression keeps me exhausted and anxiety keeps me awake, so I get no respite from my brain. Top that with the stress of nursing school, and I literally don’t feel well.” — Bria M. 2. “Well, I’m alive!” “ I just realized that whenever people ask me how I’m doing, I say, ‘Well, I’m alive!’ or ‘Well, I’m here!’ It’s basically my way of saying that somehow, I am still alive and carrying on even though I am so exhausted and fight every day.” — Kellyann N. 3. “I didn’t sleep well last night.” “ It’s more acceptable to be tired from a bad night’s sleep than it is to be too exhausted to deal with life today.” — Ciara L. “It’s an immediate response I turn to because I’m just always tired of my depression, but I’m not the best at lying.” — Max W. 4. “Eh, you know.” “ No, they probably don’t. But are they still able to identify with you? One hundred percent. And that makes them think you’re OK.” — Josie S. 5. “It’s too much.” “I say this whenever all my thoughts overwhelm me and I have no way of truly telling anyone how bad I really feel.” — Erin R. 6. “I’m exhausted.” “Just not the kind that can be cured by sleep. Some days I get so tired of fighting to survive and don’t want to fight anymore.” — Alecia F. “It’s the truth, every illness I have exhausts me to the core, but they usually brush it off as mom exhaustion (which also plays a part).” — Joanna G. “‘I’m tired’ usually means a lot from not feeling well to being emotionally exhausted.” — Breeanna M. 7. “I’m just out of it today.” “Code for: I really don’t feel myself right now and it’s scaring me. Those days don’t happen often but when they do, I’m afraid I’m relapsing and I will need to readjust my medication.” — Christa M. 8. “I’m fine.” “‘I’m fine, honestly.’ There are many times I’ve been struggling and even though I’ve been asked if I’m OK, I just can’t always seem to be honest and explain that I’m not. Usually because I can’t even make sense of it myself to tell someone else. Then I kick myself afterwards for not saying something. Can’t win.” — Amy W. “[For me], fine never means fine. If I’m vague like that, then I’m hurting but won’t admit it. If I’m good, I’ll say that but won’t openly admit to struggling.” — Jackie S. 9. “I’m bored.” “ Meaning that I’m so sick and tired and I’ve had too many struggles today and I don’t feel very good.” — Denisa 10. “I’m having an ‘off day.’” “Code for I don’t feel like me today, today is harder than other days. I may not act like I need you checking in on me, but I actually really do.” — Jenna L. “‘Off’ means I need time off from any responsibilities and wait for the feeling to pass. Hopefully.” “I’m just a lil off. It’s my code for: ‘I feel like I’m imploding but I don’t want to burden you.’” — Jace P. 11. “I’m hanging in there.” “Usually said because I don’t want to bother anyone with the things that are going on in my head.” — Katie S. 12. “I’ve been listening to music a lot today.” “Music is how I get away from the nightmare in my head. And when I can’t listen to it, I’m just quiet. Unfortunately the people around me don’t recognize either of these. Ever.” — Megs G. 13. “I don’t want to be alone.” “That’s when it’s really bad and I really need someone. Otherwise I’m usually silent and not my bubbly self.” — Milly S. 14. “I’m all good, don’t worry about it.” “It’s just what I do. [I] don’t want others worrying about me — gotta help fix them before I fix me.” Alexis D. 15. “I just can’t today.” “ [When I’m] not feeling too good.” — Scarlett E. What would you add? If you or someone you know needs help, visit our suicide prevention resources page. If you need support right now, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text “START” to 741-741 . Unsplash photo via Timothy Paul Smith

    You're Invited!
    Journaling Workshop
    Thursdays @ 5:00 p.m. PST / 8:00 p.m. EST
    Need a non-judgmental space to reflect about your week? Join Mighty editor Sarah for a free journaling workshop. All you need is something to write with.
    Save Your Spot

    Signs You Could Have 'High-Functioning' Depression

    If I were to ask you to picture and describe a depressed person, what would you envision? Someone having trouble getting out of bed every day? Someone who’s calling into work sick because they can’t leave the house? Someone who’s isolated from friends and possibly sleeping 10 or 12 hours a day? Someone who can’t stop crying and who’s feeling hopeless? Or would you envision a popular, college-educated professional living it up in the big city with a great job, a good group of friends and a long list of accolades to her name, but who wakes up each morning with a gripping sense of anxiety and an internalized pressure to continue to be “perfect” and “keep it all together?” Would you picture a successful Millennial startup employee who you admire for his discipline and drive but who inwardly is devastatingly self-critical and relentlessly demanding on himself and who, after work, copes with his life with a drink or two and several hours of gaming? And would you picture that smiling, competent, friendly coworker of yours who always seems to be getting All The Things done but who secretly, inwardly feels like she’s a complete failure and fears time is flying by and she’s wasting it every day? Let’s face it: you’re probably not going to picture these folks. And yet each of them could be a perfect example of someone dealing with what’s come to be known as “high-functioning depression.” While high-functioning depression doesn’t look like the stereotype of depression most of us hold in our heads, this diagnosis nevertheless carries significant risks if left untreated. But the uniquely tricky thing about high-functioning depression is that it’s hard to spot precisely because the people dealing with it look, from the outside, like they’re holding it all together. This can lead to a lack of ability to self-identify (or have those around you identify you) as depressed and, moreover, a possible resistance to seeking treatment because of the stigma surrounding more “typical” depression. And this is a big problem. So in today’s blog post, I want to explain to you what high-functioning depression really is, walk you through 11 signs of high-functioning depression and how this may show up, explain the unique risks associated with high-functioning depression, and share more about how you or your loved ones can get the help you need if you identify with high-functioning depression. What is High-Functioning Depression? In my opinion as a psychotherapist, high-functioning depression is a pop psychology term for what’s clinically known as dysthymia. Dysthymia, according to the “Diagnostic And Statistical Manual of Mental Disorders 5th Edition”  (DSM 5), is a mental health disorder characterized by: “Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years,” and includes the presence of two or more of the following symptoms, “Poor appetite or overeating; insomnia or hypersomnia ; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; feelings of hopelessness.” And yet, while these symptoms may look diagnostically similar to the symptoms we think of when we envision major depressive disorder (MDD), individuals dealing with dysthymia may not have the same severe levels of impaired biological and mental functioning that can make major depression easier and more obvious to spot. In other words, someone struggling with dysthymia may still be able to get up and go to their demanding, prestigious job, be in a romantic relationship, post the believable smiley photos on Instagram, regularly get together with their girlfriends for happy hour and generally handle all the logistical adulting stuff of their life — passing for someone who doesn’t “look depressed.” But inwardly, this same person may be gripped with a challenging set of symptoms invisible to those of us who love and know them. Symptoms that may greatly diminish their overall quality of life, their career, their relationships, and bloom into more challenging mental health concerns if left untreated. 11 Real-Life Ways High-Functioning Depression Can Manifest Above, I provided you with what the DSM-5’s clinically indicative dysthymic symptoms. Now let’s talk, in layman’s terms, about 11 ways that some of these symptoms may manifest in your real life. 1. Difficulty experiencing joy. With high-functioning depression, the things that used to bring you pleasure — whether this is a cherished yoga class or a monthly ritual of getting together with your girlfriends — these same things don’t bring you joy anymore. They may feel like burdens or events you want to avoid because it feels like more of an effort than a support. 2. Relentless criticality — of self and others. You may have a relentless and invasive internal narrative that’s critical of yourself, of others and of the world in general. You think you’re a failure, you think your boss is an idiot, your partner’s the most irritating person to have ever lived, and life’s just one big slog. This chronically negative thought pattern may feel like something you just can’t turn off. 3. Constant self-doubt. You may constantly doubt whether or not you’re on the right career path, whether you’re in the right relationship, doubt what you’re doing with your life and if you can even handle being an adult. This pattern of constant self-doubt may be situational or pervasive but it’s something that feels like you just can’t get over. 4. Diminished energy. If it feels like getting through each day is like walking up a mountain with a backpack of rocks, if you feel like you barely have the mental, emotional and physical energy to handle your life anymore, if your overall energy levels are greatly diminished, this could be a sign of high-functioning depression. 5. Irritability or excessive anger. If you find yourself blowing up over small things — your partner says something wrong, your co-worker messed up a project, your kid just broke your favorite coffee mug, if you find yourself exploding in a way that feels disproportionate to the event, if irritability and excessive anger are something you’re wrestling with, this may be a sign. 6. Small things feel like huge things. Similarly, if you find yourself feeling overwhelmed or greatly stressed by an event that happens that maybe wouldn’t have felt like such a huge deal in the past (a friend cancels weekend plans, the grocery bags break when you’re carrying them in, your darn trackpad stops working because you spilled some coffee on it) and it feels like the End Of The World instead of the annoyance that it is — if you find your stress responses disproportionate to the event itself, this may well be a sign of high-functioning depression. 7. Feelings of guilt and worry over the past and the future. You worry that you chose the wrong career in college, you question whether you’re in the right grad school program, you worry about paying off all those student loans, you worry your biological clock is running out, you worry that you married the wrong partner, you worry about who’s going to care for your folks when they get older, etc. We all have these worries from time to time, but if feelings of guilt and worry over your past and future feel pervasive and dominant, this may be more than “normal” worry. 8. Relying on your coping strategies more and more. If you find yourself needing extensive zone-out time after work and on the weekends, turning towards your coping mechanisms more often than not — such as substances or behaviors like using alcohol, drugs, excessive gaming, constant Netflix, etc. — all in an effort to escape your life, this could speak to underlying depression. 9. Generalized sadness. If you find yourself feeling a generalized sense of sadness you can’t seem to pinpoint the cause of, if you drop your mask and armors of smiling competency when you close your door behind you, if you feel a subtle sense of hopelessness, this could speak to high-functioning depression. 10. Seeking perfection. This one’s a tough one. In a way our society condones perfectionism — getting good grades, getting into the Ivies, landing that amazing tech job, striving, striving, striving. But perfectionism has a shadow side where striving turns into unrealistic demands of yourself and psychologically beating yourself up when you fall short of the bar you set for yourself. If you find yourself doing this and it’s causing you distress, be curious about whether this a sign of high-functioning depression. 11. Inability to rest and slow down. If you need to clean up, tidy and organize the house after you arrive home from an exhausting day of work before you even consider letting yourself rest, if you find yourself uncomfortable with slowness, stillness and fallow periods of time because of the uncomfortable thoughts and feelings you come into contact with when you do actually slow down, this could be a sign of high-functioning depression. The Unique Risks To Being Someone With High-Functioning Depression. Mental health struggles come in all shapes and sizes but, as we undo the stigmatization and globalization of mental health scripted over these past few decades, most of us likely still have an unconscious image in our heads of what a depressed person looks like. And while this internalized image of someone who can’t get out of bed, who can’t hold down a job, and who has constant suicidal ideations may be one form of depression, it doesn’t mean that someone who sees themselves in the list above or in the clinical descriptor of dysthymia isn’t also dealing with depression. But these folks may not be willing to see themselves as depressed. And this can be a big problem. Because, in my clinical opinion, there’s a unique set of risks to being someone with high-functioning depression. First, because you’re still “holding it all together” it may make it harder for both you and others to spot the very real mental and emotional strain you may be under because you pass. You fly under the radar. You and those around you doubt the seriousness of what you may internally wrestle with because, after all, your life still looks pretty great from the outside, right? Second, as someone who is high-functioning, you may grow up believing that with enough effort and willpower, you can achieve, gain or fix anything that life throws at you. Not so with high-functioning depression. High-functioning depression isn’t just a bad attitude, and you can’t just “will your way” out of it. High-functioning depression is a biological and psychological disorder that requires adequate and clinically appropriate treatment. Arguably, the more you push and “will yourself out of it” instead of seeking proper support, the worse your symptoms may get. For example, if left untreated, high-functioning depression, or dysthymia, can potentially bloom into major depression or major depressive episodes where your biological and psychological functioning is more severely impaired. Or, perhaps in your attempts to deal with your high-functioning depression on your own, comorbid disorders — such as eating disorders or substance use disorders — can develop from your attempts to manage your intolerable feeling states. Bottom line: Dysthymia, or high-functioning depression, requires adequate clinical treatment as much as the most stereotyped version of major depression does. And the good news is that with proper clinical treatment, dysthymia can be managed. Treatment and Supports for High-Functioning Depression. While there is no single reason why someone develops dysthymia or high-functioning depression and while there is not necessarily a way to prevent it, there are several evidence-based effective treatment modalities to help you manage and support yourself if you deal with it:  Psychotherapy  and/or medication. In fact, according to a paper from “ The Canadian Psychological Association ,” “Psychotherapy is as effective as medication in treating depression and is more effective than medication in preventing relapse. For some patients, the combination of psychotherapy and medication will be more beneficial than either treatment on its own.” So if you see yourself in this article today, I strongly encourage you to  seek out a therapist  and/or speak to your doctor or psychiatrist about what treatment options may be available to you. The reality with high-functioning depression and moving through your days is that it can often feel like you’re attempting to build a castle on a foundation of quicksand.  Get the help you need  to build a solid, stable foundation for yourself — whatever that takes! — so you can build and craft a life in a more sustainable way. You’re so worth it. Now I’d love to hear from you in the comments below: Did you see yourself in this article? What’s one piece of advice you would give someone resisting seeking out therapy or talking to their doctor about possibly being depressed because they’re afraid of the stigma, believe therapy doesn’t work or that they can just handle it on their own? Leave a message in the comments below so our community of readers can benefit from your wisdom. And until next time, take very good care of yourself. Warmly, Annie Additional Resources: 1. 5 Important Things to Remember If You’re Experiencing Depression. 2. Four Effective Tools For Managing Anxiety. 3. The Mindful Way Through Depression: Freeing Yourself from Chronic Unhappiness . 4. DBT Skills Training Handouts and Worksheets , by Marsha Linehan, Ph.D. Follow this journey on Annie Wright Psychotherapy We want to hear your story. Become a Mighty contributor here . Image via Death To Stock/Contributor