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3 Things You Should Know About 'High-Functioning' Depression

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“High-functioning” depression is not a clinically recognized branch of depression. However, its prevalence has sparked conversations about depression in mental health circles and beyond. “High- functioning” depression feels like faking it without ever making it.

I have spent so much of my time trying to make myself look and act like I am “OK” that when I finally accepted that I needed help, I had no idea how to ask for it. Constantly pretending to be a way I didn’t feel left me with dozens of emotions I’d spent too long suppressing to even name.

With “high-functioning” depression, there is an expertly crafted costume of normality, happiness, and energy that clouds the suffering underneath. Not even those closest to the sufferer may know the extent of their pain. Like all unseen illnesses, it’s difficult to communicate feelings with no visual representation. Especially when hiding those feelings is a characteristic of your neuroticism.

To better communicate and challenge myself to be open, I’ve decided to share three things I wish people knew about “high-functioning” depression.

1. I constantly feel like I’m faking it.

This goes in every direction. Having a good day? Must be fake. Having a bad day? Also, probably fake.

On bad days, the faking it is methodical. It is 45 minutes trying desperately to hairspray a near-invisible cowlick into submission. Or applying, removing, and reapplying my makeup several times because it doesn’t look right.

My appearance is extremely important to me these days. I don’t want to “look depressed.” I don’t want people to ask me if I’m tired or if I’m feeling OK. I don’t know if my verbal lies will be all that convincing these days. So, I make doubly sure that my nonverbal ones are. I put on my costume and pretend like I got sleep the night before and feel fine.

On good days, I just feel guilty. I wake up and realize I actually feel OK. Then immediately question the validity of my whole depression diagnosis. There are a lot of, “Well, if you had depression …” comments made to me by myself on these days.

These are the days when I am most likely to stop taking medication cold turkey because, “Oh, I’m actually fine and totally won’t have a mental breakdown in like three months.”

2. For me, “high-functioning” is a coping mechanism.

Like many people, I developed the symptoms of depression at a young age. Despite there being an ample history of mental illness in my family, empathy was in short supply (for each other and ourselves). I dealt with a lot of your standard uneducated responses to depression:

“You’re just lazy.”

“Toughen up.” Or “Cowgirl up” in my family — it’s a rodeo thing …

“Quit thinking about it and you’ll be fine.”

All of them are pretty bad in their own way. But the one that has always stuck with me was, “You’re just doing this for attention.”

I tried a lot of different things to escape the stigma of mental illness, and ultimately my symptoms were mild enough most of the time so, I could spend long periods just pretending that I wasn’t ill.

I could hide my suffering under a fake personality and everyone else’s desire that I not bring up the depression stuff at dinner. I never wanted people to judge me and as a result, I made it harder for myself to get help.

3. Asking for help is the bravest thing you can do.

Many people might look at being “high-functioning” as putting on a “brave face” and conquering depression. I’ll admit some days it can really feel like that. In the long run, I had conquered nothing. I’d only avoided it. When I came home from school, or work, my depression was sitting on the couch waiting for me and I couldn’t fake being fine to myself.

I was 16 when I’d finally come to my wits’ end. I knew that if I didn’t do something, I wouldn’t make it to my high school graduation. I knew this, but no one else did.

After years of being “high-functioning,” I had to justify a stay in the psychiatric ward not only to my family but also to the doctors in the emergency room. I’m reminded with every breath I take how lucky I am that they believed me.

Even though after my release the same accusations of “faking it for attention” came my way, they stung less. I knew that I had made the right choice for myself. I knew that asking for help had been the right thing to do.

If you have lived with “high-functioning” depression or any illness you feel compelled to hide, let me know one thing you wish people understood about your experience.

Lots of love,

Photo credit: mheim3011/Getty Images

Originally published: January 16, 2021
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