Successfully taking on responsibilities is the calling card of high functioning depression and anxiety, but meeting life’s demands does not mean the internal distress from these conditions is less severe.
When people talk about living with depression and anxiety, they’re usually referring to experiences beyond natural low moods or feelings of anxiousness.
Not everyone living with anxiety and depression exhibits the same level of external impairment, however. When you’re able to meet the demands of everyday life while also living with a mental health disorder, you may be experiencing high functioning depression or anxiety.
What defines “high functioning” anxiety and depression?
“High functioning” is not an indication of depression or anxiety severity.
It’s a nonmedical term that indicates you have the ability to carry out your daily activities despite symptoms of a mental health disorder.
Dr. Nick Bach, a psychologist from Louisville, Kentucky, explains, “It means that although an individual may be dealing with mental health challenges, they can still maintain a certain level of functionality in various aspects of their life, such as work, relationships, and self-care.”
You can be high functioning and still live with severe depression or anxiety.
High functioning depression and anxiety are still depression and anxiety. There’s no diagnostic difference.
Why you may be able to successfully meet your daily responsibilities when someone else can’t isn’t always straightforward. Everyone’s different, even when it comes to experiences of mental health disorders.
There’s no single thing that makes you more or less able to get up in the morning and brush your teeth, for example.
According to Bach, your individual coping mechanisms, level of personal motivation, and present support systems can all be factors. How well you’re adhering to treatment plans and how accessible those resources are to you also matter.
“Certain personal traits, talents, or skills may contribute to higher functioning levels even with the presence of a mental health condition,” he adds.
If you’re exceptionally skilled at accounting, for example, even on a low-performance day at work, you might still appear to be on top of your game.
High functioning depression and anxiety may mean you’re productive, but there’s also a downside.
When the external signs of depression and anxiety are hidden from others, they may not recognize you’re living with a mental health condition. This can mean accommodations for people who aren’t high functioning aren’t made available to you.
You may even be accused of being dishonest about your mental health.
“Usually, someone with high functioning anxiety or depression is underfunctioning compared to their usual baseline, but it’s not apparent because they are able to meet general expectations,” explains Dr. Roberta Ballard, a clinical psychologist from Atlanta, Georgia.
She indicates, “Their internal landscape might be a complete mess — overanalyzing, worrying,
sleep-deprived — but they are generally able to present themselves to the world as being fairly together.”
As a nonmedical term, there are no defined criteria to determine when you’re high functioning while living with a mental health disorder.
In general, high function implies you’re meeting most of your responsibilities. It doesn’t mean you’re meeting all of them, but you’re productive enough that people around you might not notice anything different.
Within that high function are still symptoms of anxiety or depression. Ballard states someone high functioning could experience suicide ideation internally, yet externally they may just be more reserved than usual.
High functioning symptoms can be subtle, but that doesn’t mean they’re absent.
In addition to keeping symptoms internalized, you may also find you’re prone to certain behaviors when living with high functioning depression and anxiety.
Bach indicates common behaviors of high functioning people can include:
- working excessively
- seeking external validation from others
- internalizing emotions
- masking symptoms with cheerful composure in social settings
These behaviors are often ways to hide or cope with internal distress. Seeking external validation, for example, may combat internal feelings of self-doubt and low self-worth.
You’re not alone
Depression and anxiety can feel overwhelming, even if you’re able to soldier through your daily tasks. You are never alone. You don’t have to tolerate depression or anxiety simply because you’re high functioning.
To learn more about depression and anxiety or to find resources in your area, you can visit:
Depressive and anxiety disorders are treatable. Being high functioning does not eliminate the need for treatment.
“It’s important to note that while some individuals may appear high functioning, it does not mean they do not need support or treatment,” Bach says. “Everyone’s experience with mental health conditions is unique, and seeking professional help and engaging in self-care practices are crucial steps toward overall well-being.”
Seeking treatment for depression and anxiety can start with your primary doctor or a mental health professional.
Treatment approaches vary depending on the condition you’re living with, but depressive disorders and anxiety disorders may involve a combination of medications and psychotherapy.
Your doctor may prescribe medications such as:
While medications provide symptom relief, psychotherapy can help address the underlying causes of anxiety and depression.
Cognitive behavioral therapy (CBT), a therapeutic approach that helps restructure unhelpful patterns of thinking and behaving, is used for both conditions.
The type of medication you’re prescribed and the model of therapy you undertake will be specific to your circumstances and the mental health challenges you’re facing. Not everyone may require medications; talk with your doctor if you feel you may be experiencing high functioning anxiety and depression.
Living with high functioning depression and anxiety means you’re able to meet enough of your responsibilities to maintain external function. You might do your chores, for example, meet your work deadlines, and appear composed in social settings.
Being high function is not an indication of depression or anxiety severity, however. You can still be experiencing extreme psychological distress even if you don’t externalize it.
Treatment for depression or anxiety can help improve your quality of life. You don’t have to endure a mental health disorder just because you’re taking care of your responsibilities.