High-Functioning Depression Test

Table of Contents

Depression is one of the most common mental health disorders in the United States. An estimated 8.4% of US adults have had at least one major depressive episode4. One kind of depression, high-functioning depression, affects approximately 3% of the US population5.

Despite how many people suffer from this kind of depression, it often goes undiagnosed and therefore untreated. Even with the stigma of mental health disorders slowly diminishing, high-functioning depression is oftentimes not taken seriously and can be looked at as just having a low mood.

Depression can take on many different forms, but people with high-functioning depression suffer from depressive moods chronically. This type of depression can be difficult for others to recognize and sometimes even difficult to recognize within yourself.

What is High-Functioning Depression?

High-functioning depression can also be called dysthymia or Persistent Depressive Disorder (PDD). PDD is a chronic form of depression that can last for many years and has constantly evolving diagnostic criteria due to it being poorly understood.

Someone who suffers from this kind of depression often is good at hiding their symptoms. Their symptoms may appear less severe and less visible, but more long-lasting. Often people who suffer from this disorder can appear to be doing well on the outside while struggling internally.

This internal struggle in people with high-functioning depression can go on for years and with little relief from their symptoms. Daily tasks and activities can require a large amount of energy for individuals with PDD to accomplish.

Symptoms of High-Functioning Depression

High-functioning depression symptoms share many of the same characteristics as someone who is struggling with other kinds of depression.

The symptoms that overlap include:

Specific Symptoms of High-Functioning Depression

The common symptoms that appear in most depressive disorders are an ongoing struggle for people with high-functioning depression. PDD is less severe than major depression, but to be diagnosed you must be struggling for at least two years as an adult or one year as a child or teen. In addition, to be diagnosed with high-functioning depression you must present with at least two depressive disorder symptoms.

Major Depressive Episode Symptoms

People who struggle with high-functioning depression often become susceptible to major depressive episodes during or before their persistent depressive disorder. The presence of both persistent depressive disorder and a major depressive episode is sometimes called double depression. Symptoms in a major depressive episode that differ from PDD include:8

Causes & Risk Factors of High-Functioning Depression

The exact cause of persistent depressive disorder is cannot be known for sure and the development of this disorder may be due to more than one cause. There are certain factors that can increase your likelihood of developing PDD.

These risk factors and causes include but are not limited to:2

Potential Complications from High-Functioning Depression

High-functioning depression is a chronic condition that can be linked to other conditions due to the struggle of this disorder being long-lasting. PDD can also be associated with other kinds of mental health disorders causing more distress in these individuals.

PDD can be linked to:2

Treatment for High-Functioning Depression

Treatment for High-Functioning Depression or PDD can include therapy, medication, or a combination of both. Psychotherapy is often a preferred treatment for people struggling with PDD. Examples of psychotherapies that can be used include CBT, DBT, and individual psychotherapy. The combination of therapy and medication can be more effective than medication alone.

Medication-assisted treatment may be another therapeutic method to help with your PDD. Medications often used to help with depressive symptoms are SSRIs and SNRIs which are classified as antidepressants.

Selective Serotonin Reuptake Inhibitors (SSRIs) help to increase the level of serotonin in the brain by blocking the receptors that reabsorb it1. Serotonin is a neurotransmitter that is responsible for regulating your social behavior, appetite, sleep, memory, mood, and sexual function. Experts believe that people who suffer from depression have lowered levels of this type of neurotransmitter in their brain, which is why SSRIs are so frequently prescribed to people diagnosed with depression.

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) help prevent the reuptake of both serotonin and norepinephrine in the brain6. These two neurotransmitters have been known to be imbalanced in the brain of a person struggling with depression. Norepinephrine is responsible for preparing your body for activity and helps with focus and alertness.

Help Your Current Symptoms

Although medication and therapy are evidence-based modaltities that are well-known to help with depressive symptoms, there are additional activities that can help with your symptoms while getting treatment.

To help with your current symptoms you may :

Alternative Methods of Treatment

Individuals with high-functioning depression may not receive results from traditional methods of treatment. Antidepressants and evidence-based therapies may not be enough to help you find recovery from your depressive symptoms. Choosing the right mix of treatments and supports that work for your depressive disorder may be key in you finding recovery.

Light Therapy

Light therapy can be used in people who struggle with getting out of bed due to their depression7. Light therapy uses an artificial light source to help with serotonin levels in your brain and can help create a more consistent sleep pattern.

This treatment is non-invasive and generally safe with low risk. A light therapy lamp can be used at home and you can stop this type of therapy for a few days at a time without the return of your depressive symptoms.

Repetitive Transcranial Magnetic Stimulation (rTMS)

Repetitive transcranial magnetic stimulation (rTMS) is an alternative, non-invasive option for people who are struggling with depression but are not seeing results from traditional treatment. rTMS involves the placement of coils on the top of the head and uses electromagnetic frequencies to stimulate underactive areas of the brain.

rTMS attempts to activate the neurotransmitters (ie norepinephrine, dopamine, and serotonin) that are commonly at a lower level in people who suffer from depression. This alternative method is non-invasive and requires no medication or surgery. rTMS is a safe option that often shows no to mild side effects.

Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is an alternative therapy used in people with depression that are not responding to antidepressants or psychotherapy3. ECT is a procedure where the patient is put under anesthesia and controlled electric currents pass through their brain. As a result, a brief and controlled seizure occurs that affects your neurons and chemicals in the brain.

This type of treatment typically takes four to six treatments before seeing any major improvements to depression symptoms. Side effects of ECT can include memory loss, confusion after the treatment, headaches, muscle pain, and nausea.

Get Help with High-Functioning Depression

Although high-functioning depression can be misunderstood as a less severe depression type, this chronic depression can have serious consequences. PDD can often go misdiagnosed or untreated. People with this type of depression may appear to have less severe symptoms than someone with Major Depressive Disorder, but people with PDD are often better at hiding there symptoms.

If you or a loved one appear to be struggling with high-functioning depression, now is the time to seek treatment. Please contact Clear Care Center to learn about our treatment program and our empathetic staff can answer any questions you may have.


  1. DiGiacinto, J. (2021, November 15). SSRIs (selective serotonin reuptake inhibitors): What are they? Healthline. Retrieved February 3, 2022, from https://www.healthline.com/health/depression/selective-serotonin-reuptake-inhibitors-ssris
  2. Mayo Clinic Staff. (2018, December 8). Persistent depressive disorder (dysthymia). Mayo Clinic. Retrieved February 3, 2022, from https://www.mayoclinic.org/diseases-conditions/persistent-depressive-disorder/symptoms-causes/syc-20350929
  3. NAMI. (2021). ECT, TMS and other brain stimulation therapies. NAMI. Retrieved February 3, 2022, from https://www.nami.org/About-Mental-Illness/Treatments/ECT,-TMS-and-Other-Brain-Stimulation-Therapies
  4. NIMH. (2022, January). Major depression. National Institute of Mental Health. Retrieved February 3, 2022, from https://www.nimh.nih.gov/health/statistics/major-depression
  5. Patel, R. K. (2021, July 1). Persistent depressive disorder. StatPearls [Internet]. Retrieved February 3, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK541052/
  6. Sansone, R. A., & Sansone, L. A. (2014, March). Serotonin norepinephrine reuptake inhibitors: A pharmacological comparison. Innovations in clinical neuroscience. Retrieved February 3, 2022, from https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4008300/
  7. Watt, A. (2021, October 28). How does light therapy help treat depression? Healthline. Retrieved February 3, 2022, from https://www.healthline.com/health/depression/light-therapy#pros
  8. Zambon, V. (2020, May 19). Major vs. persistent depressive disorder: Understanding dysthymia. Medical News Today. Retrieved February 3, 2022, from https://www.medicalnewstoday.com/articles/major-depressive-disorder-vs-persistent-depressive-disorder#causes