In 2011, I attempted to take my own life for the 3rd time, and was consequently thrusted into the world of mental health. Back then, I remember knowing that something was wrong with me, that I was different than everyone else. To this day, I am not entirely sure exactly what is wrong with me, but I do know that I continue to struggle with Depression. Over the years I’ve come to find it is the ugly cousin, Treatment Resistant Depression. Though to the rest of the world, at least those who don’t know me well, I appear fine, functional, and almost as if there is nothing wrong in my life. This could not be further from the truth.

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The Signs

Here are some of the ways I’ve found to identify if you, or someone you love, may be struggling with High Functioning Depression:

Feeling sad or empty most days but still managing daily tasks.

This is me, every day. Hiding behind a “mask” like everything is fine, but there is always crippling depression hiding around any corner. Waiting to strike at any point, any time, and for any reason

Experiencing low energy despite adequate rest.

I’ve found that when even when I would sleep well, I would still wake up just as exhausted as I was when I closed my eyes the night before. Despite sometimes sleeping for up to 9 or 10 hours!

Increased frustration or mood swings.

I really only struggled with this during my teenage and young adult years. As of late, I tend to supress all my emotions. That turns out to be something else not entirely unrelated however.

Diminished pleasure in activities once enjoyed.

This is probably the hardest to recognize in High Functioning Depression, as I still perform my pleasurable activities as they help as a distraction and to pass time. The problem being that I no longer enjoy them anywhere how I used to, and are simply filling a void, rather than enjoying myself.

Avoiding social interactions while maintaining appearances.

This is definitely the one that hit me the hardest, because I also suffer from severe Social Anxiety. If you notice someone in your life who used to be more open suddenly withdrawal, then kind of open up again. This may be the cause

Setting unrealistically high standards for oneself.

I do this constantly, and my depression has a way of convincing me that these impossibly high standards are the only thing keeping me from totally falling apart. Though this can be difficult to distinguish in people who also have partial or diagnosed OCD

Struggling to focus on tasks, despite appearing engaged.

Again, pretty difficult to distinguish from ADHD or other Executive Function Disorders. At least with me, this particular symptom tends to interweave and feed off of my slight Executive Function issues.

Insomnia or oversleeping.

This is probably the first sign that I showed, unknowingly, to the world. When I was in my early teens, it began taking me 1-3 hours to fall asleep, sometimes not at all. I would also then oversleep due to the lost sleep trying to fall asleep. So this one can be quite vicious to deal with, but pretty noticable to others.

Unexplained aches or digestive issues.

Little did I know back then, figured it was growing pains, aches from football practice or being beat up. My back, joints, and other commonplace sites of pain for people far older than I was, and still am, hurt like nobody’s business. There was also a time my digestive problems were attributed to Celiac’s Disease, which I ended up not having.

Feeling detached or emotionally flat.

Like I talked about in #3, this can usually mask the irritability, at least it did with me. I would get unreasonably angry over small things, or justifiably angry at larger things, but suppress it all to “keep the peace”. This ultimately hurt me in more ways than one, mainly that now I have to rediscover how to healthily process all emotions rather than suppress them to avoid upsetting people.

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Recognizing these signs can be the first step toward seeking help. For me, I’ve struggled with all of these in some way, at one time or another, usually all at once. Many of them are shared issues with a number of other mental, or physical illnesses. Which makes it rather difficult to tell what is depression, and what might be a long night out or a crippling health condition lurking just under the surface. There is no reason to sound the alarm if you notice any of these in yourself or others. Though it certainly wouldn’t hurt to check in with a professional or a loved one.

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The Causes

• Genetics: A family history of depression can increase the likelihood of developing depression yourself.
• Lifestyle Factors: These often walk the fine line between choice and necessity, but a poor diet, lack of exercise, substance use and insufficient/too much sleep can negatively impact mental health.
• Chronic Stress: Ongoing stress from work, relationships or financial pressures can contribute to depressive episodes or long-term symptoms.
• Personality Traits: Traits like Perfectionism, High Sensitivity, High Empathy, and High Intelligence can predispose individuals to depression.
• Comorbid Conditions: Having other mental health issues can often feed into or develop depressive symptoms, as many symptoms are shared across illnesses.
• Life Events: Significant life changes, such as loss, trauma, or major transitions can trigger and/or worsen depressive episodes.
• Isolation: Lack of social supports or feelings of loneliness can exacerbate depressive symptoms, even in seemingly successful individuals.
• Unrealistic Expectations: Pressure to maintain a facade of success and happiness can lead to feelings of inadequacy and depression.

This of course is not by any means an exhaustive list of what could or is causing your loved ones or your own depression. Though recognizing these causes, and possibly any specific to your loved one or yourself can help in identifying, managing and even treating High Functioning Depression. To be fair though, despite being able to see the red flags from miles away, does not mean that we can realistically avoid these issues. Working with a mental health professional and giving yourself some self-empathy can go a long way in finding a fine line or balance to your life while attempting to locate and correct the possible root cause(s) of your illness. Though in some cases, while you can identify the root cause of your illness, it isn’t always something that can be fixed. Sometimes, the best you can and should do is managing the symptoms and yourself to avoid triggers that could start or worsen your depression.