According to a 2015 report by the Substance Abuse and Mental Health Services Administration, an estimated 6.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year. Though depression is common, how each person experiences depressive symptoms is different. High functioning depression (HFD) looks and feels similar to major depression, but may not be as severe. Depression typically inhibits motivation and energy. People who experience HFD, however, can forge ahead with effort to achieve their goals. This means individuals with high functioning depression can still maintain everyday tasks, and even achieve exceptional tasks. As such, they may present to you as functional people externally, who get tasks done, and act pleasant or happy. Many people with HFD have had it for a long time-maybe even years-and have learned to manage it well. High Functioning Depression may look like: Sadness or hopelessness for no identifiable reason Low-grade, chronic unhappiness Small bursts of energy followed by chronic exhaustion Chronic sense of emptiness, even while connecting with loved ones Vacillating irritability Feeling like nothing you achieve is good enough A strong desire to present to loved ones as “okay“ Pressure to get things done perfectly but we’re not achieved, feeling indifferent or like a failure Difficulty making decisions Loss of appetite or overeating Difficulty concentrating or staying focused Insomnia or oversleeping Difficulty staying present in the moment People with HFD who share their experience with others may hear “I never would have guessed that about you!” While these people often have good intentions and just might not know much about mental health disorders, what you may hear in those moments is: “But what could you be depressed about?” or “What could possibly be so bad about your life?”. What people don’t realize is that battling a mental health condition is often done internally — and that those of us dealing with them spend plenty of time asking ourselves those same questions. Depression is not just something you can just snap out of, or be singled down to one thing that caused it. Depression is a medical condition caused by a combination of biological, and chemical imbalances that can fluctuate with lifestyle choices. A misconception is that depression can be willed away by positive thoughts. People who experience HFD need treatment too. Seeking therapy is a great place to start. Talk to a mental health professional to discuss what treatment approach is best for you, but for those with HFD, a good place to start may be allowing loved ones to support you, taking some time to rest and slow down, and being able to give yourself compassion when not everything gets done in a day. Angie Gereis, PsyD Clinical Psychologist The Blue Clinic Specializing in the treatment of relationships, sadness, worry, trauma Downtown Los Angeles Psychology Practice