The Reality of “High Functioning” Depression

The day I turned in my master’s thesis, I woke up early. I curled my hair and applied a generous coat of makeup — even making time for contouring and setting spray. I posed for pictures with a school friend; we beamed, holding our freshly printed and bound 100-page documents. Sometimes, I look back at the photos to inspect the scene: I appear comfortable, leaning against the ivy-covered wall at my university, which I chose for its prestige. I’m flashing my pearliest smile and showing off my perfectly polished fingernails, which matched the color of my dress.

That afternoon, I turned in my thesis, dropping it triumphantly in a large basket on the dean’s desk. I chatted with one of my professors, hugged several of my classmates and walked back to my apartment. Then, I crumbled to the floor, unable to even take my shoes off, and sat there for seven hours. I leaned against the white wall of my kitchen, ruminating on my feelings of emptiness. Even when my loving and supportive dog nudged me with her nose to ask for a walk, I struggled to move.

While I can’t say for sure what image I presented to the world that day, I don’t think that anyone would have guessed that I was in the throes of a deep depression. I looked put together, I was keeping up with my academic responsibilities, and I seemingly had my life “in order,” but in reality, I was barely hanging on. In fact, I was at the lowest point in my life.

Understanding High Functioning Depression

I belong to a category of people who live with “high functioning” depression. While this is not a clinical diagnosis, it has become a widely understood term to describe the reality of many: Depression doesn’t look the same in everyone — and there are plenty of “normally” functioning people who are privately battling depressive symptoms.

Essentially, this term refers to anyone who is grappling with mental health issues while accomplishing their day-to-day tasks and upholding their responsibilities.  

1 in 5 U.S. adults experience mental illness, and as this number has grown, the conversation surrounding mental health has evolved. More and more people are discussing their mental health journeys and sharing their symptoms and diagnoses, but this dialogue still has a long way to go to be inclusive. We must remember that mental illness can look different in everyone. Depression isn’t just the one-dimensional depiction we see in media: someone who experiences total isolation, won’t get out of bed and refuses to participate in everyday life.

During my two years in graduate school, I was able to attend class, keep up with most of my homework and complete a large thesis project. I paid my rent, and I called my family regularly.  I also felt a constant pain radiating in my chest and an all-encompassing sadness that clouded my ability to picture a future for myself. I thought about self-harm and suicide frequently — racking up alarming internet searches about suicide methods and putting together a will. Whenever I wasn’t bound by social expectation, I folded in on myself. The rumination would start slow; I would reflect on my loneliness and perceived inadequacies. Every limb hurt. Every move was excruciating. Sometimes I would cry myself into exhaustion; other times I didn’t have the physical energy to cry. But I found ways to (eventually) get out of bed and complete my baseline tasks.

It's important to note that this is not a universal experience of high functioning depression. Not everyone in this category is necessarily high achieving while hiding extreme lows; perhaps they are just barely accomplishing tasks or dealing with less severe depressive symptoms. This colloquial term leaves room for a wide range of experience — all of which are valid and deserving of empathy and treatment.

How to Help Others With High-Functioning Depression

Establishing that mental illness manifests differently in everyone is the first step to evolving the mental health conversation. But what should we do with this information? I am not a mental health professional or qualified to give medical advice, but I can reflect on the things that could have helped me on my own journey.

1. Check in with your friends, even the ones who seem to be doing well. This advice is hardly new — it’s plastered on social media graphics and inspirational posters. But it is critical to the well-being of people with high functioning depression. There were certainly times when I looked “ok” but was desperately needing extra support. A simple text from a friend could have eased some of the tightness in my chest.

2. Don’t assume you know everyone’s story. While I think I acted relatively “normal” during the throes of depression, I know there were days when my behavior and demeanor came off as odd or cold. I remember some classmates rolling their eyes and making occasional snide comments. It’s natural to make judgments, but I encourage you to challenge this tendency and remind yourself that there is always a more complex picture. And given the staggering numbers, it is more than likely that someone in your life is battling mental illness.

3. Open up. If you’re comfortable sharing some of your own story — your challenges, your vulnerabilities, your fears — you are actively building community with people who are struggling. Looking back, I remember thinking that I was the only person who could possibly experience such negative thought patterns and fears. Had someone close to me opened up about their own challenges, I would have found some comfort in knowing that I wasn’t alone.

Ultimately, through therapy and medication, I have found some level of recovery. My depression is not what it once was; I don’t experience extreme lows or suicidal ideation anymore. I have developed coping skills and found a support system to guide me through the rough patches.

When I think about how much my emotional well-being has changed, I can’t help but notice that my appearance to the outside world has remained the same: everything looks “fine.” But appearances are not the full story. Depression can look like me.

Margot Harris is a Content Manager with the Marketing & Communications team at NAMI. She has an MFA in nonfiction writing from Columbia University and previously worked as a digital culture reporter at Business Insider. She lives in Washington, D.C.