You may have heard the phrase “high-functioning depression,” which suggests that some people with depression may function quite well and experience minimal impairment from this mental health condition. While it is possible to have a mild case of depression, experts have begun to question whether it’s really appropriate to use the term, “high-functioning depression.” Below, learn about the meaning of this phrase, as well as some of the common misconceptions surrounding high-functioning depression.
What Is High-Functioning Depression?
When people use the phrase, “high-functioning depression,” they are often referring to a case of depression that is so mild that it goes unnoticed. A person who lives with high-functioning depression may continue to fulfill duties at work and home, and others in their lives do not recognize that they are struggling with poor mental health.
In many instances, people who are said to have high-functioning depression are actually experiencing what is called persistent depressive disorder. This is a clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. It is also commonly referred to as dysthymia or dysthymic disorder.
When a person lives with persistent depressive disorder, they experience a depressed or irritable mood for at least two years, or for at least one year if diagnosed as a child or teen. In addition to a depressed or irritable mood, someone with persistent depressive disorder will experience two of the following symptoms:
- Fatigue or low energy levels
- Eating either too much or too little
- Sleeping either too much or too little
- Poor self-esteem
- Difficulty concentrating or making decisions
- Feelings of hopelessness
How High-Functioning Depression Differs from Major Depression
To understand the nature of high-functioning depression, it’s important to know how persistent depressive disorder differs from major depression. The primary difference between the two is that symptoms of the persistent depressive disorder tend to be less severe when compared to major depressive disorder. This explains why persistent depressive disorder may be considered “high-functioning depression.”
The reason that persistent depressive disorder typically appears less severe than major depression is that a diagnosis of persistent depressive disorder only requires two symptoms in addition to depressed or irritable mood, whereas a diagnosis of major depression requires that a person show five symptoms of depression, one of which must be either a depressed mood or a loss of interest in usual activities.
Given that a person with the persistent depressive disorder may only show two symptoms beyond a depressed or irritable mood, their symptoms may appear rather subtle in comparison to major depressive disorder. This leads to the persistent depressive disorder being labeled as high functioning, which may be inaccurate.
How High Functioning is Persistent Depressive Disorder?
While it is common to refer to the persistent depressive disorder as high-functioning depression since people with this condition experience fewer depressive symptoms, labeling it in this way may not tell the entire story. In fact, the chronic nature of the persistent depressive disorder can make this condition quite debilitating.
Research shows that when compared to non-chronic major depression, individuals with a persistent depressive disorder are more likely to experience the following complications:
- Lack of social support
- Impairment in functioning
- Increased likelihood of co-occurring mental health disorders like anxiety
- Higher risk of suicide
- Greater likelihood of experiencing dysfunctional thinking patterns
Based upon the above findings, it is actually paradoxical to refer to persistent depressive disorder or dysthymia as being “high functioning,” because people who have this form of depression actually tend to function worse in daily life. Their symptoms may not be as noticeable, but they are long-lasting and can take a negative toll on well-being.
Could It Be Treatment-Resistant Depression?
Persistent depressive disorder or dysthymia could actually represent a form of treatment-resistant depression. When depression is treatment-resistant, this means that a patient does not respond adequately to usual courses of treatment, like medication and/or talk therapy. In cases of persistent depression, it might be that a patient continues to experience some symptoms of depression because they are resistant to usual treatment methods.
Studies with persistent depressive disorder suggest that around 40% of patients with this form of depression are treatment resistant. What this means is that high-functioning depression may not be so high functioning after all. Instead, persistent depression or dysthymia may represent a hard-to-treat form of depression that does not always subside with treatments that are generally effective for depression.
So, what is the answer to cases of treatment-resistant depression? When two trials of antidepressant medications have failed, it may be time to try an alternative treatment approach. One such alternative approach is the use of transcranial magnetic stimulation (TMS). TMS involves the use of an electromagnetic coil to deliver pulses to areas of the brain that are involved in mood regulation. Numerous studies have found that TMS is effective in treating depression.
Seeking TMS Treatment for Depression
If you live with treatment-resistant depression, TMS services are a suitable treatment option. This modality is effective, and it is considered non-invasive. Treatment sessions can be completed in about 20 minutes, and you can return to your usual activities afterward. A magnetic stimulating coil will be placed over your head to stimulate the nerves responsible for mood.
Pulse TMS provides this treatment option for patients in the Los Angeles area. Contact us today to learn about TMS services or to determine if you are a candidate for this form of treatment. Generally, you must have attempted other treatment options with little to no success to be eligible for TMS.