Many people believe that depression is when you spend all day in bed or feel completely broken. However, there's another type of depression that becomes a daily part of life. This is called functional depression (or high-functioning depression).

This type of depression is not so easy to understand. In this condition, the person may not even realize what's happening. They proceed with their day, but it's so exhausting that they can't move themselves. It's like an unseen burden that can be seen or touched. They go to work, take care of their families, and appear fine on the outside. While on the inside, they feel tired, sad, and drained of energy all the time.

If this case sounds like yours, remember that you are not alone. A study shows that about 1.5% of US adults suffer from high-functioning depression every year. The good news is that functional depression is a condition that can be treated with therapy, medication, and learning coping skills.

What are the symptoms of functional depression?

The symptoms of functional depression are often silent and almost unnoticed. The true look of functional depression is like:

You feel tired and sleepy all the time, and you can't rest. You always wake up tired.
Nothing truly inspires you anymore. The leisure activities that once energized your life have lost their shine. Hanging out with friends is still open, but you no longer enjoy them.
You judge yourself more than anyone else. Even the smallest mistake seems too big to you.
You say "I'm fine" mechanically, even when you're not. Especially when you're not.
You mindlessly keep yourself busy to pass the time. Because when you stop, your thoughts take over.
The worst part is that everyone assumes you're doing well. Therefore, you start to doubt yourself.

Why Functional Depression Occurs?

Functional depression doesn't have a single cause. Multiple factors can lead to functional depression. Some of the factors are:

Brain chemistry: Imbalances of brain chemicals (certain neurotransmitters) that regulate mood. This isn't a character flaw, but simply biology.
Life challenges: Job stress, relationship problems, and money worries. When it all adds up, some people are left holding the burden.
You learn to hide your feelings: Maybe you grew up in a family where showing emotions wasn't safe, or you work in a place where vulnerability was considered a weakness. So, you learn to wear a mask.
Social media makes it worse: On social media, everyone appears happy. Their lives seem perfect. This makes your struggles seem even more isolated.
Life today is exhausting: We're always connected, always busy, always comparing ourselves to others. This constant pressure can take a toll on anyone's mental health.

Many people are more prone to functional depression. For example:

Overachievers: Expectations for you are so high that even failing to reach the sky makes you feel sad.
Caregivers: You put everyone else first, and you can certainly put off your soul's needs for another day.
People with anxiety: Your brain is already under a high load. Depression just adds more work to it.
People with challenging careers (e.g., doctors, lawyers, teachers, managers) often struggle silently. They learn to cope with pain. They are adept at solving others’ problems, but ignore their own.
People with a family history: If depression runs in your family, you may be more likely to experience it. This doesn't mean you will become depressed, but your environment or lifestyle factors may work in a way that makes it more likely.
Women who face different kinds of pressures: Hormonal changes, societal expectations, and juggling multiple roles can all contribute to depression.
Young people in their twenties and thirties: It happens when life gets difficult. Career pressure, relationship decisions, and financial stress. It can be very difficult to manage.
People who have experienced trauma: Childhood abuse, accidents, or the loss of loved ones. These experiences can change the way your brain processes stress.

Functional Depression Treatment

Some people may think they are doing very well and, therefore, don't deserve help. They keep telling themselves, "Other people are worse off than I," or "I have so many good things, so I should be happy." This thinking only prevents them from moving forward.

Don't wait to seek help. You deserve to be happy. You should just live every day instead of wasting time and underestimating yourself. A mental health professional, such as a board-certified psychiatrist, can assist with the diagnosis process and provide personalized treatment. Now you have a great opportunity to connect with an online psychiatrist from the comfort of your own place (i.e., home or office).

What professional help can they provide?

Better ways to cope with emotions that don't involve suppression
More joy and meaning in everyday activities
Guidance on staying true to yourself in your feelings
Help in building strong relationships with others

What is the best treatment for functional depression?

The first step of functional depression treatment is getting the right diagnosis. Remember to be honest about how you're feeling with your depression doctor. It's hard. You're used to saying, "I'm fine." But your doctor needs to know the real story, your symptoms of fatigue, numbness, and lack of joy.

Typically, the treatment of functional depression is:

Talk therapy: Talk therapy (such as acceptance and commitment therapy, cognitive-behavioral therapy, and cognitive processing therapy) is not about "thinking positive" or "counting your blessings," but rather learning and practicing tools to deal with your negative thoughts. A therapist will help guide you on how to overcome your sadness and not view your problems as mere superficialities.
Medication: Your brain chemistry may need some support to cope with life's challenges. There's nothing wrong with taking medication. Would you also say ‘no’ to diabetic medicine if you are diagnosed with diabetes?
Lifestyle changes: Regular exercise, good sleep, and healthy eating aren't cures, but they do help. Think of them as tools (a base) that help increase the treatment efficacy.
Support system: This is probably the hardest part. You're used to handling everything alone, but loneliness worsens depression. Find someone you can be honest with, whether your friend, a loved one, or a therapist.

Treatment for functional depression isn't one-size-fits-all. What works for your friend may not work for you, and that's okay.

Other coping skills to follow:

Keep an eye on your "everything is fine" mask.
Take small breaks throughout the day to check in with your feelings.
It's okay to do simple tasks slowly.
Understand that you're not the root of your problems.

Remember to be patient with the treatment process. It takes time to work. Sometimes, depression medications and therapy can take up to months to work. You didn't develop functional depression overnight, and you won't be able to cure it overnight. Some days will be better than others. This is a normal phase of the recovery process. Just keep on pushing through, and you’ll see how life feels less heavy with time.