8 Signs of High Functioning Depression

High functioning depression, also known as persistent depressive disorder, and previously called dysthymia, is a form of depression that can be difficult to detect because the symptoms may not be as obvious as those of major depression.

For depression to be considered persistent you have to have been experiencing your symptoms most of the day, nearly every day, for at least 2 years if you are an adult and for at least 1 full year if you are a child.

So let’s get into the 8 signs that you or someone you know may be experiencing high functioning depression.

Persistent feelings of sadness, hopelessness, or emptiness — we all experience these things at one time or another but a consistent, ongoing, and hard to shake feelings of sadness, hopelessness, or emptiness could be a sign you have persistent depressive disorder.

Loss of interest in activities that used to bring pleasure — when a person experiences ongoing depression they tend to eliminate the fun and social activities from their schedules. When you struggle to function in your day to day life just getting up and going to work or school can be draining, leaving little to no interest for socializing or doing really anything you don’t have to.

Decreased energy and difficulty with motivation — functioning with depression is draining. If you have difficulty motivating yourself or coming up with the energy to do things you may be experiencing depression. And when this struggle lasts for a long time, you might be struggling with persistent depression.

Changes in sleep patterns or appetite — Eating and sleeping are everyday occurrences and vary from person to person. When considering this symptom for yourself it’s important to think about it as a CHANGE from previous functioning rather than in a numeric measurement. Increase or decreased sleep and appetite can be a symptoms of many issues unrelated to mental health so consider the situation and the length of time you have noticed the changes. When a person struggles with ongoing depression the increased or decreased use of sleep and food is acting as a coping strategy. If you notice a significant or ongoing change in sleep or eating patterns you may be suffering from persistent depression.

Difficulty concentrating or making decisions — making decisions and concentration require a large amount of mental energy. These skills are diminished when a person is struggling with ongoing depression.

Self-critical thoughts or feelings of worthlessness — negative self talk has a huge impact on our emotional health. When a person is struggling with persistent depression their ability to challenge their thinking and talk positively to themself is diminished.

Physical symptoms such as headaches or digestive problems — We call these somatic symptoms. It’s when a person is struggling with their depression so much that they have physical illness type responses. If you notice recurring stomach aches or headaches over a two year period it may be caused by persistent depression.

Difficulty managing daily responsibilities and tasks — High functioning Depression is still depression. Over time, without treatment, the person will experience a progressive decrease in their daily life functioning. Missing appointment or deadlines, missing kids special events, forgetting to pay bills, dishes and laundry piling up, and an overall struggle to manage daily life.

It’s important to note that everyone experiences these symptoms differently, and it’s possible to experience high functioning depression without experiencing all of the symptoms discussed today. If you’re concerned that you or someone you know may be experiencing high functioning depression, it’s a good idea to speak with a mental health professional for an assessment.

Persistent depression is treatable and often with interventions as simple as talk therapy. There are medications that can help and I know not everyone is a fan of medication treatments. But know that there are options available and talk to your doctor if you are struggling. You can also seek counseling from a mental health provider such as myself.

Leave a comment if there is a mental health topic you would like more information about. Bye!


5 Steps To Prevent Relapse During The Holidays

Katie Donahoo

Photo by Nicola Barts on

1. Acknowledge The Risk

Holidays are a time of increased expectations and stress. It is important to acknowledge the things that make this true so you can prepare to deal with them: family obligations, increased or decreased work hours, financial strain, social events, gifts, etc. It goes on and on.  Recognize the risk for relapse and acknowledge it to yourself. If you ignore the risks or refuse to see them for what they are you can be blind sided by them and fall into relapse. 

2. Make A Plan

Who: Who am I going to choose to spend my time with? Friends, family, co-workers, children, spouse, sponsor, allies? Who has my best interests in mind? Are these people in recovery or supportive of my recovery? Are they actively using? 

What: What will I be doing with my time? Celebrations, dinners, parties, other social gatherings? How will I be spending my time at these events? Talking, eating, drinking, games, watching something? 

Where: At what locations will I spend my time? Are these locations triggering for me? Have I used in these locations in the past? Are these events being hosted at a bar, club, or after-hours party house/location? 

When: What time will arrive at these events and what time will I leave these events? What are my signals that I need to leave early? How will I leave; did I drive myself or am I reliant on someone else for a ride? 

Why: Why am I choosing these events to attend? What do I get out of attending these events? Do these events support my recovery? Do I feel welcomed and comfortable at these events? 

3. Practice Saying “No”

Have a few different ‘go to’ phrases prepared for declining events, invitations, or offers that do not suit your recovery lifestyle. Practice with a friend or in the mirror. Say your phrases out loud so you get used to hearing them in your own voice. Examples include: “I’m busy that day. I already have a prior commitment. No thanks. I don’t think that event is for me. I would prefer not to attend that event. I can’t help you out this year, I’m sorry.”

4. Reach For Your Support System

Go to your regular meeting. Attend extra meetings if you can. Don’t rely solely on friends and family. Reach out to your sponsor; they want to hear from you!

5. Celebrate

Holidays are time for fun and traditions. Don’t be afraid to create new traditions or a give a try to a different kind of fun. Give thanks, have fun, and celebrate. Enjoy the holiday! 


Seek professional help sooner rather than later. If you anticipate the holidays being especially difficult for you find a counselor NOW. Mental health services often require a waiting period to get started. Help is out there. Reach out today.