Let’s talk “high functioning” depression and anxiety.
I put “high functioning” in quotations because I want to roll my eyes at this classification of anxiety/depression but, more importantly want to address what this label feels like to me, as a therapist who works with a lot of people who are considered “high functioning”.
When someone talks about “high functioning” depression or anxiety what they mean is that although an individual may deal with symptoms of depression and/or anxiety, they still are able to complete majority of the tasks in their daily life. A lot of times, complete those tasks exceptionally well too. They can show up to their job. They can engage with family or friends. Take care of their house. Parent their children. All while dealing with symptoms. I’ll be really honest though, when I hear someone reference “high functioning” depression/anxiety, all my brain thinks about is how good someone has been at masking.
Generally speaking, society doesn’t like when someone is down or vocalizing the potential negative outcomes of a situation. Generally speaking, people are applauded for coming across as “normal” or looking like they have their shit together. They are good at "playing it cool", if you will. Society loves the parent who appears involved with their child through the pictures they post on social media. Or the recent graduate talking about their promotion and climb up the corporate ladder. Society doesn’t like to acknowledge that achievements and photos don’t provide a comprehensive picture of who someone is or how they feel.
In my experience, the individuals who are labeled as “high functioning” are often struggling the most and a lot of the time are in denial about the impact that their symptoms are having on how they feel. Headaches? We'll just remedy that with meds. GI issues? No worries, I'll just skip a couple meals. Worries that keep them up at night? I'll just have an extra couple cups of coffee in the morning. Unhappy? Must mean I just need to work harder or that I am missing that "thing". After all, if someone has "the job" and "the family" and the appearance of having it together, they must be okay… right?
If society fails to get a whole picture (which includes someone’s mental health) when looking at a person, they are not applauding just someone's accomplishments. They are applauding how well that person hides very real (very human and normal) parts of themselves. Parts that are often hurting and screaming to be seen and cared for. But in a society that values image and status over most, there is little appreciation or acceptance for real.
“I have a good family. I have a good job. Our house is beautiful. We make enough money. I can’t figure out why I feel so badly.” Time and time again I hear this. Someone has checked the boxes on the list that was handed to them when they were a child. They reached the goals. They have everything they’ve ever been told they should want or strive to attain to be happy. And yet…. Symptoms are still there. My heart genuinely aches for these people. They’ve forgotten somewhere along the way that they, as human beings, are more important than anything they might own or achieve. That they have the answers within themselves to find and create whatever life they want. They feel lost. Stuck. Confused. Frustrated. Depressed. Like an imposter.
“High functioning” doesn’t mean an absence of severe symptoms. It means that on the outside, it looks like someone has it together. Calling someone “high functioning” implies that maybe that person doesn’t need as much help as someone who is “lower functioning.” In my experience, “high functioning” just says someone blends in better with society. That masking is a mastered skill at this point in their life.
If you are someone who has “everything” that you thought you were supposed to have but are still noticing things like frequent worry, restlessness, lack of motivation, physical symptoms that you can't explain, fatigue, sadness, difficulty with sleep, overall life dissatisfaction or more, I strongly encourage you to look deeper within yourself. Could you maybe be someone who has “high-functioning” depression and/or anxiety? Have you been shoving parts of your real self down because you feel people or society won’t accept them? Are you telling yourself that when you reach that next goal or next chapter of life, everything will be better?
I’m just here to tell you;
There are people who will accept you for who you are now.
How you are feeling, right now, that matters.
Masking gets to be fatiguing and you don’t owe that to anyone.
All parts of you are so worthy of being seen and heard.
If any of this resonates with you, please reach out to someone for support. Be it friend, family member, or therapist. Be brave enough to let someone see you, because it does take bravery. You deserve nothing less than that.
Brooke Halliday, MA, LPCC (she/her)
Owner of Redbird Counseling