HIDDEN DEPRESSION | San Diego Psychiatrist Explains High-Functioning Depression, Medical Treatment

In a fast-paced world, it’s hard to tell who is just taking life seriously from someone with high-functioning depression needing treatment and medication at face value. We all have our own struggles deep within, but how we handle situations makes a huge difference. Over time, we have developed various ways to cope with life’s pressures and demands. Some bury themselves in work, others choose to “dance in the rain,” and some just accept things as they are. While we can normally move on from a sad or tragic episode after some time, individuals with high-functioning depression take a slightly different turn.

High-functioning depression can affect an unsuspecting individual. You can still function normally at home, school, or work, even if you feel melancholic internally. You may feel like a duck that seems to be swimming peacefully but paddling hard underneath the water.

Note, however, that being functional does not mean you can safely skip medical care. It is better to understand what is high functioning depression first before rejecting or accepting medical treatment for depression.

Understanding High-Functioning Depression

high functioning depression treatment medication
Gloomy and dark are the classic descriptions of a clinically depressed person. It is a mistake to ascribe these to all types of depression, as there are many types. High-functioning depression or persistent depressive disorder (PDD), or dysthymia, is a unique case. It might take time for your family and friends to notice your condition because, somehow, you can still get along with other people, work efficiently, and adjust to your environment without issues. You can be punctual, a top performer, and a superb homemaker, but these are all a façade. Deep within, you find it difficult to feel happiness or joy. You are emotionally less reactive or indifferent. It is as if you have accepted it as a baseline, having lived with the kind of emotion you have for some time. The changes in your brain functioning happen in the background while still being able to meet life’s ordinary demands.Many studies suggest that depression occurs due to chemical imbalances (dopamine, serotonin, and norepinephrine), although this does not capture the real complexities of this mental illness. A psychiatrist or mental care provider can diagnose the disease through tests and assessments. High-functioning depression is seen through a list of signs and symptoms similar to other types of depression but may be less severe.

How Could We Miss It?!

Recent studies show that 16.2 million, or over 6% of American adults, suffer from bouts of depression at least once a year. The causes can vary from environmental, social, genetic, and age. We can easily identify a person who is possibly suffering from it based on mood swings, low energy levels, cold social interactions, and poor performance.

High-functioning depression is an entirely different issue. Despite having depression, you display normal behaviors on most days and suddenly switch to non-stop crying for no reason. If you manage to end your week on a high note, you may yourself cast down after. The attacks can be unpredictable.

How and Why Depressed Individuals Manage to Hide Their Condition?

If work and studies are stressful for others, individuals with high-functioning depression may find their job a rewarding distraction. Being occupied with paperwork means no room for heavy and negative thoughts and emotions, which can also flood them if they try to meditate or relax. This behavior explains why many choose to bury themselves with work for more than 40 hours a week and eventually lead them to successful careers.

Cheslie Kryst: An Example of Hidden, High Functioning Depression

Cheslie Kryst was Miss USA 2019, she was a successful attorney in her 30s, and she was a top entertainment correspondent in New York. She seemed to have it all — beauty, fame, prestige, glitz, and glamor.

On January 30, Kryst committed suicide in Manhattan, New York. It shocked the community, it shocked her friends, but it also shocked her family. They had no clue she was going through high-functioning depression. For years, Kryst hid her condition and continued to succeed, until it overcame.

High-functioning depression may seem bearable, and you may think it isn’t worth a psychiatric consultation. As long as you are functioning and able to get through the day just fine, you think you can move forward “winging it.”

Kryst may have had the same notion—unfortunately, we’ll never truly know how she was struggling and coping. However, high-functioning depression is a silent killer, an invisible disorder that gives you suicidal thoughts depending on the severity of the attack. Without sharing those overwhelming feelings with family, friends, and a psychiatric care provider, the chance of getting better slips.

Kryst’s incident is a warning—everyone is susceptible to the struggles of depression. And trying to get by and mask high-functioning depression is not the answer. It never will be.

High Functioning Depression—Triggers and Symptoms

If left untreated, high-functioning depression can consume you. Not prolonging treatment can save your life. But positive thoughts may not be enough to get you out of the rug. Depression is a medical condition that needs to be addressed as soon as you are diagnosed.

Even though high-functioning depression is hard to detect, it has signs and symptoms. There are also various factors that trigger an attack.

Symptoms of High-Functioning Depression

People with PDD may display the following symptoms:

  • Mood changes
  • Persistent sadness
  • Loss of interest in social activities
  • Occasional isolation
  • Weight loss or weight gain
  • Difficulty sleeping or staying awake
  • Low self-esteem
medication for high functioning depression

These are minimal depression symptoms that wax and wane. You may recognize these symptoms as PDD seasonal depression, or something in between. You may feel down most days or fine some days. This can be a constant feeling for a period of two years. People with high-functioning depression also go through the following:

  • Most of the time, your mood is down.
  • The feeling of happiness doesn’t last long, and it sometimes co-exists with sadness that seems to have no relief.
  • Even with enough rest or sleep, you still feel tired.
  • On some days, you just feel lethargic or unable to function normally. It’s a struggle to get out of bed or perform any tasks.
  • You may be able to deliver or accomplish your work for the day, but it’s a struggle to do so.
  • You feel hopeless, unworthy, and not deserving of happiness.
  • You may be able to socialize a little, but only after forcing yourself. You prefer isolation occasionally or less crowded.
  • Sometimes, you cry a lot for no apparent reason.
  • If left undiagnosed and untreated, it can lead to substance use, difficulties maintaining a relationship, or troubles at school, at home, and at work.

You have become familiar with the routines and emotions, so you choose to live with them. You may believe that your condition is not severe enough to warrant medical management of depression. In reality, you need help more than ever, or the condition will catch up on you one way or the other. The persistent feeling of sadness and hopelessness can become unbearable, leading to suicidal thoughts.

What Triggers It?

Depression is triggered by major life events and other factors, such as:

  • Loss of a loved one
  • Changes or Loss of job
  • Divorce
  • Moving to a new environment
  • Breakup
  • Failing in class
  • Financial problems
  • Getting a bad rating
  • Failing to achieve a goal
  • High-stress level

The trigger can be anything that matters to you the most. You can downplay the negative effects on your mental and physical well-being, but the impact on your life is something you cannot ignore. Mostly, the factors causing it are environmental, so mild depression tends to go away when the issues that cause it get resolved. The condition may recur or not.

How It All Starts with Acceptance—It’s Okay

high functioning depression and suicide
People with high-functioning depression have developed their own coping mechanisms. But acceptance is the only way that you can truly begin to deal with your depression the healthy way. This means you are building a bridge to help you reach others and help others reach you.If you have to deal with it on your own, knowing you have a battle to fight empowers you against destructive thoughts and feelings of worthlessness and hopelessness.

One of the most important things to do is to consult a psychiatric care provider who is committed to helping you get through tough times.

High Functioning Depression Treatment and Medication: What Are They and How Can They Help?

Early diagnosis is critical, and medication for high functioning depression is urgent. Do not prolong the harm it’s causing your mental health and personal life. The first step is to seek help from a mental care provider or psychiatrist who will evaluate your symptoms and prescribe the appropriate medications and treatment programs.

Medical Treatment for Depression

Your hesitation to undergo medication is understandable. Perhaps you worry about the stigma attached to individuals on medication for any type of mental illness. Maybe you do not want to be seen as weak or incapacitated. You may also be doubting the effectiveness of medication and wonder: “Is medication the best treatment for depression?”, or “Should I go on depression medication?” You are not alone. A lot of people think many times before taking the leap. Psychiatric care providers at Peak Wellness do not guarantee full recovery with one medication: “Each case of depression is different, and every individual has a different way of handling depression or responding to medicines.” There is no one-size-fits-all medication.

They can see progress in some individuals who take a certain medication for a few weeks, while the condition remains the same in others. If they have to switch to a particular type of medication, they do so and monitor how a client responds to it. Many, however, find medication that matches their symptoms and continues to improve.

Among the most prescribed are medical treatments for anxiety and depression, as the two conditions often co-exist.

medication for high functioning depression

SSRIs (Selective Serotonin Reuptake Inhibitors)

SSRIs are known to improve mood and address other symptoms of high-functioning depression. It works by increasing the brain’s serotonin level, a type of neurotransmitter. They are also prescribed to people with anxiety disorders.

  • Prozac (Fluoxetine)
  • Zoloft (Sertraline)
  • Celexa (Citalopram)
  • Paxil or Pexeva (Paroxetine)
  • Lexapro (Escitalopram)
  • Wellbutrin
  • Remeron (Mirtazapine)

Although they are all SSRIs, their potencies differ, and how quickly your body metabolizes one determines may result in various side effects. Also, depending on how your body responds to it, a particular drug may take a long or short time to work.

SNRIs (serotonin-norepinephrine reuptake Inhibitors)

For severe forms of depression and anxiety disorder, doctors also prescribe SNRIs (serotonin-norepinephrine reuptake Inhibitors). This medication works by increasing the brain’s serotonin and norepinephrine levels by delaying or blocking the reuptake. These neurotransmitters are known to regulate one’s mood. The following medications are prescribed to individuals with depression and/or anxiety disorder:

  • Pristiq (Desvenlafaxine)
  • Cymbalta (Duloxetine)
  • Fetzima (Levomilnacipran)
  • Effexor XR (Venlafaxine)

The Holistic Approach: Medical and Psychological Treatments for Depression

Medication greatly helps in alleviating the symptoms. However, it is not the only and best medical treatment for depression. Peak Wellness also recommends its holistic treatment approach, a treatment program not commonly offered in other medical institutions. With a holistic approach, psychiatric care providers prescribe medication in combination with behavioral therapy and wellness activities.

There are cases where an individual would need to undergo cognitive behavioral therapy (CBT), which aims to change thinking patterns. Peak Wellness includes a list of wellness exercises such as meditation, yoga, and recreational activities that let the mind and body rest. These activities are done alongside taking medications to help you cope.

The holistic treatment approach offers long-term solutions to depression, anxiety, and other mental illnesses. Based on the number of individuals who are on the road to recovery, the program proves successful. But this cannot be attributed to Peak Wellness alone. Your 100% cooperation and willingness to get better and have a new lease on life are significant factors that make healing possible.

The Road to Recovery—Getting Help from a High Functioning Depression Specialist

high functioning depression treatment medication
Having a high functioning depression treatment medication plan soon after finding out about your condition can help you recover faster and live life to the fullest. The crisis may not end abruptly, but you will begin to see progress if you do not sway and focus on your goal.You do not have to go through the process alone. Aside from your family and friends, you have Peak Wellness support from day one. At Peak Wellness, we don’t stop at prescriptions or 15 minutes of consultation. We are here to guide you all the way, offer you personalized solutions, and listen to your concerns thoroughly as we formulate the next steps.

Our psychiatric care providers and depression specialists will help you manage your mental health. With our comprehensive depression treatment program in San Diego, you are in good hands. Call us right away to schedule an appointment!