Functioning… and suffering: high-functioning depression
A couple weeks ago, I wrote that I'd recently read The Perfectionist’s Guide to Losing Control by Katherine Morgan Schafler. Additional ideas Morgan Schafler elegantly articulated in her book have stuck with me and pop up as themes in conversations with friends and online newsletters to which I subscribe. One such idea is that “no one can hide their suffering better than the highly functional person.” (Morgan Schafler, 2023, p. 3). Being highly functional often comes back around to bite someone because it’s a reputation from which it’s hard to get away.
Often, being highly functional means you are asked to get even more done. I receive newsletters from The Matriarchy Report substack; one headline from a recent one was, “Women prove they can hold it all together. We thank them by giving them more to hold." This newsletter continued about sociologist Jessica Calarco’s book, Holding It Together: How women became America’s safety net. (Gender-implications and feminist perspectives aside, it’s likely the case that we tend to ask people who can hold it all together to hold even more.) I’ve often heard people make statements to the effect of “if you want a task done well/quickly, give it to the busiest/most highly producing/responsible person around.” Admittedly, nothing is 100% true in all circumstances, and there are often exceptions: not every highly functional person hides their suffering (or does it well if they try); not every person who can hold it all together can hold more; and not all busy or responsible people can handle even more work. Nevertheless, these statements acknowledge some type of pattern.
Functioning isn’t necessarily the same as doing well
Some people thrive doing all the things and holding all the responsibilities. But that’s not the case for everyone who can hold or juggle or accomplish a lot. Though it’s not actually a specific mental health diagnosis, a lot is said and written about the idea of “high functioning depression.”
Too often when we think about depression, we think of someone who isn’t able to get out of bed, who can’t keep up with self-care (not the kind popularized by the wellness industry that wants you to buy their soothing lotions and aromatherapy tools, but the kind like showering and brushing teeth and getting out of the pajamas that have been worn for three days), who is totally hopeless–and thus, doesn’t do anything. We don’t always imagine a person with depression to be the person who appears to be functioning—and potentially even kicking ass —to the outside world as they perform the responsibilities required by their job (even a high-stakes one!) and handle other tasks for which they feel a duty to complete.
But functioning doesn’t mean doing well. Or even not doing poorly. That person who experiences what is discussed as “high-functioning depression” and who shows up for everyone may be so outwardly focused that they’re never asked how they’re doing, so those in their life don’t actually know how down they’re feeling. Or, if they are asked, the person may not want to deflate the conversation or bring others’ moods down, so they minimize their feelings or quickly try to change the topic. Alternatively the person with so-called high-functioning depression avoids their own feelings, focusing instead on tasks and others’ needs, to the point they can ignore how empty or despondent they feel themselves because not ignoring these feelings may cause everything to tumble or break down.
Despite not being impaired or incapacitated in an observable way, the high-functioning person who has feelings of numbness or emptiness or sadness or hopelessness may still endorse symptoms of depression.
They may feel helpless to get out of their situation, i.e. the life they helped construct in which they continued to seek positions with more responsibility and more perceived power but now feel trapped.
They might be uninterested in hobbies or activities that used to bring them satisfaction or contentment or joy; they may still show up to social gatherings, but it’s to show their face and maintain the perception they have it together rather than because they want to be there.
They might not be sleeping, either because they can’t or because they need additional time somewhere to accomplish all their responsibilities in order to appear to be functioning. (Or they might be sleeping all weekend long because they don’t feel the pressure to function the way they do during the week.)
Some of this not sleeping to accomplish responsibilities could be due to the fact they can’t concentrate–a classic symptom of depression.
They might be having negative thoughts about themselves, like wondering why they can’t hold it together and function “like a normal person.” Or question why they can’t be like someone else.
Or they might have suicidal thoughts, as they feel so empty, trapped, sad, and hopeless because though they’re functioning and holding their shit together, they question if this is really all life has to offer.
Help for those with depressive symptoms
People experience depression for all sorts of reasons, and there isn’t any one answer as to why someone feels depressed—if they even want to label it “depression” for themselves. They may just feel dysregulated or “off” or some other descriptor that suggests everything takes about ten times the energy that it should or used to. It might be hard to recognize that someone who is high-functioning may, in fact, be feeling depressed because of all that person’s efforts to create a different perception or illusion within their professional, social, or familial relationships.
If you’ve read this and see yourself in these descriptions, please reach out. If you think this describes someone you know, maybe talk with them; ask them how they’re doing; maybe encourage them to talk to a therapist or counselor who can help.