High functioning depression (or HFD) is the mental health diagnosis given to an individual who exhibits symptoms of high-level depression but manages to maintain overall functionality in life. An HFD person will often engage in activities that would be considered “normal” and healthy for a typical person, maintaining a job and even social relationships (though they may not appear as close and involved as typically expected). However, they might find it challenging to take care of themselves or participate in their mental well-being treatment, leading to worsening mental health. Because those with HFD feel less empowered than those without mental illness, they may also be more likely than other groups to come up short on self-care, such as enough rest, following medical advice regarding their mental health.

One of the most common signs that a person is depressed isn’t sadness or even feeling down. Instead, it’s anger and irritability. It’s impatient with everything from traffic to slow computers and or snapping at family members who don’t deserve it. However, in high functioning depression — where people continue to function well in their lives despite feeling terrible inside — goes unrecognized mainly because patients aren’t complaining about feeling depressed and often continue to work or go about the activities they usually do without complaining appearing sad.

A patient can look like they’re on top of the world — they’re successful, productive, on top of their game — but be struggling with this profound sense of emotional exhaustion. Recently, in the news, we heard about the tragic, untimely suicide of Cheslie Kryst, a model, attorney, a tv host who, from the surface, appeared to have it all. Yet, she suffered from mental health challenges and sadly took her own life.

Mental health is a hot topic and one that has been appearing more frequently in the news because of increasing reports of mental attacks such as school shootings. Yet many people who have mental illness go without getting treatment for issues such as depression, and they are not the stereotypical patient. Depression can be a very secretive disorder, like cancer, is initially often evades the detection of the patient. Depression, like cancer, often goes undetected in a patient until it has advanced into an untreatable stage. In mental disorders, it is not always easy to spot when someone is suffering unless they express how they are feeling.

The suicides of seemingly successful and happy people highlight the insidious, sometimes sleuth depression hides. People still stereotype depressed individuals are being disheveled, tired-looking individuals with socioeconomic status. However, mental disorders do not discriminate, and anyone can have a mental illness. Their high functioning capabilities are how they mask mental illness.

It’s believed nearly 80 percent of suicide victims had depression or another mental health issue such as clinical anxiety, and these issues go undiagnosed and untreated.

High-functioning depression is a mental disorder that is not usually recognized by the person who has it, even though they suffer significantly from mental anguish. The inner emotional state of people with high-functioning depression is often chaotic. Sometimes it leads to substance abuse or pathological gambling addictions, which are ways of escaping from their mental illness for a little while.

People suffering from high-functioning depression might not recognize they have any mental issues. When they look in the mirror or at a photograph of themselves, these individuals will see someone else looking back at them. They feel they appear fine, but internally their feelings tell differently.

As health care professionals, it’s essential that screening for depression be frequent, regardless of age, as we see depression in teenagers, as well as adults. People who suffer from high-functioning depression deserve our sympathy and support. Sadly, some in society might not react most compassionately. For example, after the death of Cheslie Kryst, I read hundreds of comments on various social media platforms in response to her death. There were many supportive comments on the post. However, some of the analyses showed pervasive ignorance regarding mental health.

February is Black History Month, so I will take the time to tie in mental health concerns in the African American community. I am not sure if mental illness is more challenging to diagnose in the black community because mental health services are not readily available or some social stigma attached to mental illnesses. Or, it could be a combination of both reasons. In my opinion, mental health services should be readily available and accessible for individuals to navigate.

Also, perhaps mental health clinics are grouped as such, which might cause individuals to be resistant to go to the mental health clinic for obvious privacy concerns. For example, maybe mental health clinics can do something about the confidentiality issue and reevaluate how the clinics are set up. Suicide is a genuine concern with depressed individuals, and depression does not discriminate if you are a doctor, a lawyer, or a busy professional.

If this message strikes a chord, please reach out. I have practiced medicine for over a decade, and I have firsthand seen those showing signs of clinical depression fall through the cracks. Please take care. Know that your life matters and you are loved.

Tomi Mitchell, a family physician and founder of Dr. Tomi Mitchell Holistic Wellness Strategies, is not only a distinguished international keynote speaker but also a passionate advocate for mental health and physician’s well-being, hosting her podcast, The Mental Health & Wellness Show. With over a decade of experience in presenting, public speaking, and training, she excels in creating meaningful connections with her audience. Connect with her on Facebook, Instagram, and LinkedIn and book a discovery call.

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