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High Functioning Depression and High Functioning Anxiety
Looking like a king, feeling like a pawn.
Is Counseling for Me?
Many clients I work with ask the question, “Is what I am experiencing normal? Should I be considering counseling?” They have a good job, positive support from family and friends, but something seems off. They dread getting up in the morning. Or they feel numb while doing the things they should be enjoying. Perhaps they and hide and isolate from their loved ones. Ultimatley, they lack enjoyment, struggle to relax, or feel empty. Despite all their effort, nothing seems to improve. While external reflections of success are an important component of happiness, they do not always represent our internal experience.
High Functioning Depression
Although high functioning depression is not a formal diagnosis, it is an emerging term used by clinicians. High functioning depression is an individual appears to have minimal impairment in function, but still experiences symptoms of depression. Historically, whenever the term ‘depression’ is used, the effects are thought to be obvious. Loss of job, lack of money to pay the bills, and isolation from loved ones are common examples. However, depression can be much more subtle than meets the eye. In sum, one can lead a functional life and still have depression.
High Functioning Anxiety
High functioning anxiety is not a formally recognized medical diagnosis either. However, the same basic concept applies. One can seem to be functioning in all areas, but still experience the symptoms of anxiety. Although an individual points to successful benchmarks in their life, there is still frequent worry, mild problems with sleep, feelings of being overwhelmed, an occasional but brief attack of anxiety, etc.
Masking Symptoms of High Function Depression and High Functioning Anxiety
Anxiety can give the outward appearance of a model employee. A boss would see an employee arriving early to work and be self motivated. They may also notice a perfectionist and someone willing to help others because they struggle to say no. No one suspects that the motivation behind these behaviors is driven by fear, worry, and nervous energy. Similarly, no one may recognize the toll you pay for this appearance of success. The do not see the lack of sleep or the difficulty relaxing even when home. Nor do they comprehend the constant feeling that something terrible is about to happen.
What is Happening?
The problem often lies in our mind’s powerful ability to rationalize and normalize these negative symptoms. We can look to our job, relationships, finances, physical functioning, etc. as evidence of wellbeing. We can be hypnotized into believing our social media profile defines us. Perhaps we blow off moodiness, fatigue, and negativity as an off day, even though it happens most days. Or we power through the brief nature of symptoms, downplaying the important signals are bodies are trying to communicate with. Rather than encouraging change, their social supports may also ignore the warning signs. They too just look at the overall picture of success and use that as evidence that things are okay. We may fall into negative coping strategies to manage symptoms, including overeating, drugs, alcohol, or watching too much TV.
How Can Counseling Help with High Functioning Anxiety or High Functioning Depression?
Surprising or not, many of the clients I work with fit into this category. From all outward appearances, they seem to have it together. They hold good jobs. Friends and family would characterize them as “successful” and “put together.” They exercise on a regular basis and watch what they eat. They go on vacations, smile for pictures, and are good parents. But their inward experience is very different. By the time they reach my door, they suspect there is something off with their personal experience. Maybe it is a negative coping strategy, problems with sleep, or an outburst that surprised them. It could be a loved one pleading with them to find a different job or take a vacation.
Regardless of whether your experience of anxiety and/or depression is debilitating or not, the use of cognitive behavioral therapy has been demonstrated to be an effective treatment (see resource tab for studies). By first looking at the connections between thoughts, emotions, and behaviors, we can start the change process.
Suggestions for High Functioning Depression and High Functioning Anxiety
Given the difficulty of these barriers, acknowledging the symptoms and resulting problems of high functioning depression and anxiety is the first step. This can be especially difficult given the fact that our brain can focus on our success, ignoring our symptoms, as evidence of wellbeing. Above all, we deserve to be both successful and happy. So, what can you do if you suspect you may have high functioning depression and/or anxiety?
Tips For Coping with High Functioning Depression and/or High Functioning Anxiety
1. Share your concerns with close friends and family. Ask them for their feedback on these concerns. This can be a very difficult conversation to have, and you must be ready for and appreciate the honesty that have to offer. Sometimes it can be helpful to ask for specific examples for them to help clarify a point.
2. Consider taking one of the following quizzes. They can help guide you to some further symptoms and problems. Assessing for high functioning anxiety and assessing for high functioning depression. You could also ask a loved one to take the quiz for you and compare results as a conversation starter.
3. Use an alarm for two weeks to do a self check in. Document feelings, thoughts, and behaviors in that moment. Doing so may give us a more honest evaluation of our symptoms rather than relying on our historical recall. There are various apps (such as Reflectly) that can assist you. They offer a way to schedule random alarms that can help us to assess our experience when we might otherwise be distracted. They also offer a user-friendly interface to document your experience on your mobile device.