Picture a depressed person. What springs to mind? Someone barely able to get out of bed? Tears constantly streaming down their face?
I used to think like this, too. As a clinical researcher and psychiatrist, I thought I knew the criteria for depression. I was confident that the illness presented clearly – both to the sufferer and the observer.
Indeed, my career was my life, and on the surface I had it all. Successful job, happy marriage and a beautiful young daughter. But something wasn’t right.
At first, I thought it was just burnout. After all, the symptoms I was experiencing – a lack of interest in anything I used to enjoy, an inability to feel happiness – could be attributed to over-stretching yourself professionally. I was still going about my daily life as normal, which surely excluded me from having depression?
So I took a step away from my practice and tried to rest. ‘Tried’ being the operative word. I still felt utterly exhausted. It wasn’t that I was sad – I was simply unable to feel happy.
But unlike ‘traditional’ depression sufferers, who report feeling an overwhelming sadness and deal with their turmoil by shutting down, I was keeping myself busy so I didn’t have to acknowledge my feelings and actively feel ‘sad’. Outwardly, I appeared to be successful.
Dr Judith Joseph, board-certified psychiatrist and researcher specialising in mental health and trauma
In other words, I was a ‘high-functioning’ depressive.
I began conducting clinical research, and realised many others also experienced every symptom of depression… except the ‘shutting down’.
But why do some depressives ‘function’ while others don’t? It boils down to the way we’ve learnt to deal with traumatic events in our lives – whether we acknowledge the way they make us feel or bury them. It’s something that’s often established in our childhood.
I grew up with limited resources and at times depended on government assistance. My parents instilled in me that I had to work to survive. Ever since, I’ve lived with the terror that, if I stop working, I might run out of money.
Therefore, the way I’ve always dealt with adversity is to work hard. It’s a distraction from my true feelings.
As my depression heightened in 2021, my marriage began to break down, too. Divorce is a serious trauma, and it’s ok to recognise this. It certainly worsened my symptoms.
So, how do you know if you’re suffering from high-functioning depression (HFD)? In short, if you feel a constant absence of happiness, even when you step away from stressors in your life – such as work or family responsibilities – but you’re still functioning relatively normally, then you’re experiencing HFD.
‘High-functioning depressives’ mean you can still work, live and seem ‘happy’
To recover, you need to think about the different factors of your life – the biological, the psychological and the social – to help work out what makes you unhappy.
First, consider biological factors. How’s your health? Are you going through any hormonal changes, such as the menopause, which could affect your mood? I suffer from an underactive thyroid, which can lead to low mood and anxiety.
Next, move on to the psychological. Think through the traumas you may have experienced that could be affecting your mood now. Take time to consider those that may not be immediately obvious, too.
Lastly comes the social elements. Is anything in your day-to-day life draining you of joy? Are your friends irritating you? Do you like your home?
Now you can begin your recovery in earnest. The route to joy is through finding pleasure in the everyday. Remember the ‘five Vs’: validation, vent, value, vitals and vision.
Validation is crucial. Accept your emotions and you’ll cease to fear them – and, in turn, stop repressing them.
You need to vent, too. Talk about your feelings, write them down, even compose a song about them!
Then remember what brings you value. What makes you feel like your life has meaning? For me, that was creating a community online, sharing my advice with those in need.
Don’t forget your vitals, either. When I was in the throes of HFD, I wasn’t eating properly. Once I paid attention to my diet, choosing brain-loving foods such as salmon and berries, I noticed an improvement in my mental state.
Finally, nurture a vision for future happiness. Always have something to look forward to, however small.
What I’ve learnt through my experience is how damaging it can be to bury your emotions.
My advice? Do yourself the courtesy of learning what it is that makes you happy.
