Are You Living With High Functioning Depression?

Jordan crushes deadlines, always responds to texts, and shows up for everyone. But for months, Jordan hasn’t felt genuinely happy, just exhausted from faking it.

If this resonates with you, you’re not alone. New research shows that depression has increased by 60% over the past decade, with more people than ever facing mental health challenges. Yet depression doesn’t always look the same for everyone—especially when it’s hidden behind a busy, successful life. Let’s explore what high-functioning depression is, symptoms to look out for, and practical ways to get the support you deserve. 

What is high functioning depression?

High-functioning depression describes someone who manages their daily life (work, friends, family) while privately struggling with sadness, worry, or persistent emptiness. Everyone feels sad or down at times, but depression is different. It is persistent and affects how you think, feel, and function.

While “high-functioning depression” isn’t an official medical term in the DSM-5, many healthcare providers recognize it as persistent depressive disorder (PDD), a form of depression that can last years without treatment. The American Psychiatric Association notes that while this term has gained popularity on social media and may help reduce stigma, it’s not a formal medical diagnosis. You might also hear it called “smiling depression” or “hidden depression.”

Who experiences high functioning depression?

High-functioning depression can affect anyone, regardless of their age, gender, or life situation. It impacts people who continue to manage their daily routines while internally struggling.

Maya Nehru, licensed marriage and family therapist (LMFT), explains why it often goes unnoticed. “People with high-functioning depression meet their deadlines, smile and say 'I'm fine,' show up for others. Plus, high-functioning depression can often hide behind success.”

This often makes it hard to spot. In fact, the same skills that help someone function can prevent them from recognizing they need help.

How some celebrities handle high functioning depression 

Many celebrities have shared how they manage depression while maintaining successful careers, showing us that high-functioning depression really can affect anyone.

Lizzo 

Video: Lizzo opens up about depression and healing

Despite her Grammy wins and successful music career, Lizzo has been open about managing her mental health. She describes how talking to someone weekly is “very healing” while she continues to perform and create. 

Dwayne “The Rock” Johnson 

Video: Dwayne Johnson describes his depression

Johnson has shared how he dealt with depression while maintaining his demanding career as an actor, producer, and entrepreneur. He explains that “a lot of times you just wake up blue and you don’t have that choice” but calls vulnerability “your superpower.”

Emma Chamberlin

Article: Emma Chamberlin talks about depression, anxiety, and burnout

The social media influencer and creator describes how depression can feel like “living robotically” and how she tends to “overly discipline myself and I don’t let myself have a lot of fun,” often signs of high-functioning depression while maintaining a successful career. 

Demi Lovato

Video: Demi Lovato talks about their depression and healing

Demi Lovato has been open about managing mental health challenges through their successful singing career. They’ve shared how meditation and inner work helped them find clarity and healing.

Many other famous people have shared similar stories—athletes like Naomi Osaka, musicians like Kid Cudi and Billie Eilish, and actors like Taraji P. Henson and Elliot Page. With an estimated 21 million U.S. adults experiencing at least one major depressive episode each year, these stories show us that successful people can struggle with depression and mental health, too.

Stephanie Gilbert, LMFT, reminds us: “It's important to know that high-functioning depression could happen to anyone and reaching out for help is a sign of strength.”

High functioning depression symptoms

Being aware of some common symptoms can help you recognize when it might be time to seek support. Since many of these symptoms can also overlap with other mental health conditions, such as anxiety disorder or bipolar disorder, only a healthcare professional can provide an accurate diagnosis.

Emotional symptoms:

• Feeling hopeless or worthless

• Sad or low mood most of the time

• Getting annoyed or frustrated easily

• Having difficulty concentrating

• Being hard on yourself

Behavioral symptoms:

• Not enjoying the things you used to love

• Sleeping too much or too little

• Avoiding friends or social events

• Having trouble making decisions

• Feeling unmotivated even when getting things done

Physical symptoms:

• Tired all the time even after sleeping

• Change in body weight or appetite

• Low energy or fatigue

“Depression can hide under overachievement, humor, risky behaviors such as excess partying, risky sexual encounters, reckless driving, excessive drinking, substance abuse, etc. These behaviors may lead the person to emotional numbness,” explains Johana Jimenez, licensed professional counselor (LPC).

Research also shows that people with high-functioning depression had higher levels of trauma and anhedonia—the inability to enjoy experiences or activities that usually would be pleasurable.

The struggle no one sees

Sometimes people can seem “fine” on the outside but are struggling with their mental health on the inside. Nehru captures it like this: “It’s keeping your calendar full so you don’t have to sit with your own thoughts. It’s showing up for others with warmth and humor, and then collapsing in exhausted silence when you’re finally alone.”

The hidden struggle manifests in different ways:

• People don’t want to be a burden and stay quiet.

• People think depression looks a certain way (constantly crying or isolation), but it can be more subtle.

• People hide it well or brush off things as stress or “just life.”

• People may work extra hard to uphold perfectionism while hiding how they really feel.

Why treatment is important

High-functioning depression isn’t an official diagnosis, but it usually describes persistent depressive disorder (PDD). PDD means having depressive symptoms for two years or more. It needs treatment from a mental health professional (doctor, therapist, or counselor). A 2020 study in Germany found that people with PDD have more health problems and life challenges than people with short-term depression.

Without treatment, PDD can get worse. Gilbert explains the risks: “The biggest risk of someone continuing to suffer without treatment is that the symptoms worsen. Specifically, there’s also the concern that someone may experience suicidality, meaning their symptoms are so severe that they are having thoughts of hurting themselves. This is a very serious symptom, and anyone experiencing this symptom should seek help right away, including calling 988 or going to the closest emergency room.”

If you’re struggling with thoughts of self-harm or suicide, call or text the 988 Lifeline for support. The lifeline is free, confidential, and available 24/7, 365 days a year.

How to manage high functioning depression

The first step is recognizing that your feelings are real and important. You don’t have to keep “pushing through” alone. Here are ways that can help:

Professional help

• A therapist can teach you coping strategies through different therapies like cognitive behavioral therapy (CBT)

• A doctor can determine if medication such as antidepressants might help

• Regularly check in with your mental health providers 

“I often work with high-achieving individuals, immigrants, professionals, caregivers, and parents who carry a lot silently,” reflects LPC Jimenez. “In communities where mental health is stigmatized, it can be hard to name the heaviness. Therapy can offer a space to pause, to breathe, and to come back to yourself.”

Take care of yourself

• Move your body regularly (swimming, yoga, walking) 

• Eat regular, healthy meals (fruits, vegetables, whole grains)

• Get 7-8 hours of quality sleep each night

• Spend time in nature when you can

• Practice deep breathing, meditation, or other coping strategies

Stay connected

• Tell trusted friends, family members, or chosen community what you’re going through

• Join support groups and connect with others who understand what you’re experiencing 

• Participate in book clubs, fitness groups, creative classes, spiritual groups, pet-focused activities, or other interest-based groups

• Volunteer for causes you care about or get involved with local or cultural community events 

• Connect with online or social spaces (Discord servers, Facebook groups, Reddit) related to your experience or identity 

Project Healthy Minds is here to help

No matter how well you’re “handling things” on the surface, your mental health struggles are real and deserve support. If you find that you are keeping up with your daily responsibilities and experiencing symptoms of depression, don’t dismiss it as “just stress.”

A mental health professional can provide a proper diagnosis and create a treatment plan tailored to your needs. Check our curated directory for services that may help. Your life matters, your feelings are valid, and help is available. You don’t have to carry this alone.