Understanding High-Functioning Depression in 2025: Signs, Treatment, and Personal Stories

It’s early Monday morning. I rise at 4:30 a.m., head to the gym, return home, shower, and begin crafting a story due later that day. As my husband stirs, I join him upstairs for a brief chat while he prepares for his day.

Meanwhile, our daughter wakes, singing joyfully from her crib: “Mama!” I gently lift Claire and together we head downstairs to prepare breakfast. We cuddle on the couch, and I savor the comforting scent of her hair as she eats.

By 7:30 a.m., I’ve completed my workout, dressed, worked briefly, kissed my husband goodbye, and started the day with my toddler.

Then, the weight of depression quietly settles in.

The Many Faces of Depression

“Depression manifests uniquely across individuals and personalities,” explains Jodi Aman, psychotherapist and author of You 1, Anxiety 0: Win Your Life Back from Fear and Panic. “Even those who appear highly functional may suffer invisibly.”

According to the 2015 Substance Abuse and Mental Health Services Administration report, approximately 6.1 million U.S. adults aged 18 and older experienced at least one major depressive episode within the past year, representing 6.7% of the adult population. Anxiety disorders affect an estimated 40 million adults, about 18% of the population.

Mental health professionals emphasize that while depression is common, its symptoms and experiences vary widely. It may not be visible to others, highlighting the importance of understanding its diverse impact.

“While depression often suppresses motivation, high-functioning individuals frequently push forward to achieve their goals,” notes Mayra Mendez, PhD, psychotherapist and program coordinator at Providence Saint John’s Child and Family Development Center. “Their drive helps them maintain productivity despite internal struggles.”

Historical figures like Winston Churchill, Emily Dickinson, Charles M. Schultz, and Owen Wilson exemplify how high-functioning individuals can manage depression while excelling in their fields.

Debunking the Myth: Depression Isn’t Something You Can Simply 'Get Over'

Living with depression and anxiety for much of my adult life, I often hear, “I would never have guessed.” While well-meaning, such comments often reflect misunderstandings: “What could you possibly be depressed about?” or “Your life seems perfect.”

Many don’t realize that mental health battles are internal and complex, with sufferers frequently questioning themselves in the same way.

“Depression isn’t something you snap out of or that always stems from a specific event,” says Kathryn Moore, PhD, psychologist at Providence Saint John’s Child and Family Development Center. “Clinical depression can cause profound sadness or hopelessness without external triggers.”

Mendez adds that depression isn’t simply a matter of mindset or positive thinking. “It’s a medical condition involving chemical, biological, and structural brain imbalances affecting mood regulation.”

Common misconceptions include equating depression with sadness or assuming it will resolve without intervention. “Sadness is a natural response to life’s challenges, but depression is persistent and often requires treatment,” Mendez explains. Symptoms include hopelessness, lethargy, emptiness, irritability, and difficulty concentrating.

Personally, depression often feels like observing life from a distance, as if detached from my own experiences. Even when I smile genuinely, a lingering sense of being an impostor remains, akin to the bittersweet feeling of laughing after a loss.

Why High-Functioning Individuals Must Seek Treatment

Moore emphasizes therapy as an essential starting point for those with depression. “Therapists help identify negative thought patterns and habits contributing to depression. Treatment may also involve medication, mindfulness techniques, and mood-boosting activities like exercise.”

John Huber, PsyD, from Mainstream Mental Health, advises stepping outside comfort zones. “High achievers often carry an invisible weight, like running a race with extra pounds. Reducing this burden can involve unplugging from technology, spending time outdoors, or exploring new hobbies. Even crafting has shown benefits for depression.”

From my perspective, openly discussing depression is vital. It may feel daunting at first, but confiding in trusted friends, family, or professionals reveals that many share similar struggles. Speaking out reduces the isolation that often accompanies mental health challenges.

Ultimately, no matter how depression presents, having support makes facing it more manageable.

Looking Forward: Awareness and Acceptance

Despite ongoing research, much remains unknown about mental health. However, it’s clear that depression and anxiety affect countless individuals, making awareness crucial.

Being depressed doesn’t equate to laziness or poor character. While I can accomplish much, I recognize my limits and the importance of seeking help and building a support network.

And that’s perfectly okay.

Caroline Shannon-Karasik’s work has appeared in Good Housekeeping, Redbook, Prevention, VegNews, Kiwi, SheKnows.com, and EatClean.com. She is currently compiling a collection of essays. Learn more at carolineshannon.com or follow her on Instagram @carolineshannoncarasik.

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