"I'm Fine": The Hidden Weight of High-Functioning Depression

I have a close friend who likes to joke that she comes from a “dual-dysfunction family.”  Her mother was a “high-functioning alcoholic”, while her father was a “high-functioning depressive”.  In the decades I have known her, she has done a lot to evade her mother’s fate.  She rarely drinks.  She doesn’t keep alcohol in her home.  She does not drink alone.  Recently, she stopped at two beers during an afternoon hangout on the

sofa and called it “overindulgence”.  Being alert to her gene pool has helped her to evade that side of the family history, but the depression side of the dual-dysfunction was harder to dodge.

As a highly educated woman who owns her own home, takes vacations, loves her pets, and has a meaningful career with a lot of autonomy, she is a successful, fulfilled person.  She has achieved a lot, and there is profound satisfaction and contentment in that, but her mental health doesn’t always let her believe it.  

Depression can present in many forms.  For some, it is a devastating crash that just pulls the rug out from under them and takes hold before they really know it has begun.  For others, it is a long, slow process of weaving in and out of days that feel “meh” and days that feel overwhelming, rarely encountering a day that feels “good”.  People equate depression with sadness.  I like to describe it more as watching paint dry in high humidity, tedious, not very interesting, and devoid of emotional variety.

When I work with clients who are both high achievers and people with depression, one of their greatest frustrations is that others do not believe them when they talk about having depression.  It is possible for someone to earn six figures at a job they love and have depression.  It is possible for someone to work out five days a week, track their macros, and be in the best shape of their life and have depression.  It is possible for someone to be pregnant with the child they have always longed for and have depression.  It is possible to be on a dream vacation and have depression.  Somehow, our cultural narrative doesn’t accept that. 

My friend has always been a person who forges ahead and just keeps going.  She overcomes obstacles.  She course corrects when life goes in an unexpected direction.  She is resilient and resourceful.  She doesn’t always let herself enjoy that or celebrate it.  I see the emotional barriers for her, that desire to push into something deeper, lighter, and more joyful.  Medication has improved her functioning, therapy has given her tools and meaning, and finding a job where she is valued has provided peace and consistency.  There are still days when she wakes up and doesn’t care about most of it.  She just wants to put a pillow over her head and not engage.  There are still moments when she shows up anyway and “fakes being okay”, until she can go home, cuddle her animals, and stare at the wall until she finds the energy to go to bed.  The next day is often better, but sometimes it isn’t.  The unpredictability of that is often the load that is carried with high-functioning depression, and it is often the part that others don’t want to acknowledge.  When my friend tells me she is feeling depressed, I always believe her. 

Written by: Deanna Diamond, LPC