What is functional depression?
Functional depression is an informal term that designates a “milder” form of depression. It is difficult to detect in affected people.
Since functional depression is not an official diagnosis, there is no clear definition of it. Some specialists claim that it is the colloquial name for dysthymia.
It is a condition characterized by symptoms such as insomnia or hypersomnia, fatigue and hopelessness, for at least two years.
Others believe that depression, like many other mental illnesses, exists on a spectrum: from severe depression to moderate and high-functioning depression.
One thing is certain, however: the term “high functioning” refers to the ability of affected people to function as normal. Their academic or professional performance does not suffer.
Despite the absence of a clear and universally accepted definition for functional depression, this term has gained more and more popularity in recent years. Perhaps one reason is that functional depression defies stereotypes about depression. Most of us, if asked to describe a person diagnosed with depression, would imagine a person who does not get out of bed, unkempt, unsociable, slow.
The reality is that depression, like other mental illnesses, manifests itself differently in different people. Sometimes apparent success and happiness can hide great suffering. The concept of functional depression validates the experience of those people who, although they are perfectly integrated in society and fulfill their duties successfully, are deeply unhappy.
What are the signs of functional depression?
In functional depression, the symptoms are not fundamentally different from those of normal depression. But usually these are more subtle. Also, some people with functional depression tend to deny the severity of their symptoms. They don’t accept that there could be anything wrong. That is why it is very important to know what the warning signs are, to be able to recognize them in those around us and in ourselves.
Here are the main signs that you may have functional depression:
1. Difficulty enjoying yourself (anhedonia)
Anhedonia is the inability to feel pleasure when doing activities that we used to enjoy. It can manifest as a lack of interest; passivity; emotional flattening; the feeling that the world no longer has color. Eventually, it leads to social withdrawal, refusing to go to events or meetings with friends and family.
2. Tendency to criticize excessively (self and others)
An inner critical voice may arise that is harsh with both you and those around you or the world in general. It may say things like:
- “you are good for nothing”;
- “who cares, there’s no point, life has no meaning”;
- “my bosses/colleagues/friends/partner are idiots”.
Most of the time, you have no control over this voice and you even end up believing it.
3. You consistently doubt yourself
Suddenly, you’re questioning every decision you’ve ever made.
You often ask yourself the following questions:
- if you have the right career;
- if you should break up with your partner;
- if you will ever be able to have a fulfilled life.
These doubts end up occupying a large part of your thoughts and overwhelming you, but you can’t ignore them.
4. Low energy
If you constantly feel like you’re climbing a mountain while carrying a bag of rocks, or that you simply have no energy and zest for life, you should take these signs seriously. If you find yourself frequently making excuses like “I’m having a stressful week at work” or “It’s because of daylight savings”, you should ask yourself if you’re in denial.
5. Excessive irritability or anger
Depression is associated with a state of lethargy and passivity. So it may seem surprising that anger characterizes functional depression. But as mentioned before, functional depression is different from the clinical diagnosis of depression. So, if you happen to have tantrums triggered by little things (your child breaks something, your life partner says something inappropriate), it may be a sign.
6. Generalized state of sadness
If you feel sad without being able to identify a specific cause and this emotion has come to dominate your inner life, it may be an indicator of functional depression. However, most people with this condition will hide this sadness. This contributes to the feeling of isolation and the pressure to always pretend.
7. Inability to stop and take a break
You are always on the go, busy, running from one meeting to another, replacing work at the office with work at home, and you avoid stopping and resting. You don’t feel comfortable when you slow down. That’s because you’re afraid of the unpleasant thoughts that may arise if you take the time to listen to them. If you find yourself in this description, you may be suffering from functional depression.
8. You strive for perfection
Of course, some would argue that in the highly competitive world we live in, we are all engaged in the race for perfection. However, there are people who take perfectionism to unhealthy extremes. If when everything doesn’t work out perfectly, personally and professionally, you are very affected and punish yourself (insult yourself; deny yourself certain things), ask yourself why.
9. Feelings of guilt and worry about the past and future
We all sometimes replay embarrassing moments from the day at the end of the day when we’re trying to fall asleep. Worries about the future are also normal, especially when it is uncertain. Surely these are universal human experiences.
In the case of those with functional depression, they take over their mental space. If you feel shame, guilt, or worry constantly, even about minor things, consider getting evaluated by a mental health professional.
10. The smallest things seem very significant
In other words, you look like you’re exaggerating. Things that wouldn’t have affected you before (a friend cancels a date; your phone screen breaks; you’re late for work) now seem like the end of the world. You get overly stressed and upset about the events that trigger these negative feelings.
The trap of functional depression
At first glance, functional depression is a milder, almost benign form of clinical depression. People with this type of depression manage to keep their jobs, even be successful, continue to be good parents and have a social life. The paradox, however, is that it is this very ability to function as if they are perfectly healthy that keeps affected people from receiving specialist help, support and compassion. Clinical depression is a condition that is often seen on the outside, through latency in speech, spontaneous bouts of crying or emotional flattening, blank stares, carelessness. Functional depression is usually an inner suffering, well camouflaged and hidden from both those around and the affected individuals.
Functional depression tends to occur mostly in highly motivated, perfectionistic people who believe they can do anything they set their minds to. This belief can lead them to believe that depression is just an obstacle that they can overcome on their own. So they do not seek the help of those close to them, nor of specialists. This can lead to deterioration of their general condition, until they reach major depression or suicidal thoughts.
It is important to understand that although it seems like a mild affection, functional depression must be taken seriously and treated by a specialist, just like major depression.
Treatment
As mentioned before, people with functional depression seek the help of specialists much less often than those with major depression. Many of them either deny what they feel and find excuses or justifications. Many times they do not consider that they could be the signs of a mental condition, but an existential crisis.
For people with major depression, family and friends are sometimes the ones who convince them to see a doctor. But for people with functional depression, this rarely happens, because usually no one notices that something is wrong. So, the step of going to a mental health professional is the first and most difficult step to healing.
Treatment is similar to that of major depression, consisting of psychotherapy or antidepressant medication, or a combination of the two. Unlike major depression, progress can be slower, and harder to notice, as the general condition is not greatly altered. So it takes patience and persistence to achieve beneficial and lasting results, and to prevent relapses.
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