Someone who can’t stop crying and who’s feeling hopeless?

Or would you envision a popular, college-educated professional living it up in the big city with a great job, a good group of friends, and a long list of accolades to her name but who wakes up each morning with a gripping sense of anxiety and an internalized pressure to continue to be “perfect” and “keep it all together”?

Would you picture a successful Millennial startup employee who you admire for his discipline and drive but who inwardly is devastatingly self-critical and relentlessly demanding on himself and who, after work, copes with his life with a drink or two and several hours of gaming?

And would you picture that smiling, competent, friendly coworker of yours who always seems to be getting All The Things done but who secretly, inwardly feels like she’s a complete failure and fears time is flying by and she’s wasting it every day?

Let’s face it: you’re probably not going to picture these folks.

And yet each of them could be a perfect example of someone dealing with what’s come to be known as “high-functioning depression.”

While high-functioning depression *doesn’t* look like the stereotype of depression most of us hold in our heads, this diagnosis nevertheless carries significant risks if left untreated.

But the uniquely tricky thing about high-functioning depression is that it’s hard to spot precisely. Because the people dealing with it look, from the outside, like they’re holding it all together.

This can lead to a lack of ability to self-identity (or have those around you identify you) as depressed. And, moreover, a possible resistance to seeking treatment because of the stigma surrounding more “typical” depression.

And this is a big problem.

So in today’s blog post, I want to explain to you what high-functioning depression really is. Walk you through 11 signs of high-functioning depression and how this may show up. Explain the unique risks associated with high-functioning depression. And share more about how you or your loved ones can get the help you need. Especially if you identify with high-functioning depression.

What is High-Functioning Depression?

In my opinion as a psychotherapist, high-functioning depression is a pop psychology term for what’s clinically known as dysthymia.

Dysthymia, according to the Diagnostic And Statistical Manual of Mental Disorders 5th Edition* (DSM 5), is a mental health disorder characterized by:

“Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years.” AND, includes the presence of two or more of the following symptoms. “Poor appetite or overeating; insomnia or hypersomnia; low energy or fatigue; low self-esteem; poor concentration or difficulty making decisions; feelings of hopelessness.”