What Does It Mean to Be High-Functioning in Depression?

• Symptoms
  • What are symptoms of depression?
• Types
  • What are the types of depression?
• Causes
  • What causes depression?
• Treatment
  • How is depression treated?

Although not a clinical term, high-functioning depression is a phrase often used to describe a form of depression that may be less debilitating than others.

Depression ranges from mild to severe, and in many cases can impair the ability to function. With high-functioning depression, depressive episodes may be milder or allow a person to live a relatively “normal” life.

People with depression may experience symptoms including:

• Low energy
• Low mood
• Lack of interest, also called anhedonia
• Sadness or depressed mood most of the day and nearly every day, also called dysphoria
• Guilt and feelings of worthlessness
• Decreased activities
• Concentration and attention problems
• Decreased or increased appetite
• Significant weight loss or weight gain
• Restlessness and lack of sleep
• Suicidal thoughts

• Major depression: The person stays depressed most of the time for most days of the week.
• Persistent depressive disorder or dysthymia: The person stays depressed for more than 2 years. Symptoms are generally milder than those of major depression.
• Bipolar depression: The person has alternating periods of depression and mania (feeling extremely high in energy).
• Premenstrual dysphoric disorder: Many women experience depressive episodes before their menses.
• Seasonal affective disorder or seasonal depression: Depression mainly occurs during the fall and winter seasons and the symptoms go away during the summer and spring seasons.

• Low levels of the following
  • Serotonin: Associated with satisfaction and feeling good
  • Dopamine: Associated with drive and motivation
  • Norepinephrine: Associated with energy
• Hypothyroidism
• Chronic diseases
• Emotional events such as loss of a loved one
• Genetics (mutation in serotonin transporter gene, CREB1 gene, on chromosome 2)
• Drugs such as:
  • Beta-blockers
  • Oral contraceptives 
  • Methyldopa
  • Barbiturates
  • Interferons

Treatment of depression generally involves psychological counseling and medications. Medications may include:

• Selective serotonin reuptake inhibitors (SSRIs)
  • Fluoxetine
  • Escitalopram
  • Citalopram
  • Sertraline
  • Paroxetine
• Dual acting antidepressants (serotonin and norepinephrine reuptake inhibitors or SNRIs)
  • Desvenlafaxine
  • Venlafaxine
  • Duloxetine
• Tricyclic antidepressants
  • Amitriptyline
  • Nortriptyline
  • Desipramine
• Atypical antidepressants
  • Mirtazapine 
  • Trazodone
• Mood stabilizers (mainly used in the treatment of bipolar depression)
  • Lithium
  • Lamotrigine 
  • Valproate
• Benzodiazepines (used for anxiety and sleep disorders)
  • Clonazepam
  • Diazepam
  • Alprazolam

Withdrawal symptoms are most commonly seen in people taking medications for depression. When medications are suddenly stopped, withdrawal symptoms may include:

• Headache
• Dizziness
• Nausea
• Vomiting
• Restlessness
• Sleep disturbances
• Agitation

To prevent withdrawal symptoms, do not stop taking any medications or change doses without consulting your doctor.