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By LifeLine

High Functioning Depression

The Mystery Illness

Depression can happen to anyone, old or young, rich or poor. There are certain traits that we are conditioned to look for, expect and with help can overcome. One member of the mood disorders family is a little harder to identify and sometimes goes by other names like persistent depressive disorder or PDD and dysthymia.

Unknowns are hard to process. High functioning depression can be an elusive diagnosis, but one that is very real. Although high functioning depression or HFD isn’t a clinically recognized diagnosis, its traits are commonly found in other mental illnesses like major depressive disorder (MDD), chronic depression, and clinical depression.

Where teens are involved we see and expect acting out, rebellion, challenging the status quo for behavior. What we don’t expect is a seemingly smooth road with little to no bumps or confrontations.

And though hidden depression can be hard to detect there are several things we can look for.

• Easily irritated
• Bad mood
• Easily triggered frustration
• Overwhelmed easily
• Tearfulness
• Isolation
• Feelings of hopelessness
• Overeating or decreased appetite
• Insomnia or oversleeping
• Lethargy

Identifying persistent depressive disorder is something left to a professional because it can mimic and included other mood disorders. Things they all hold in common are the deterring from normal behaviors, social interactions, and academic or professional performance. Those who normally have involved online interactions may resort to more solitary activities like solo gaming. High functioning depression stands alone, however in that individuals with HFD are better able to mask those symptoms, especially to those who know them best. To the outside world, these teens can appear quite successful and focused, even achieving goals in school and their personal lives.

Severe depression differs from persistent depressive disorder in severity and duration. A severe depressive episode can last up to several months and impede normal functioning like certain responsibilities and personal hygiene and be accompanied by guilt, suicidal thoughts, and behavior.

HFD is usually identified by long term depression where episodes can last up to several years and though isn’t as an intense experience, can actually be more harmful in its cumulative effects.

High functioning depression may also meet the criteria for MDD or major depressive disorder as well and is also frequently accompanied by high functioning anxiety. The rate of HFD and HFA together are near twice the rate in teen girls as in boys, most likely because girls tend to be more in tune with their emotional sides.

By the time the signs of high functioning depression are apparent the extent of the depression can be vast. At this point, the loved ones can be the first line of treatment by securing a professional diagnosis of high functioning depression. In the meantime, there are several ways to treat PDD in teens at home.

Ways to treat High Functioning Depression at home:

Increased Sleep

If your teen is showing symptoms of insomnia, or struggling to get to and stay asleep, or the quality of nightly rest is lacking, improving nighttime routines to disinclude stimulation from devices and or activities that would stir them up.


Exercise can help with mood management and reinforcing good sleeping habits. Physical activity can create natural dopamine and endorphins that encourage improved moods.


Though communication is usually on the more difficult side with teens, it is a fruitful endeavor, and well worth the effort. Learning to create an open space and comfort zone where all topics are welcome is important. Many times children worry about stressing their parents out with their depression symptoms and opt to keep those thoughts feelings and expressions to themselves.


Having specific routines give a measure of comfort and insulation against depression. Knowing they can count on regular events and tasks that are required of them helps to manage emotional waters.


Under the guidance of a professional like those at Lifeline For Youth, medications may be suitable to create stability in order to learn coping skills to better handle situations teens struggle with. Mood charting printouts and journaling can assist your teen in tracking ups and downs that may become a little more vague with high functioning depression. This can help tailor the individual program towards a high success rate and optimum outcome.

What they're feeling is REAL

Often someone who contends with the persistent depressive disorder will feel as though their symptoms aren’t serious enough to be classified as “real” depression or not severe enough to warrant intervention.

Low self-esteem and feelings of unworthiness can often prevent PDD sufferers from seeking help.


Avoiding help may nudge teens to find their own ways of dealing with depression. This can often find them resorting to controlled substances like alcohol or recreational drug use. It is important to monitor behaviors that may indicate suicide contemplation. Very often those with hidden depression will give very little indicators that they are dealing with extreme sadness and inner turmoil and will catch people completely unaware if an attempt at suicide is made.


Possible Suicide Indicators

Hygiene habits and lack of self-care (including sleep habits) are a sign of a depressive state and should be monitored closely. Changes in toiletry habits can especially indicate depression, rather than just learning to care for oneself on a regular basis.

Changes in eating habits outside of fluctuations caused by growth spurts are something to watch as well. Often hidden depression can cause weight loss and weight gain without trying.

A prominent indication of suicidal thoughts in teens with depression is finding new homes and owners for their important or cherished belongings and possibly working up a type of will.

If you notice these behaviors please don’t hesitate to contact emergency services immediately. The National Suicide Prevention Hotline can be reached at 1-800-273-8255 and can be reached by texting “START” to 741-741 as well as an online chat option at

Call us today

If you think your teen might be suffering from high functioning depression or any other type of depression, please give us a call today. Trained professionals at Lifeline For Youth can answer your questions, and provide solutions to fit every individual.

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