How to recognise the more subtle signs that someone might be struggling, and exhibiting high-functioning depression
Depression doesn’t always announce itself with sadness or tears. In fact, its manifestations can be frustratingly subtle and easy to overlook. With one in six adults in the UK experiencing moderate to severe depressive symptoms, it affects individuals from all walks of life, and transcends age, gender, and socioeconomic boundaries. From high-achievers hiding behind a veneer of success to the elderly living with loneliness, depression can lurk in the shadows.
Appearances can be deceptive
We have to move away from this idea that people ‘look depressed’ based on their external appearances, like their hair, makeup, or clothes. While changes in grooming can hint at shifts in mental wellbeing, they aren’t foolproof. People may keep up appearances while silently struggling, making superficial cues unreliable.
With that said, a dip in personal hygiene is one thing to look out for, as sometimes the idea of showering and doing laundry can feel like too much to face. There can be physical changes too, such as weight gain or loss. Putting on weight might be perceived as a bad thing (due to societal expectations), which can affect a person’s confidence and further exacerbate low mood.
On the other hand, weight loss may be praised by onlookers. Una Archer, a therapist at Harley Row Clinic, explains: “A person who is suddenly thin might get complimented on their new physique. This could lead them to feel at odds if they feel unwell, but are told they look great, ultimately leading to self-doubt and low self-worth.”
There is also a link between physical health and depression. Una says: “Along with mood symptoms, a depressed person might feel generally run down in their body, and have body aches, pains, or even numbness in parts of their body.” This means that an unexplained flare-up of existing conditions, such as headaches, stomach issues, or chronic pain, could be linked back to depression.
Behavioural changes
People with depression often feel they have to wear a mask to fit in, and doing so takes an immense amount of energy. Therefore, the prospect of another day ‘faking it’ in social settings can lead to cancelling plans, failing to respond to messages, and generally cutting themselves off from friends and family. To make things worse, this avoidance can often be accompanied by feelings of guilt.
While these external behaviours might not seem like a big deal, they are really just the tip of the iceberg, and don’t represent the intense inner turmoil and the emotional toll depression can take on an individual.
This means that even when someone is continuing with their daily routine and seemingly positive behaviours, we’re not privy to the underlying emotional experience.
“For example, a keen swimmer who usually always feels better after a swim might notice that their low moods don’t shift despite keeping up, or even increasing, their exercise regime,” says Una.
“To an outsider, this person appears as if they are coping and achieving. They are carrying on life ‘as usual’, and even could be viewed as thriving as they pursue fitness goals. However, inside the swimmer feels very different.”
Mood swings
Similarly, it can be easy to get reactive when someone acts in a way that seems out of character, which stops you from seeing the warning signs of depression. Unexplained irritability or mood swings can make you avoid someone who is struggling, and the changes in productivity might lead to further conflict. So, if you notice a colleague’s work begins to slip, or your flatmate suddenly lacks the motivation to do their share of the housework, there could be a deeper issue at play.
They may continue to function in a way that looks normal from the outside, and might be performing well at work and maintaining seemingly positive habits such as exercise and eating well, yet underneath there is a cocktail of symptoms bubbling away. This is sometimes described as ‘high-functioning depression’, as it can be tricky to detect while the person masks how they’re really feeling to keep up with day-to-day expectations.
Communication is key
It’s important to encourage open communication around depression, as hard as it may feel for everyone involved. Because of the ongoing stigma around mental illness, conversations are often steeped in shame, with the person affected worried about being judged, or feeling like a burden to friends and family. Whether a loved one seems to be functioning well, or is masking their struggles, approaching them with unconditional acceptance creates a safe space for open dialogue. Remember, the swimmer who appears to be thriving externally may be battling inwardly.
Begin by expressing genuine concern and a willingness to listen. Avoid judgmental language and aim to create an atmosphere of empathy, trying not to dismiss the other person’s experience with phrases like ‘things could be worse’.
Remind them that it’s OK to admit to feeling upset, and to have bad days. This normalisation and acceptance will pave the way for more open discussions and, hopefully, practical steps towards getting help.
Empower yourself by understanding depression beyond the surface. Explore resources like happiful.com, podcasts, and books that discuss the nuances of depression. Knowledge is a powerful tool to break down the stigma surrounding mental health. When it comes to your own mental health, try to act as a compassionate witness to your emotions, and trust in your own experience, even if you don’t exhibit all the tell-tale signs.
“If you notice depressive symptoms that last more than a few weeks, or don’t respond to your typical coping mechanisms, it might be time to check-in with a professional,” says Una.
If your strategies and support networks aren’t working as they used to, remember it’s OK to ask for help. Seeking professional support is not a sign of weakness, but a proactive step toward healing.
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