7 signs of depression you may not notice in high-functioning person

A person may continue working, meeting deadlines, maintaining relationships and even appearing cheerful, while privately struggling with what they are going through.

1. Everything feels like an effort

High functioning depression is a popular term used for those who seem to be functioning well – meeting deadlines, socialising, managing relationships, doing all their chores, and generally seem all put together and successful – while privately struggling with depressive symptoms.

Think of it as a duck that seems to be gliding around peacefully on the surface of the water but is paddling furiously under water to be able to do just that.

Ms. Ritika Aggarwal, Consultant - Psychologist, Jaslok Hospital & Research Centre said, "Everything feels like an effort: While they may continue functioning, ordinary tasks seem to require disproportionate mental energy"

Dr Kedar Tilwe, Consultant - Psychiatrist, Fortis Hospital Mulund and Fortis Hiranandani Hospital, Vashi said, "Difficulty in maintaining focus : Concerns with concentration leading to uncharacteristic errors or decrease in performance is commonly seen and can frequently be noticed by colleagues and peers."

2. They appear constantly busy

Dr Aggarwal said, "They appear constantly busy: Staying occupied tends to become a way to avoid uncomfortable thoughts, emotions, or silence where thoughts could increase"

For some people, staying busy can become a way of coping with uncomfortable thoughts and emotions. From the outside, this may simply look like productivity or ambition, making the underlying distress harder to notice.

Dr Darshan Yallapa Jotibannad, Consultant Psychiatrist, SPARSH Hospital, Infantry Road, Bangalore said, "Others try to manage by being overly busy and perfectionistic or controlling. Work and success can provide temporary relief from their distress, but being always too much can mask serious underlying emotional stress."

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3. They may feel emotionally numb or lose interest in what once mattered

Dr Aggarwal said, "They may feel emotionally numb: You may notice it with sentences like “I don’t feel much anymore”, or find that things they once enjoyed, no longer gives them the same enjoyment or feeling of purpose – it may feel like one is on auto-pilot"

Dr Tilwe said, "Decreased interest in previously pleasurable activities: Lack of interest in hobbies or self-care and mental wellbeing activities that the person previously enjoyed is an often-seen sign."

Dr Jotibannad said, "An individual can keep going to events and carrying out activities that no longer make them happy. These can include hobbies, relationships, food, physical activity or accomplishments."

4. They become more irritable

Depression does not necessarily show itself in terms of visible signs of sadness.

Dr Jotibannad said, "Depression does not necessarily show itself in terms of visible signs of sadness. These emotions can range from frustration, irritation, anger, to hypersensitivity to demonstrate the level of emotional overload being experienced."

Dr Aggarwal said, "They may feel unusually irritable or impatient: Chronic emotional strain can show up as frustration, anger outbursts, or irritability"

5. Their sleep pattern changes and rest doesn't feel restorative

Tilwe said, "Sleep cycle changes : Difficulty in falling asleep especially due to constant worries can be noticed easily by spouses and loved ones."

Dr Jotibannad said, "Lack of sleep may cause bad sleep quality or may lead one to wake up while asleep. Sleep deprivation may also be defined as the problem of insomnia. Their industriousness makes them unaware about their problem."

Dr Aggarwal said, "Rest doesn’t actually feel restorative: In spite of going on holidays, sleeping in, spending time recharging, they may still feel exhausted, mentally overloaded, and unable to switch off"

6. They withdraw in subtle ways and say “I’m fine”

Dr Jotibannad said, "They Withdraw in Subtle Ways

Rather than withdrawing entirely, they might gradually stop making plans, have shorter conversations, avoid calls or be emotionally distant. While their schedule may seem fine, their relationship to other people may be waning."

Dr Aggarwal said, "They may often reply with “I’m fine” even while they’re withdrawing: They may stop sharing what they’re experiencing, avoid difficult conversations, decline invitations on the pretext of being busy, or insist they don’t want to burden others with their problems."

Dr Tilwe said, "Sudden social withdrawal: A sudden withdrawal from social commitments or decreased interactions with friends and relatives is often an indicator of concerns. Often another indication also may come from decrease in social media use , increased doomscrolling, or even alarming status updates that the person posts."

7. Their self-talk becomes negative

Dr Jotibannad said, "They Speak Negatively About Themselves

It is very important to pay attention to such phrases as “I am a burden,” “Nothing really matters,” or “They would all be better off without me.” Although it may sound funny, there is an element of hopelessness under all these phrases."

Dr Aggarwal said, "Self-talk has quietly become harsher and more negative: In spite of functioning well, they may be having thoughts like, “I’m failing”, “I’m not doing enough”, “I can’t keep this up”, etc"

These changes may be easy to overlook precisely because the person continues to function.

It’s important to remember that high functioning is not the same as having good mental health, and one doesn’t need to “look depressed” to be struggling.

How to respond

Dr Jotibannad said, "It’s not safe to judge that an individual is fine simply because he or she looks fine from the outside. Ask relevant and concerned questions like “you seem tired. How are you doing?” Listen attentively without trying to solve everything, minimize the person’s feelings or compare him/her to another person."

If symptoms continue, if there is poor health status left for a certain time, or if the person has issues of everyday life and living in general, seek the help of a psychologist, psychiatrist, or another type of specialist.

Dr Aggarwal said, "And if the above changes are persistent, worsening, or starting to affect sleep, relationships, work, day-to-day functioning and well-being, consider consulting a mental health professional rather than waiting for it to become a crisis situation."

Suicide prevention starts from recognizing things that other people fail to notice. A person might look fine, be productive and even smile but actually be suffering. Sometimes, reaching out might seem like a little thing, yet this act alone might be the start of help.

Sometimes, presence without judging might allow a suffering person to talk about his/her secret feelings.

Discussions on suicides can be triggering for some. But suicides are preventable. If you are looking for help, some suicide prevention helpline numbers in India are 011-40769002 from Sanjivini (Delhi-based, 10 am - 5.30 pm) and 044-24640050 from Sneha Foundation (Chennai-based, 8 am - 10 pm), +91 9999666555 from Vandrevala Foundation (Mumbai-based, 24x7).