High-Functioning Depression: 5 Misconceptions and Ways to Challenge Them

Depression is a common mental health condition. Globally, almost 6% of adults cope with the condition.¹ In the US in 2021, it affected around 14.5 million adults aged 18 and older. That’s almost 6% of all US adults. But not all these people received treatment.² 

Depression isn’t always obvious. For some people, the vortex of hopelessness and low mood doesn’t prevent them from completing their daily tasks. It also doesn’t stop them from acting like everything is fine. These people are living with high-functioning depression, also known as “smiling depression” or “hidden depression.” 

Unfortunately, high-functioning depression is sometimes seen by others as “not that bad” or simply just a personality trait. But being able to function day to day does not mean that depression is any less severe. And there are other misconceptions that circulate, often preventing people from seeking support.

If you’re concerned that you or someone you care about is dealing with depression – in any form – it’s important to reach out for support. Depression doesn’t go away on its own, and when left untreated, can worsen. 

In this blog, we’ll talk about depression as a whole before focusing on the misconceptions about high-functioning depression and discussing how to find support.  

Depression – An Overview

Depression is a serious psychological illness that can be extremely difficult to cope with, for both the person with it and those who care about them. It also typically requires professional help, as the symptoms don’t resolve on their own. But it can get better with support. 

What Are the Symptoms?³

Feelings of worthlessness, emptiness, and hopelessness, along with trouble concentrating and not enjoying things you used to, are indications that someone might be dealing with depression. For a diagnosis of depression, the symptoms need to last at least 2 weeks.⁴ 

It’s worth noting that symptoms can show up in different ways, with men and women showing the signs differently. For instance, women tend towards sadness and guilt while men tend towards anger and frustration.⁵ 

Why Does Depression Develop?

Depression is complex and multifaceted, so it’s not fully known why it develops in some people and not others. However, there is a genetic link, as someone is more likely to develop it if they have a family member with it. It’s also associated with stress and physical health problems. Also, if you’ve started taking medication for a condition and start noticing depressive symptoms, it might be worth checking the side effects list.^6,7

What Is High-Functioning Depression?

High-functioning depression can be difficult to identify, both by the person with it and their friends and family. And it’s for this reason that it’s also known as “hidden depression.” For instance, people with the condition might seem to be able to function at home and work, but internally they are feeling very similar to people with more obvious depression.⁴

High-functioning depression isn’t a formal diagnosis by itself, but because it’s a form of depression in disguise, it can lead to a delayed diagnosis, which can make it more difficult to treat. So if you feel like something isn’t right, it’s worth reflecting on why this might be the case.

Further, the term “high-functioning depression” is not ideal. For instance, it might encourage the view that you should be able to see the manifestation of depression for it to be “real.”⁸ 

The key difference between someone with high-functioning depression and someone with clinical depression is the ability to continue with work and family life.¹⁰ But the impact on energy levels can still be enormous – with simple tasks feeling like a huge effort that can lead to exhaustion and maybe even burnout.^11,12

Well-hidden symptoms can be difficult to recognize, so detecting HFD symptoms in someone else can be difficult. And while they feel the same internally as others with major depression, someone might distract themselves from symptoms by keeping busy or withdrawing emotionally.¹⁰ Additionally, symptoms could develop so slowly that someone might not notice them creeping in.^4,12 

Further, it’s important to be aware that myths about high-functioning depression could perpetuate stigma and prevent someone from seeking much-needed support. So it’s important to recognize what these are to allow us to challenge them.

5 Common Myths About High-Functioning Depression

The following are common myths that people can have about high-functioning depression:^8,13,14

1. “People With High-Functioning Depression Are Just Exaggerating Their Depressive Symptoms”

These people have depression and need support, just like anyone with any form of depression. They deserve better than just about scraping by – with the right help, they could figure out how to thrive again.

2. “High-Functioning Depression Is Just Mild Depression”

Symptoms of high-functioning depression can be mild or they can be severe. However, the key is that someone with it is able to keep up with daily demands, even if it is a struggle to do so. 

3. “People With High-Functioning Depression Seek Help Straight Away”

People with high-functioning depression are unlikely to seek early support as they feel they’re coping (insofar as they are meeting daily demands). They are, therefore, less likely to be on medication or under the care of a therapist. They may not speak to anyone about how they feel, either.

4. “It’s Easy for People With High-Functioning Depression to Tell People They’re Finding It Hard to Cope”

People with high-functioning depression are less likely to talk about it since they may feel there is nothing wrong with them, even if they are finding it hard to cope. They may even feel embarrassed and question the significance of their symptoms.

5. “If Someone Is Coping, They Must Not Have Depression”

This is not true. HFD symptoms can be as severe, but people with it may seem to be coping day to day. They might even have developed certain coping strategies to allow this to be possible. However, they may be more prone to self-harming behaviors in attempts to find a release for their emotions.

Coping With High-Functioning Depression: What Can You Do?

Awareness – of yourself and others – is critical to overcoming the challenges associated with hidden depression. Not everyone with depression will have the same symptoms; some will be able to maintain a façade while others cannot. 

If you’ve noticed a change in someone’s patterns, chat with them about it and see if they’re OK. They might not open up, but the conversation might be enough to get them thinking. Similarly, if you notice any changes in your own habits, reflect on why. Are you masking anything to make it seem like you’re alright? Try to be honest with yourself – there’s no shame in finding it hard to cope. 

If you’re worried that you or a loved one might have high-functioning depression, the best thing to do is seek help. The first step, as for any mental health condition, is to identify the problem.

Therapy for High-Functioning Depression

Once you’ve recognised that something might be wrong, this is when to seek professional help. The earlier you seek help, the better. 

There are various types of therapy that can help with depression, including:^4,9

• Cognitive behavioral therapy, which targets and challenges negative thought patterns that can feed into depression
• Psychodynamic therapy, which examines how past experiences could be influencing current feelings and patterns
• Interpersonal therapy, which considers how relationships may be affecting mood and ways to improve communication patterns
• Acceptance and commitment therapy (ACT), which uses the principles of acceptance and mindfulness to cope with difficult emotions
• Mindfulness therapy, which encourages a focus on present awareness. This involves really being in the moment and experiencing it, rather than thinking about “what ifs” and negative past events.
• Online talk therapy, which promotes self-improvement to help people develop healthy habits

If a clinician diagnoses you with moderate-to-severe depression, they might prescribe you antidepressant medications.⁷ These drugs improve depression symptoms by adjusting the balance of neurotransmitters in the brain to regulate mood.⁷ However, antidepressants can take time to work – weeks or even months.⁷ They can also have side effects like dry mouth, tiredness, and nausea.²⁰ It’s also good to know that medicines typically work best in conjunction with talking therapy.

Additionally, since getting professional help can take time, you could start thinking about things that could help you cope in the meantime. For instance, talking with friends and family about how you’re feeling and asking if they’ve noticed changes in your behavior can be useful. You could also try the following strategies to help ease symptoms. 

Strategies to Manage Hidden Depression

Look after yourself. Be kind to yourself. Remember you’re not alone. Practise self-care, even though it will probably be the last thing you want to do. For example, you could…

• Exercise: This doesn’t have to be a long run or calisthenics. Do as much as you feel capable of. For example, you could do a few yoga poses or some stretching. Alternatively, you could take a walk outside in nature – there’s a lot of research to say that walking in nature can help your mental health.^15,16
• Eat well: You don’t have to give up the treat foods you enjoy. But you could try replacing a few unhealthy options with a healthier, less processed alternative.^11,17 It’s also a good idea to avoid (or at least reduce) alcohol intake. Alcohol might give you a moment of respite, but it can make you feel worse in the long run as it’s a depressant.
• Socialise: This doesn’t necessarily mean partying. It means keeping up with close relationships with family and friends. Connect with the people who care about you and perhaps talk with them about what you’re feeling.¹⁸ Remember, your close loved ones might see that something is bothering you and could feel lost and helpless about how to help. Giving them insight could offer everyone involved some relief.¹⁹
• Challenge perfectionism: Remember that it’s OK not to be OK. Depression is not a sign of weakness, so you don’t always have to function at your best. Remind yourself that you can drop the facade. 

Mission Connection: Professional Support for Depression in Disguise

Depression affects many people around the world, and everyone shows the condition in different ways. Some might outwardly snap at others and feel angry, while others may turn inwards and withdraw. The first step is recognizing that something has changed – in yourself or someone close to you – and starting a conversation to consider what could be happening. Seeking professional help is an important step on the road to recovery. 

Mission Connection is here to help if you’re finding it hard to cope with your mental health. We offer a variety of specialized evidence-based mental health therapies that can support the mind and body, helping you challenge depression and figure out how to thrive. 

Reach out to our team today if you’re ready to start supporting your mental health. Relief often starts with a simple phone call.

References

1. WHO. (August, 2025). Depressive disorder (depression). https://www.who.int/news-room/fact-sheets/detail/depression
2. National Institute of Mental Health. (July, 2023). Major Depression.https://www.nimh.nih.gov/health/statistics/major-depression
3. MDCalc. DSM-5 Criteria for Major Depressive Disorder. https://www.mdcalc.com/calc/10195/dsm-5-criteria-major-depressive-disorder 
4. Stanborough, R. J. (May, 2021). How to Recognize and Help Someone with Hidden Depression. Healthline. https://www.healthline.com/health/depression/hidden-depression. 
5. WebMD. (October, 2024). Understanding Depression Disguises. https://www.webmd.com/depression/depression-disguises
6. Calm. (November, 2021). High-functioning depression: what it is and how to manage it. https://blog.calm.com/blog/high-functioning-depression
7. Gupta, S. (November, 2025). Can You Have ‘High-Functioning’ Depression? Verywell Mind. https://www.verywellmind.com/high-functioning-depression-causes-symptoms-and-treatment-5324550.
8. McCullars, A. (March, 2025). Dispelling Misconceptions About High-Functioning Depression. Anxiety and Depression Association of America. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/misconceptions-high-functioning-depression
9. Pallarito, K. (September, 2025). What Is High-Functioning Depression? Health. https://www.health.com/condition/depression/high-functioning-depression
10. Cleveland Clinic. (May, 2024). What Is High-Functioning Depression? Signs and Symptoms. https://health.clevelandclinic.org/high-functioning-depression
11. Torres, M. (March, 2025). 5 Work Habits That Are Secretly Depression In Disguise. Huffpost. https://www.huffingtonpost.co.uk/entry/5-work-habits-that-are-secretly-depression-in-disguise-goog_l_67c09264e4b09bdae0098d37
12. Joseph, J. F., Tural, U., Joseph, N. D., Mendoza, T. E., Patel, E., Reifer, R., & Deregnaucourt, M. (2025). Understanding High-Functioning Depression in Adults. Cureus, 17(2):e78891. https://doi.org/10.7759/cureus.78891.
13. McCullars, A. (2025, March 27). Dispelling misconceptions about high-functioning depression. Anxiety and Depression Association of America. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/misconceptions-high-functioning-depression
14. Okereke, P. U., Umeh, C. V., Okereke, W. O., Ndayambaje, E., Obetta, C. C., Uzor, O. F., & Oduola, O. J. (2025). High-functioning depression: A hidden burden demanding clinical recognition. BJPsych Bulletin, 1–3. https://doi.org/10.1192/bjb.2025.10193
15. Mental Health Foundation. Nature: How connecting with nature benefits our mental health. https://www.mentalhealth.org.uk/our-work/research/nature-how-connecting-nature-benefits-our-mental-health
16. Jane, C. (September, 2025). Depression in Disguise. Medium. https://medium.com/illumination/depression-in-disguise-5c621ccf964a
17. Vandenabeele, P. (September, 2025).  High-functioning depression. Do you know the symptoms? Bupa. https://www.bupa.co.uk/health/health-insurance/understanding-health-insurance/high-functioning-depression.
18. Robinson, L. (February, 2026)  High-Functioning Depression. Helpguide. https://www.helpguide.org/mental-health/depression/high-functioning-depression.
19. Malusovski, M. Coping Strategies For High-Functioning Depression. Nurseline Community Services. https://nurselinecs.co.uk/depression/coping-strategies-for-high-functioning-depression/
20. Mind. (September, 2020). Antidepressants. https://www.mind.org.uk/information-support/drugs-and-treatments/antidepressants/side-effects-of-antidepressants/#WhatSideEffectsMayBeCausedByEachTypeOfAntidepressant.