When someone has a mental illness such as depression and suffers from addiction simultaneously, this is called dual diagnosis or a co-occurring disorder. Those with dual diagnoses commonly resort to using drugs and alcohol to cope and end up developing a dependency, eventually leading to addiction. This is especially true for people with high- functioning depression.
Vice versa, those with an addiction to drugs and alcohol commonly suffer from some sort of mental illness. As a result, treatment and recovery at a rehab facility such as Granite Mountain Behavioral Healthcare in Prescott Valley, Arizona is the best option for living a high-quality life and maintaining sobriety.
Our addiction specialists have created this guide to help you or a loved one effectively recognize the signs of high-functioning depression, and erase the stigma surrounding mental health. Know that help is available before it is too late.
Table of Contents
What is High-Functioning Depression
If you looked up the term high-functioning depression in the DSM-5, the diagnostic manual used by psychologists and other mental health professionals to diagnose their patients, you wouldn’t find it under that name. This is because the official name for high-functioning depression is persistent depressive disorder (PDD).
Also known as Dysthymia, PDD is more common than people think, as there are more than 3 million cases annually in the United States. Diagnosed more in women than men, dysthymia is defined as a chronic, high-functioning form of depression, meaning it is continuous and lasts long-term. This type of depression is a lot harder to spot. While people may think of depression as the common term, it is the word “persistent” that is the focus keyphrase.
Further evidence-based research conducted by the American Psychological Association (APA) shows, that approximately 14.8 million American adults or about 6.7 percent of people aged 18 and older in the United States suffer from a depressive disorder in a given year.
Since dysthymia is classified as chronic, and not acute, suffers from this mental disorder may experience symptoms for many years before actually being properly diagnosed.
This further proves the point, that individuals suffering from high-functioning depression, who are often good at suppressing their problems often believe that the “depression” or sadness they are feeling is just part of who they are. Thus, missing the realization that what they are actually experiencing may be more severe than they originally let on.
This also explains why depression sufferers seem to hesitate in discussing with doctors, family, or friends about how they feel, as they say, they feel “fine.” Although, it is common for people with mental illness or substance abuse issues to feel embarrassed to come forward and admit they may have a real problem, and most importantly, that they need help.
However, it is crucial to understand all the ins-and-outs of both high-functioning depression and addiction, in order to effectively recognize the signs, symptoms, and risk factors of these co-occurring disorders.
What Makes Someone “High Functioning?”
As mentioned before, people who are classified as “high functioning” often do anything they can to give the impression that they have got it all together, that their lives are going very well and everything is normal. While this may be true and convincing, deep down, sufferers of depression are unwell, and constantly fighting to keep it together and survive each day at a time.
People with high-functioning depression tend to be happy, successful, intelligent, friendly, outgoing, and disciplined people. While this may be true and convincing, deep down, sufferers of this mental illness are not fine, and constantly fighting to keep it together and survive each day at a time.
Living With Persistent Depressive Disorder
Have you ever known a person who has it all; a loving family, a great job, and a decent social life? While in-person or on social media it may look like their life may be happy and perfect, the answer is nothing is perfect or always what it seems.
In fact, scientific studies have shown that the more someone appears to have it all together, it is more likely that they are going through something, but trying their best to hide it. The saying, “Be nice, because everyone is fighting a battle you know nothing about,” never rings truer. This scenario paints a picture of someone suffering from persistent depressive disorder.
Living with this type of depression is difficult, and those who do are internally plagued by negativity, and a dialogue of self-doubt. This makes people feel insecure, incompetent, and unworthy. People with this type of depression can live their daily lives, but it truly enjoying every day comes with constant challenges.
In other words, as everyone is different, a typical good day for a person with high-functioning depression looks like an individual who doesn’t have depression. This type of depression causes bad days to outweigh the good, unfortunately. While it may take only an hour or two for other people to focus and complete their tasks, those with severe depression may have an extremely hard time focusing.
Co-occurring Conditions: High-Functioning Depression and Addiction
High functioning depression and addiction go hand-in-hand, which is why it is extremely important to know the signs of both disorders so you or a loved one can get the necessary help. People who suffer from depression are twice as likely to suffer from addiction and are usually able to function well. Although, PPD and addiction are difficult to manage without professional help.
At least three-quarters of patients with dysthymia also have a chronic physical illness or another psychiatric disorder, such as drug addiction, or alcoholism. It is very common for people with PDD to have an addiction to drugs and alcohol. High-functioning depression impacts people’s lives in various ways. As a result, it causes sufferers to rely heavily on coping mechanisms, commonly drinking alcohol or using drugs.
Coping With Depression: Substance Abuse
Approximately 50 percent of people with a substance use disorder, such as alcoholism or drug addiction, are considered high-functioning. This number speaks volumes. While these people are considered to have PDD, behind closed doors, oftentimes, because they are depressed, they turn to the use of drugs and alcohol as a means to try and self-medicate and cope with their symptoms.
Vice Versa, some people are addicted to drugs and alcohol first, and then develop an onset of depression symptoms later on because of damage to the brain caused by long-term substance abuse.
No, I Can’t Just “Get Over It”- Depression vs Clinical Depression
According to the World Health Organization (WHO), while anxiety disorders are the most common mental illnesses in the United States, the prevalence of depression is not far behind, as more than 300 million people worldwide suffering from the disorder.
Defined as a mood disorder, depression is a mental illness known to cause a persistent feeling of sadness and loss of interest. Depression has many faces and a variety of different kinds. The most common types include:
- Seasonal Depression:
- Major Depressive Disorder
- Postpartum Depression
- Situational Depression
- Atypical Depression
- Psychotic Depression
The most popular type of depression affecting people today is major depressive disorder commonly known as clinical depression. It is extremely important to note, that there is a key difference between depression and clinical depression.
Someone who is not diagnosed with a certain type of depression, but is “depressed,” experience normal bouts of sadness that arise from certain situations that occur. This is called Subsyndromal symptomatic depression (SSD), meaning that a person is depressed, but their symptoms don’t meet the criteria for a diagnosis of a major depressive episode.
When you are suffering from high functioning depression the things that used to bring you joy often become things that you want to avoid. Clinical depression, however, is severe, where an individual is depressed for a couple of weeks or more, and it affects their ability to function, such as think, feel, sleep, work, eat, and handle daily tasks. The National Institute of Mental Health (NAMI) states that in order to be diagnosed with some sort of depression, the symptoms must be present for at least two weeks
Signs and Symptoms of High-Functioning Depression
If you or a loved one has been experiencing the following symptoms, either most days or every day for at least two weeks or more, this may be a sign that you are suffering from depression. NAMI states that the most common signs and symptoms of depression include the following:
- A feeling of hopelessness or negativity
- Persistent sadness, anxiousness, emptiness
- Thoughts of death or suicide, or attempt to commit suicide
- Loss of interest in favorite hobbies and activities
- Feelings of guilt, worthlessness, or helplessness
- Lack of energy and focus
- Fatigue and restlessness
- Difficulty remembering things
- Difficulty sleeping (Insomnia) and waking up in the morning
- Extreme changes in your appetite and weight
Not everyone who is depressed experiences all of these symptoms mentioned above. Everyone and their cases of depression are different, and therefore, their symptoms and treatment for the illness will vary. For example, some people may experience a few symptoms, while others will experience many. An individual’s symptoms may also depend on the stage of depression that they have.
Diagnosing High-Functioning Depression: An Invisible Disease
Truth is, for people living with high functioning depression, it is often hard to tell because these are the types of individuals who are high achievers, perfectionists, and who are experts at making you think everything is all right even when it is not.
The point is, you would never know that the person right in front of you is suffering from depression because they appear to be functioning normally.
In order to be diagnosed with depression, an individual must have a severe inability to function in life. This is why so many with PDD go undiagnosed. They appear to be functioning, but once they finish work or any other task, they immediately head home to be in isolation. Since functioning inabilities are not as bad for a person with PDD as they are for someone with major depression, this behavior can last for a very long time.
It’s even possible for someone with PDD to develop more severe symptoms that result in episodes of major depression when their symptoms are left untreated. This is why it’s important to seek treatment if you suspect that you or someone in your life may be suffering.
Just like any type of dual diagnosis, high functioning depression and addiction often go unnoticed and undiagnosed. Essentially, it is deemed an invisible disease. Navigating through life without getting help for a mental illness is not only dangerous, but it causes complications such as the likelihood of relapse and increases the risk of overdose and suicide.
How to Treat High-Functioning Depression and Addiction
High-functioning depression and addiction can be effectively treated in a safe environment using methods of detoxification, behavioral therapy, medication therapy, and other evidence-based therapies for these disorders. Detox helps with a physical dependency on drugs and alcohol, while behavioral therapy addresses the root of the problem and helps identify the reasoning behind why you are depressed to help you overcome it.
Those who need help and treatment for co-occurring disorders such as PDD and addiction can receive it in an inpatient rehab facility, monitored by trained addiction specialists. Treatment programs that last a minimum of three months (90 days) are recommended for patients with a dual diagnosis.
Ending the Stigma Surrounding Mental Health
While the stigma surrounding mental health is starting to improve, there is still a lot of work to do, and some dangerous myths to debunk. Depression is severe and persistent, and not something someone can just get over or shut off automatically.
Granite Mountain is Here to Help
If you or someone you may know is suffering from signs of high-functioning depression and addiction, the addiction specialists at Granite Mountain Behavioral Healthcare are here to help you recover and maintain sobriety. Contact us today at (877) 389-0412.