We’re often advised to ‘check in on the strong friend, too’. There’s a good reason for this- people who are struggling don’t always look like they’re struggling.
There is a tendency to judge one’s mental health by how functional they are. However, one can be depressed while still carrying out family responsibilities, going to work, attending social obligations and even making others laugh. Functioning does not equate to feeling well.
Beneath the surface, the same person may be constantly exhausted, experience consistent low moods, feel hopeless, cry in private and feel no joy in anything.
A person with high-functioning depression may:
- Get dressed and show up to work despite feeling depleted
- Meet their professional and family responsibilities as normal, except it feels much harder and takes a lot more effort than is evident.
- Show up for everyone else but fail to take care of themselves.
- Appear cheerful socially, while feeling disconnected on the inside.
- Lose interest in things they previously enjoyed, and may on occasion, still participate out of obligation to others.
- Experience chronic fatigue, struggle with concentration and with decision-making.
- Feel more irritable than usual.
- Sometimes withdraw.
- Feel guilty for struggling because they ‘have no reason to be depressed’.
- Have difficulty relaxing, because being busy helps them avoid dealing with the emotions.
The way depression presents differs for everyone. Psychologists do not consider how functional someone is in order to diagnose a depressive disorder. What we do consider are the symptoms, the duration of the symptoms, the severity, the distressed experienced and the impact on different areas of their lives.
It can be difficult to spot high-functioning depression in a loved one, but here are some signs you can look out for:
- If they are noticeably more tired without obvious reasons
- If they appear emotionally absent while being physically present
- If they appear to be unusually pessimistic or irritable compared to their usual temperament.
- If they begin to withdraw
- If they brush off concern with ‘I’m just tired’ or ‘I’ve just been busy’, when you suspect there is more to it.
A single sign is not an indication that someone is depressed, but persistent changes in mood, behaviour, sleep patterns, appetite and joy for life should be given more attention. This is especially if this continues for weeks and is impacting on some aspect of their life.
A simple check-in can make a world of difference. We sometimes hesitate when we don’t have the right words or if we’re uncomfortable with emotions ourselves. Just reach out authentically – e.g. ‘I’ve noticed that you’ve been a lot quieter recently and I wanted to check in and see how you are actually doing?’
You don’t need to have the answers, offer solutions or try to cheer them up. You just need to listen. Create a safe enough space so they feel comfortable to share authentically. If you don’t know how to help, you can assist with facilitating professional support.
If you are that strong friend, remember that you do not have to carry it alone. Don’t wait until you are falling apart before reaching out for help.
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