8 Signs You Could Have High Functioning Depression

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Just because you’re not too sad and listless to get out of bed doesn’t mean you may not be depressed. Here’s what you need to know about high-functioning depression.

You decline social invitations

High-functioning depression looks a lot like chronic low-level depression and can last around five years in adults or one to two years in children and teens, according to the Harvard School of Public Health. And while it may not leave you devastated and hopeless, high-functioning depression can seriously dent your quality of life, dampening your enthusiasm for work, school, family, and even social activities. A change in social activities can be one of the earliest warning signs. “People with high functioning depression still go to work and interact with people, but outside of work, they may stop hanging out with friends, and make excuses like ‘work’s been really stressful,'” says Jason Stamper, MD, a psychiatrist in Pikeville, Kentucky. “They will be somewhat isolative, and this often translates into distance in relationships.” Here’s how to go about connecting with others if you feel lonely.

You have other health issues

This is a two-way street. On one hand, underlying medical conditions can prompt depression. “Co-occurring medical conditions, like diabetes or cancer, cause stress and strain that can lead to depression,” says Michelle Riba, MD, professor of psychiatry at the University of Michigan and past president of the American Psychiatric Association. On the other hand, depression can lower immunity, making you more vulnerable to getting sick. Here’s how to know if it’s clinical depression or just everyday sadness.

You’re sleeping differently

Whether you can’t nod off as easily, you’re snoozing more than usual, or you’re tossing and turning, sleep problems can warn of possible depression—and it can make your symptoms dramatically worse. “Good sleep is key to good mental health,” says Carol Landau, PhD, a clinical professor of psychiatry at Brown University. Adopting these daytime habits will help you sleep better at night.

You’re worried or anxious

We’re so quick to equate depression with sadness that we tend to overlook another strongly linked emotion: anxiety. It’s important to also note that anxiety isn’t limited to fear; it can manifest itself in multiple ways, according to Dr. Stamper. You might experience mental restlessness, confusion, and that feeling of having a “pit in your stomach.” Use these magic phrases to help calm anxiety before it escalates.

You’re relying more on your vices of choice

That might mean drinking more alcohol than usual, taking drugs, eating more ice cream, or playing more video games—whatever behavior serves as an emotional crutch. “If you’re feeling sad or lonely or otherwise ‘off,’ you may drink more wine more often to cover it up,” Dr. Landau says. “This kind of self-medicating is especially troubling because substance abuse adds an extra layer of care that you need.” In addition to being addictive, drugs and alcohol especially can exacerbate symptoms of depression, anxiety and sleep problems, further hindering people’s abilities to cope. Check out the amazing health perks of cutting back on alcohol.

You’re a successful, type A personality

Affluent, educated people are, surprisingly, more likely to have high functioning depression.”The paradox of high functioning depression is that these are very often people who are educated and have important jobs,” Dr. Stamper says. “They have the benefit of education and status, yet often their careers can be huge stressors.” Dr. Landau says she works mostly with women whose lives and list of personal accomplishments is long and impressive. “In some ways, you’re better off as a low-functioning person,” she says, “because high-functioning people often don’t allow themselves to have all the necessary support.”

You’re pretty grouchy

Irritability is another common symptom of high functioning depression, and it’s especially problematic for women, according to Dr. Landeau. “People are more likely to see an irritable woman as a ‘bitch,’ rather than showing concern, like, ‘Hey, you don’t seem the same lately. Are you okay?” she says. Because women are conditioned at an early age to be less assertive and to supress “troublesome” emotions like anger, more subtle symptoms like irritability can be missed. Consider that some one in four American women have been, or will be, depressed at least once in their lives, according to Landau, and irritability may be the chief sign.

You have a family history

Experts agree that knowing your family’s history is essential for predicting and diagnosing depression. Studies show that the more relatives you have who have been diagnosed with mood disorders or drug or alcohol dependence, the more likely it is that you will too. “Knowing your genetics and family history can be enormously helpful,” says Dr. Riba. Life changes and stress can trigger your biological predisposition to depression, so knowing your history can help you not only predict, but shape, your future. Try these natural remedies to boost your mood if you’re feeling low.