When we think about suicide, the typical image is a depressed individual unable to get out of bed in the morning. However, there is a different profile of those living and working with high-functioning suicidality. While high-functioning suicidality is not a clinical term, it is linked to people who suffer from persistent depressive disorder, also known as dysthymia, and high-functioning depression.
Understanding the signs and symptoms of high-functioning depression is important because any depressive disorder increases the risk for suicide exponentially.
Persistent Depressive Disorder
High-functioning depression is not a diagnosis found in the Diagnostic Statistical Manual for Mental Health Disorders (DSM). It was previously referred to as “dysthymia” in the DSM-IV. Dysthymia is a type of depression characterized by a depressed mood lasting for at least two years.
Persistent depressive disorder (PDD) replaced dysthymia in the DSM-V. PDD, or high-functioning depression, is often difficult to detect because the individual is able to maintain a job, family, and social relationships. However, PDD can significantly impact an individual’s quality of life.
Signs and Symptoms of PDD
When someone is diagnosed with PDD, or high-functioning depression, their symptoms can fluctuate in frequency and intensity. Typically, symptoms do not abate for more than two months at a time.
In order to be diagnosed with PDD, a depressed mood must be present for at least two years. In addition to a depressed mood, the individual must have at least two of the following symptoms:
- Disrupted appetite. Individuals with PDD typically overeat or do not get adequate nutrition.
- Problems with sleep. People with PDD often have insomnia or hypersomnia.
- Low energy. PDD leads to low energy levels and extreme fatigue.
- Poor self-image. Individuals with PDD display low self-esteem.
- Poor cognition. Individuals struggle with concentration and focus.
- Hopelessness. People with PDD have little hope for change.
High-functioning depression or PDD usually first occurs during childhood, adolescence, or early adulthood and manifests as subtle changes in a person’s mood. It can be challenging to detect because it is less severe than major depressive disorder. Its subtle but persistent nature can make the condition feel like it’s an individual’s everyday baseline mood.
Another hurdle in diagnosing PDD is that about 75% of people living with PDD will also experience a major depressive episode. This is referred to as “double depression.” After the major depressive episode ends, most people will return to their usual high-functioning depression symptoms and feelings rather than feel symptom-free.
While there is no known cure for PDD, treatments can help manage the symptoms and improve quality of life. Early diagnosis and treatment are essential for managing the condition and preventing it from worsening.
Effective Treatment for High-Functioning Depression
Without treatment, symptoms of persistent depressive disorder may worsen over time. Therefore, it is essential to intervene as soon as possible to prevent functional impairment.
Treatment for PDD is very similar to treatment for major depression and typically includes the following:
Doctor-prescribed antidepressants such as SSRIs are typically taken to rebalance the chemicals naturally found in the brain. The specific type of antidepressant chosen by the doctor often depends on other medications taken and any personal preferences or allergies one may have. Some types of antidepressants can take up to a month to start to work. Missing doses or stopping some antidepressant medications abruptly can cause withdrawal reactions or worsen persistent depressive disorder, so taking medication as prescribed is important.
Psychotherapy is a type of treatment for depression that involves talking with a mental health professional. This form of therapy can help people with persistent depressive disorder by allowing them to talk about their condition and related issues. Psychotherapy can also help people understand their thoughts and feelings, which can lead to positive changes in mood and behavior. In addition, psychotherapy can provide support and guidance during difficult times. There is no one-size-fits-all approach to therapy, and an effective treatment plan will be tailored to the individual suffering from high-functioning depression.
While persistent depressive disorder is primarily treated with medication and psychotherapy, many people find holistic lifestyle changes helpful. A healthy diet and regular exercise have been shown to improve symptoms of high-functioning depression, and they have the added benefit of being suitable for overall physical and mental health. In addition, making social connections and finding ways to reduce stress can lessen symptom intensity and duration. Each person will respond differently to treatment. However, making lifestyle changes is often an excellent place to start when trying to manage high-functioning depression.
The Phoenix Recovery Center
At The Phoenix Recovery Center, we offer multiple levels and modalities of treatment for persistent depressive disorder, suicidal thoughts, and help for suicidal ideation. Our levels of care include residential treatment, partial hospitalization (PHP), and intensive outpatient treatment (IOP). Our skilled staff examines each individual case to create person-centered, comprehensive treatment plans.
While the onset of high-functioning depression is often subtle, there are some early warning signs that may be indicative of the condition. These can include feelings of sadness or emptiness that last for two weeks or longer, low energy levels and fatigue, difficulty concentrating, problems with sleep, changes in appetite, and feelings of worthlessness or hopelessness. If you or someone you know is experiencing these symptoms on a consistent basis, it is important to seek professional help. High-functioning depression can be difficult to diagnose because it is often compounded by a major depressive episode. Treatment is essential for managing the symptoms, preventing suicide, and improving quality of life. You are not alone and help is available.
For more information on high-functioning depression or persistent depressive disorder and effective treatment options, call The Phoenix Recovery Center today at (801) 438-3185.