High-functioning depressive disorder is a diagnosable type of depression that is more accurately called Persistent Depressive Disorder, or PDD.

An important characteristic of major depression is that the symptoms are severe enough to make functioning in daily life difficult to impossible. It can cause someone to struggle with school and work, to maintain relationships, to be able to socialize, and even to leave the house or keep up with basic cleaning and hygiene.

With PDD, on the other hand, a person experiences milder symptoms of depression and as a result is still able to function.

For anyone observing someone with PDD it may seem as if they have it all together and are doing well. But, on the inside, a person with PDD is struggling, feeling sad and hopeless, suffering from low self-esteem and lack of energy, and often just going through the motions of doing the most basic things needed to function.

Just going through the motions is no way to live, but the good news for those struggling with PDD is that it can be effectively treated to reduce symptoms, boost mood, and improve daily functioning. The first step to getting good treatment is to get an accurate and professional diagnosis. A psychiatrist or other mental health professional uses criteria laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose this condition:

• A depressed mood that lasts most of the day, most days, for two years or more
• At least two symptoms when in a depressed mood: changes in eating, changes in sleep, low self-esteem, lack of energy, difficulty concentrating, and hopelessness
• No relief from the depressed mood for longer than two months during a two-year period
• A degree of distress or impairment caused by the depressed mood

The above criteria are used to diagnose PDD, but only if these symptoms cannot be caused by another mental illness or medical condition.

While it is easy to justify not getting treatment for this condition because of the ability to function normally, basic functioning is not enough. Someone with high-functioning depression lives with a near-constant, low level of depression for long periods of time. They may function, but it is a daily struggle. Good treatment can boost mood, improve functioning, restore some of the joy to life, and improve overall quality of life. Without treatment, this condition will not get better.

Treatment can also minimize or prevent some of the potential complications that high-functioning depression can cause in a person’s life:

• Difficult relationships, lack of close relationships, and social isolation
• Chronic pain and other illnesses
• Poor performance at work or school
• Other mental illnesses, including major depression
• Suicidal thoughts, behaviors, and attempts

At Bridges to Recovery, we help select coping mechanisms that work best for each individual, such as meditation, exercise, and creative activities. We facilitate practicing these strategies so clients can continue to use them when they return home after treatment. Clients may participate in group therapy sessions or in support groups to connect with others who are also suffering.

While medications play an important role in managing high-functioning depression, the best treatment includes therapy. We provide access to several different types of therapy provided by experts who have experience in compassionately guiding you through your healing process. Every client is different and treatment plans are individualized. The types of therapies we use to treat depression include:

• Individual psychotherapy. One-on-one psychotherapy is the classic type of talk treatment that helps you explore your emotions and experiences that underlie negative feelings and behaviors. Individual therapy is an essential component in treatment for high-functioning depression.
• Cognitive Behavioral Therapy (CBT). CBT is a very effective and commonly used therapy to treat high-functioning depression. This type of therapy helps patients retrain their thinking patterns and change their actions, helping them overcome their fear of social situations. Group and family therapy are also provided in residential treatment.
• Relational therapy. High-functioning depression can wreak havoc on interpersonal relationships. Relational therapy can help you learn how your relationships, life experiences, and emotions are all connected and take steps to develop healthier relationships.
• Family therapy and education. Therapy that involves your family may be a great way to help educate the people most important to you about your social depression and about how they can best support you.
• Trauma-focused therapies. If a traumatic experience is an underlying or contributing cause of your high-functioning depression, we offer therapies that will specifically focus on processing and reframing these traumas to help you improve your symptoms.
• Acceptance and commitment therapy (ACT). ACT focuses more on accepting unhelpful negative thoughts as they are, rather than trying to replace them with positive thoughts. The aim is to teach people living with high-functioning depression to cope with negative thoughts and feelings better instead of replacing those thoughts and feelings.
• Relaxation and mindfulness techniques. Alternative and holistic therapies may also be used to treat high-functioning depression. Most commonly, meditation, yoga, and exercise are employed.

The prognosis for those suffering from high-functioning depression is excellent. With a commitment to the residential treatment process, as well as other factors like social support after treatment, it is possible to achieve lasting change.