FOR THOSE WE CANNOT SEE – High functioning depressives

It may seem hard to imagine, but amongst us live high achieving people who suffer from chronic depression. It is not easy to detect, and often quite difficult to diagnose because the symptoms are not presented publicly. This continuing, low-level of depression is called dysthymia.

This type of depression is not as severe as the debilitating major depressive disorders, but certainly causes disablement in function and a decreased ability to enjoy life. The first step in increasing the quality of life is to get a valid diagnosis and seek appropriate treatment. It is not something you simply have to strong-arm yourself through with mere willpower.
 
It is the kind of illness that hides behind the ability that facilitates achievement or accomplishment. The person continues to function well. Often the individual struggling with these feelings will have a difficult time realising that living with these feelings are not normal, or necessary. Treatment has the potential to alleviate a depressed mood, measurably increasing daily functioning, help the person to have a more positive expectations and to increase the general quality of life.

Typically the high functioning depressive will be able to rise on time in the morning for their demanding, high level job, be able to maintain a romantic relationship to varying degrees, be able to maintain friendships, and generally be able to adult successfully. All of these behavioural patterns are visible within the invisible capsule of a depressed mood.

In evaluating the quality of your emotional life, there are a few very general ways in which these symptoms can present themselves. When we experience fairly constant negative thoughts we tend to avoid quiet and restful times. During these times our thoughts have potential to become evident and this is unpleasant. Therefor the person will experience a drivenness to remain busy, even if exhausted.

When people have inescapable depressed thoughts, a fairly constant experience of self-doubt tends to be present. They seem to experience uncertainty in many aspects of their lives without clear indication that something is wrong or inappropriate. Doubtfulness might arise regarding career, partners, life course, creativity, determination and a spectrum of other contexts.

Guilt and worry are familiar bedmates with depressive thoughts. The depressed person will most probably have regular feelings of worry over a wide variety of life circumstances. These feelings of worry can span from the past, into the present and project into the future. The person might also feel fairly constant guilt regarding minor setbacks and mistakes in their lives.

High functioning depressives will usually relate that joy certainly was part of their lives at some point. They can identify times and activities that brought a genuine smile to their faces and feelings of elation being experienced. These same situations now bring no high spirits, in actual fact these very familiar situations now feel like chores or obligations to be avoided.

With the lowered emotional capacity that comes hand in hand with depressive thoughts, higher levels of testiness, irritability and higher emotional arousal is often present. The person usually has insight into the inappropriateness of the reaction to the stressor. An anger outburst that follows a less than disastrous life event is usually indicative of lowered, compromised emotional capacity and mental ability.

During times of good physical health our daily energy levels should be sufficient to cope with the regular demands that life require of us. High functioning depressives report a diminished level of energy that is not due to physical illness, increased life demands or lack of sleep. They often report feeling exhausted before the day has started and that they dread trying to get through the day. They do however get up, get going and get more depressed.

Life happens to all of us and we all have events that bring sadness into our lives. Mostly sadness dissipates when we then move on to what is positive and what we feel great for. With the high functioning depressives these feelings of sadness returns regularly and appears as soon as they relax or are not consciously busy with activities. These thoughts of sadness might, or might not, be related to a specific event, but is present far more regularly than their absence. The sadness is generally experienced with elusive feelings of hopelessness, difficult to relate to life experiences.

These constant low-level feelings of depression can become overwhelming in terms of the self-esteem of the person. In order to understand these unexplained and ofter unjustified emotions, the person can develop a pattern of self criticism. Their inner voice is constantly telling them the something is wrong, therefor their attempts at living effectively are failing. They feel the failure internally and become ven more critical. This thought pattern can be projected onto others and soon this critical way of living becomes apparent when they become very critical of the people around them.

The high functioning depressive might have a number of insights into their functioning already. They might not have found the correct diagnosis, but they usually know that something is wrong. In order to fix what is wrong, they can, inadvertently, fall into perfectionism in terms of living a life that attempts to avoid all that is wrong. This creates deep and relentless tension. The feedback to self and others can be harsh and remains their endeavour to avoid feeling worse about themselves.

The first step to a better life would be to deal with the potential shame of admitting that you are depressed. The degree of your depression should be determined by entering into a process with a health professional. The treatment protocol varies in terms of the extent and depth of your symptoms. Regular follow-up and re-evaluation of your symptoms can lead to a life where you could possibly live symptom free for most of the time.

JF

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