Depression has many faces, and high functioning depression is one of them, which can have serious consequences if not addressed and treated. While many mental illnesses are severe enough to impair a person’s ability to function. In some cases, a mental illness may be less severe, and although a person experiences symptoms, they are still able to function normally (or almost normally) most of the time.

The signs and symptoms of high functioning depression are similar to those caused by major depression but are less noticeable, which is why you should be looking out for them. Here are some clear signs and symptoms that can indicate whether you’re suffering from high functioning depression or not.

Depression affects all personalities and can look very different in various people. High functioning depression, officially called persistent depressive disorder (PDD), is the real deal, however it can be difficult to detect in oneself, and even more so in others.

To the outside world, a person with PDD seems completely fine but internally, that person is struggling. This can lead some to think that high functioning depression is not as ‘serious’ as major depression, but it should be diagnosed and treated, just like any other mental illness.

High functioning is not the same as fully functioning—with this type of depression there is still some impairment. When someone is able to function but still experiences significant symptoms of depression, that’s what is called PDD. Previously, this mental illness was called ‘dysthymia’ and is sometimes still referred to by that term.

High functioning depression is a recognised mental health condition that should be diagnosed by a psychiatrist or other mental health professional. There are certain criteria that describe the symptoms and that need to be met for a precise diagnosis to be made. Many of the symptoms are similar to those used to diagnose major depression.

An individual suffering from PDD experiences a depressed mood most days and for most of the day, for a minimum period of two years. The depressed mood must include two or more of these symptoms: lack of energy and fatigue, insomnia or oversleeping, decreased appetite or overeating, difficulty concentrating and making decisions, lowered self-esteem, and feeling sad and hopeless.

In addition to these symptoms that cause a depressed mood most of the time, there are a few other criteria that have to be met to make a diagnosis of PDD. The symptoms mentioned above must be felt on most days for at least two years without any relief from depression for longer than two months during that period, otherwise, you might just be having a rough few months.

If the individual has been through a period of mania or hypomania, an unusually euphoric and energetic mood, then this might not be PDD. You should also be careful whether these symptoms of depression aren’t better explained by a different mental illness, a medical condition, or by substance abuse.

Finally, the symptoms and depressed mood mentioned previously must cause some impairment in one or more areas of normal functioning and significant distress in the individual. Only after ‘meeting those criteria’ will you be able to confirm whether you’re suffering from high functioning depression. And even then, you may also meet criteria for major depression.

You’re feeling down most of the time, and no matter how many times your friends and family refer to you as grumpy or gloomy, you simply can’t shake it off. When you do feel happy, it doesn’t last long. You feel tired all the time, whether you’ve slept enough or not. You’re not lazy, but people might assume so just because you can’t summon the energy needed to function normally. You manage to do everything you’re supposed to do, like go to work, keep your flat clean and force yourself to interact with others just enough, but it always seems like a monumental effort.

You feel bad about yourself, and judge the way you look or the way you behave. You gain or lose weight without meaning to, because you either have no appetite or overeat without thinking about it. You may cry without an obvious reason sometimes. At work, you do your best but focusing on a task is a real challenge. PDD can result in substance abuse, chronic pain, relationship difficulties, and problems at work or school.

Trust me, it can. While PDD may not be as severe or debilitating as major depression, no one should have to live with a constant low mood when effective treatments are available. First things first, you’ll need to get a diagnosis before even thinking about medication. As easy as that sounds, realising that your symptoms are actually clear signs of a mental illness is the hardest part. PDD hides behind your ability to function. That’s exactly when loved ones need to guide and support you, they could have the highest chance in recognising that something is wrong.

Once diagnosed, high functioning depression can be treated with a combination of therapy and medications. Antidepressants can help but they can take several weeks to work, and beware of their side effects. This means that you might have to try a few different types to find a medication that works best for you.

Therapy is also a major help when treating PDD. By teaching you ways to recognise negative patterns in your thoughts and actively change them, therapy can be the first step towards ‘recovery’ in many cases.

Getting help is essential, because treatment (both through therapy and sometimes medication) can make your life more enjoyable, improve your mood and your functioning. It can bring you a better quality of life. Battling with a mental health condition is often done internally, but that doesn’t mean you shouldn’t reach out for external help, it’s there for you.

Mental health has a lot of stigmas attached to it, and for many of us, speaking out freely about our struggles can be difficult. Somehow, over the years, young people started looking for comfort through memes on social media, which allow them to speak about their concerns with a little more ease. But why is it that, for many of us, it is easier to share our issues through jokes and humour?

Instagram is a paradoxical place. It is no secret that social media platforms are immensely harmful to our wellbeing, and, surprise, surprise—according to a study conducted by the Royal Society for Public Health in 2017, Instagram was proven to be the worst social media platform for our mental wellbeing. There are endless reasons for this, be that the constant anxieties of ‘keeping up’ or comparing ourselves to others.

But users on Instagram are slowly changing the scene, all the while trying to make the platform a better place—whether it’s influencers taking a pledge to be more transparent, or people advocating for Instagram to remove the ‘like’ feature. The platform also serves as a home to an ever-growing online meme community, one that is driving the conversation around mental health, and de-stigmatizing it one meme at a time. 

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Mental health is a heavy topic, but it doesn’t have to be. “I think there is a lot of great support and conversation, but it is on a more serious tone. And while I think that is necessary, I also think that the seriousness and the weight of it sometimes add to the pressure and the stigma of the illness itself,” @thementallytrillest told Screen Shot. @thementallytrillest is one of the few Instagram accounts prompting the conversation around mental health, through funny, witty and self-loathing memes.

Cori, perhaps better known as @manicpixiememequeen, started her meme account as a way to cope with her own struggles. In 2017, she was experiencing some mental health issues, and her uncle had just tried to commit suicide. “I did what any other person would do: I made an anonymous ‘finsta’ to shout my personal problems out to the void of the internet in the form of memes. The creation process made me feel productive, rather than feeling like I was wallowing or pitying myself,” she told Screen Shot. “@manicpixiememequeen has given me so many incredible opportunities to generate discussion about mental health,” Cori added. She went on to speak at Stanford University, and she even had several therapists message her, thanking her for posting the memes. “Some of their patients have used my memes to start a conversation in private sessions,” Cori explained.

For some members of the older generations, memes do not carry as much cultural significance as they do for the new gen. Of course, depicting our personal struggles through memes may seem like an unconventional coping mechanism, but when it comes to mental health, our generation is the most outspoken one. Memes make difficult conversations easier to have—somehow seeing somebody go through the same struggles as you, and still be able to laugh about it makes you feel like you can relate to people, and in the end, it makes you feel a bit better.

“Mental health issues can feel and be incredibly alienating, and memes that address these issues help people feel less alone and may even encourage them to speak and seek help,” Alia, also known as @memesturbationation on Instagram, shared with Screen Shot. She explained that memes not only help her process her feelings, but help her acknowledge them as well. And this ability to feel less isolated, and to relate to other people online is what creates such a wonderful community, one that is safe and welcoming, and one that uses memes as a unique language for today’s century, driving the growing conversation around mental health.

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Odie, known as @not.yr.boyfriend online, has been ‘meming’ since early 2016, and has built a helpful community since then. The purpose of their work is to “embody the work I am doing on myself and in my community.” They explain that they wouldn’t describe their account as a mental health page, but instead as a project of self-work that aims to shift humanity towards a culture of accountability. Memes have the potential to drive a conversation and shift opinions, be that for political or social reasons, meaning that disregarding them or the work that meme creators do would be unfair.

And yet, memes about mental health are still met with a lot of criticism. For example, @memesturbationnation previously received some criticism for her work, accusing her of romanticising and trivialising mental health, to which she responds “I think that’s bullshit. It’s just more people trying to shame and silence those who experience mental health issues. I’ve received way more messages thanking me for sharing my experience with mental illness through memes.” Is it really fair to silence creators who predominantly create a safe space as a coping mechanism of their own, and who are helping so many people online?

Mental health is a sensitive subject, and it is understandable why some people don’t engage with memes depicting subjects of their personal struggles. But Instagram can be used as a tool that many people use to reach out to others who are experiencing the same thing, to let them know that they are not alone, and to show and receive support. The beautiful thing about meme pages on Instagram is how many of them there are. Be it astrology memes, political memes, art memes or mental health memes—there is content for everyone, and a community for all. Mental health meme pages on Instagram are a reminder that it’s okay not to be okay, and they’re accessible for everyone, at any time.