Symptoms of High-Functioning Depression

Symptoms of High-Functioning Depression

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High-functioning depression isn’t an official diagnosis, but you could be experiencing symptoms of persistent depressive disorder.

“Why do I always feel sad? I can’t shake this funk I’m in.”

If you’ve ever said this to yourself, you’re not alone. Worldwide, more than 264 million people experience symptoms of depression.

But maybe you can still go to work, maintain relationships, and go about your daily responsibilities — even if something doesn’t quite feel right. Some people call this “high-functioning depression.” Do you relate?

While some use the term high-functioning depression, this isn’t a medical diagnosis. It can also be misleading since there isn’t an actual list of symptoms for it.

On top of that, this term can contribute to some stigma surrounding depression.

Many people use the term high-functioning depression, when what they’re actually describing is persistent depressive disorder (PDD), previously called dysthymia. So when we talk about symptoms of high-functioning depression, we’re usually talking about symptoms of PDD.

Since high-functioning depression isn’t a diagnosis, it doesn’t have set symptoms. But persistent depressive disorder does, and it’s often what people mean when they talk about high-functioning depression.

But what is PDD? While it has some symptoms similar to major depression, it might feel like you’re skirting just under the line of a depression diagnosis. You may feel:

  • tired
  • low energy
  • irritable
  • restless
  • foggy

Low-level depression

Some people might consider this mild depression (rather than severe). Your depressed mood is present for at least 2 years, and lasts most of the time, for most of the day.

With PDD, you might experience feelings of depression more often than you don’t. You may feel sad a lot but just can’t seem to feel better.

Sleep issues

It’s fairly common for people with depression to struggle with sleep. You may find yourself sleeping too much, or feeling tired most of the day.

You may also develop insomnia, where you have trouble falling or staying asleep.

Changes in appetite

You might not have much of an appetite, or don’t feel like eating and notice you’re losing weight. Or instead, you might find yourself overeating and gaining weight.

Low self-esteem

With low self-esteem, you may struggle with confidence and believing what you’re capable of. You could also have critical or negative thoughts about yourself, or try to overcompensate.

Trouble concentrating or making decisions

You may find yourself bogged down with indecision — agonizing over every decision you have to make. You could also have a hard time concentrating, like on a work project or book you’re reading.

Feeling hopeless

When you feel hopeless, you can start to think things are never going to get better. It might be difficult to problem-solve or focus on anything positive in your life.

Only a healthcare professional can diagnose PDD, and sometimes other conditions will need to be ruled out first.

Some conditions look similar to (or overlap with) PDD.

Major depressive disorder (MDD)

In major depressive disorder, your symptoms may be more severe than PDD, but for shorter amounts of time — at least 2 weeks.

You might:

  • experience deep feelings of worry, sadness, or hopelessness
  • sleep or eat too little or too much
  • lack interest in things you used to enjoy
  • have thoughts of self-harm

Bipolar disorder

Previously called manic depression, bipolar disorder is characterized by mood episodes that involve intense emotions, sleep issues, and racing thoughts.

Bipolar disorder is known for its highs — mania or hypomania — but you may also have depressive episodes in bipolar I disorder, and will experience depression in bipolar II.

Symptoms can include:

  • trouble concentrating
  • feeling hopeless
  • feeling sad

You might cycle through these high and low episodes, or you can even have them at the same time.

Cyclothymic disorder

Also known as cyclothymia, this is a type of bipolar disorder that’s sometimes seen as milder — but you can still experience the ups and downs in mood.

In cyclothymic disorder, you’ll experience mood changes for at least 2 years, including symptoms of depression.

Personality disorders

Personality disorders have different symptom patterns than depression or bipolar disorder. They’re almost always diagnosed in adulthood and tend to be lifelong conditions.

If you have a personality disorder, you might have a harder time responding appropriately to difficult experiences, such as losing a job. A personality disorder can impact how you relate to others, which can also impact relationships.

Examples of personality disorders include:

  • borderline personality disorder (BPD)
  • narcissistic personality disorder (NPD)
  • obsessive-compulsive personality disorder (OCPD)

Seasonal affective disorder

Although the more up-to-date name is major depressive disorder (MDD) with seasonal pattern, you probably know this as seasonal depression or seasonal affective disorder (SAD).

It can be easy to confuse seasonal depression with PDD because both involve depression symptoms. But if you experience seasonal depression, your symptoms will tend to pop up during specific times of year.

If you think you might be dealing with PDD, there are some things you can do.

To receive a PDD diagnosis, your doctor should rule out any physical reasons for your depression, since some medical conditions like thyroid disorders or low vitamin D can mimic symptoms of depression. So they might start with a physical exam and lab work.

If a physical reason has been ruled out, your doctor will probably ask you questions about your mental health, thoughts, and feelings.

Criteria for PDD are based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). For a PDD diagnosis to apply, your symptoms need to be present for at least 2 years and not absent for more than 2 months.

Along with feelings of depression or irritability, you also need to have two or more of these other symptoms:

  • appetite changes or overeating
  • insomnia or other trouble sleeping
  • having little energy or feeling extra tired
  • feeling bad about yourself
  • difficulty concentrating or making decisions
  • feeling hopeless

More than having these symptoms, they also need to affect a big part of your life to match a PDD diagnosis. It’s also possible to meet the criteria for a PDD diagnosis and a major depressive diagnosis at the same time.

Everyone’s treatment plan will vary depending on their unique situation. But research continues to show that a combination of medication and therapy tends to be the most effective way to treat symptoms of depression.

It’s important to feel comfortable with a therapist you choose and agree with their approaches to therapy. Asking for recommendations from friends or your doctor is a good place to start, but it’s possible you might need to try out a few before you find one you like.

It can feel draining to live with persistent depressive disorder. And if you’re not sure what your symptoms add up to, it can be frustrating trying to get the right diagnosis.

If you decide to seek professional support, a good mental health professional can help you work through your emotions and help you come up with a treatment plan that meets your needs.

You can also learn more about treatment options for PDD here.

What Is High-Functioning Depression&mdashand Could You Have It?

You might appear to be getting by just fine but be suffering on the inside.

To the outside world, you’re a productive citizen. Some might even say you’re highly successful. But when the workday is done, your internal resources are spent. You beg off dinner with friends because the best you can do is plop onto the couch or dive into bed so you’ll be ready to take on tomorrow.

That’s what life is like when you have what’s sometimes called high-functioning depression. You make do, you get by, you appear to be handling things just fine𠅋ut you’re suffering inside.

High-functioning depression isn’t a true medical diagnosis you won’t find it listed in the Diagnostic and Statistical Manual of Mental Disorders, the bible of the mental health profession. But it is popping up on treatment center websites and health blogs as a way to characterize people with low mood, low energy, and anxiety, experts say.

It’s a useful term, says Johnny Williamson, MD, medical director of the Timberline Knolls Residential Treatment Center in Lemont, Illinois, because it’s “readily understandable” and encompasses people who don’t necessarily fit neatly into traditional diagnostic categories.

Most high-functioning types have dysthymia (also known as persistent depressive disorder), a low-grade depression marked by lagging energy or fatigue. These are people who are generally unhappy in life but don’t meet the definition of major depression, which is more severe. Dysthymia generally persists for two or more years. But if you have it, you probably slap on a brave face and go about your business.

Dysthymia can be difficult to diagnose because “it’s gradual and kind of sneaky,” Dr. Williamson says. He equates it to turning up the temperature in a room by one degree at a time. People often don’t recognize they have a problem until they’re sick of feeling blue all the time or until a stressful life event causes their emotions to boil over.

Even some people with major depression–the classic, episodic type that causes low mood or loss of interest or pleasure, among other symptoms­­–may be deemed high-functioning. They tend to be individuals with a lot of determination who are willing to endure significant symptoms without asking for help, Dr. Williamson explains.

Anthony Rothschild, MD, professor of psychiatry at the University of Massachusetts Medical School, believes people with major depression are “high-functioning” too. “They’re doctors and lawyers and judges . and every walk of life, but they suffer,” he says. “They’re not reaching their potential.”

There’s no clinical test for high-functioning depression. But primary care doctors and mental health professionals do use various screening tools to assess patients’ depressive symptoms and functioning. For example, your doctor may ask questions like: Are you unhappy or blue? Do you cry a lot? Do you have low energy? Do you have sleep problems?

As part of a new patient evaluation, Dr. Rothschild often poses a simple question. “I’ll say, ‘What do you do for fun?’ And if they look at me, like, Where did you come from?, then I know they might very well be suffering from depression,” he says.

What qualifies as high-functioning depression is somewhat subjective. People often fill three or four main roles in their lives: vocation (meaning work or school) intimate partner or spouse parent and friend or community member, explains Michael Thase, MD, professor of psychiatry at the University of Pennsylvania Perelman School of Medicine and co-author of Beating the Blues: New Approaches to Overcoming Dysthymia and Chronic Mild Depression. Assessing how active you are in your roles can help a mental health professional gauge high-functioning depression, he says. “You may notice that there’s a hole in this person’s extracurricular life."

Steven Huprich, PhD, professor of psychology at University of Detroit Mercy, says there may be something in a person’s nature–𠇊 particular type of negative self-image”𠄿ueling his or her chronic unhappiness. “If somebody came to me and said, ‘I think I have high-functioning depression,’ chances are not only would I hear about mood symptoms, but I𠆝 probably hear something about being kind of perfectionistic, feeling guilty a lot, feeling self-critical,” he says.

If you’re aware you’re not performing up to speed, you might also experience feelings of self-doubt, anxiety, and a loss of confidence, Dr. Williamson adds.

Unfortunately, it can be easy for people with high-functioning depression to fly under the radar because they hide their suffering well. Without support, there’s a lot of “loneliness and aloneness,” Dr. Williamson says.

But just because you’re getting by doesn’t mean you don’t need help. Since depression treatment is highly individualized, every person’s regimen will differ and may include lifestyle changes, talk therapy, and/or medication.

You might start by consulting your primary care doctor, contacting an employee assistance program, or calling a therapist. The important point, experts say, is to seek help, because depression is highly treatable.

“Where you start with treatment,” Dr. Williamson says, “is less important than the fact that you start.”

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What It Looks Like

Someone with high functioning anxiety may be the picture of success. You might arrive to work earlier than everyone else, impeccably dressed, with your hair neatly styled.

Coworkers may say you are driven in your work—you've never missed a deadline or fallen short in a given task.   Not only that, but you're also always willing to help others when asked. What's more, your social schedule also seems busy and full.

What others might not know (and what you would never share) is that beneath the surface of a seemingly perfect exterior, you're fighting a constant churn of anxiety.

It may have been nervous energy, fear of failure, and being afraid of disappointing others that drove you to success.

Though you desperately need a day off work to get yourself together, you're often too afraid to call in sick. Nobody would ever believe something was wrong, because you always portrayed yourself as being fine.

If these characteristics sound familiar, here's a look at what you might experience or what others might observe of you if you have high functioning anxiety.

11 Real-Life Ways High-Functioning Depression Can Manifest

Above, I provided you with what the DSM-5’s clinically indicative dysthymic symptoms. Now let’s talk, in layman’s terms, about 11 ways that some of these symptoms may manifest in your real life.

1. Difficulty experiencing joy.

With high-functioning depression, the things that used to bring you pleasure — whether this is a cherished yoga class or a monthly ritual of getting together with your girlfriends — don’t bring you joy anymore. They may feel like burdens or events you want to avoid because it feels like more of an effort than a support

2. Relentless criticality — of self and others.

You may have a relentless and invasive internal narrative that’s critical of yourself, of others, and of the world in general. You think you’re a failure, you think your boss is an idiot, your partner is the most irritating person to have ever lived, and life’s just one big slog. This chronically negative thought pattern may feel like something you just can’t turn off.

3. Constant self-doubt.

You may constantly doubt whether or not you’re on the right career path, whether you’re in the right relationship, doubt what you’re doing with your life and if you can even handle being an adult. This pattern of constant self-doubt may be situational or pervasive, but it’s something that feels like you just can’t get over.

4. Diminished energy.

If it feels like getting through each day is like walking up a mountain with a backpack of rocks, if you feel like you barely have the mental, emotional and physical energy to handle your life anymore, if your overall energy levels are greatly diminished, this could be a sign of high-functioning depression.

5. Irritability or excessive anger.

If you find yourself blowing up over small things — your partner says something wrong, your co-worker messed up a project, your kid just broke your favorite coffee mug – if you find yourself exploding in a way that feels disproportionate to the event, if irritability and excessive anger are something you’re wrestling with, this may be a sign.

6. Small things feel like huge things.

Similarly, if you find yourself feeling overwhelmed or greatly stressed by an event that happens that maybe wouldn’t have felt like such a huge deal in the past (a friend cancels weekend plans, the grocery bags break when you’re carrying them in, your darn trackpad stops working because you spilled some coffee on it) and it feels like the end of the world instead of the annoyance that it is, if you find your stress responses disproportionate to the event itself, this may well be a sign of high-functioning depression.

7. Feelings of guilt and worry over the past and the future.

You worry that you chose the wrong career in college, you question whether you’re in the right grad school program, you worry about paying off all those student loans, you worry your biological clock is running out, you worry that you married the wrong partner, you worry about who’s going to care for your folks when they get older, etc. We all have these worries from time to time, but if feelings of guilt and worry over your past and future feel pervasive and dominant, this may be more than “normal” worry.

8. Relying on your coping strategies more and more.

If you find yourself needing extensive zone-out time after work and on the weekends, turning toward your coping mechanisms more often than not — such as substances or behaviors like using alcohol, drugs, excessive gaming, constant Netflix, etc. — all in an effort to escape your life, this could speak to underlying depression.

9. Generalized sadness.

If you find yourself feeling a generalized sense of sadness you can’t seem to pinpoint the cause of, if you drop your mask and armors of smiling competency when you close your door behind you, if you feel a subtle sense of hopelessness, this could speak to high-functioning depression.

10. Seeking perfection.

This one’s a tough one. In a way our society condones perfectionism — getting good grades, getting into the Ivies, landing that amazing tech job, striving, striving, striving. But perfectionism has a shadow side where striving turns into unrealistic demands of yourself and psychologically beating yourself up when you fall short of the bar you set for yourself. If you find yourself doing this and it’s causing you distress, be curious about whether this a sign of high-functioning depression.

11. Inability to rest and slow down.

If you need to clean up, tidy, and organize the house after you arrive home from an exhausting day of work before you even consider letting yourself rest, if you find yourself uncomfortable with slowness, stillness, and fallow periods of time because of the uncomfortable thoughts and feelings you come into contact with when you do actually slow down, this could be a sign of high-functioning depression.

What Exactly Does It Mean to Have ‘High-Functioning’ Depression?

When I was first diagnosed with depression, many people—even those who knew me well, who cared about me—responded with the opposite of what I needed to hear. This was partly because they didn’t understand, but also partly because we live in a world where the prevailing view is that mental illness is a weakness and that a person with depression is someone who can’t leave their house, sleeps all the time, lacks enthusiasm, and neglects personal care. Most of the time, this wasn’t me at all. And even when it was, I managed to keep it hidden.

I heard a lot of “You’re the last person I’d imagine to be depressed!” or “But you have so much going for you,” and “How can someone like you have depression?” The cumulative effect of all this unhelpful commentary was mighty. It didn’t stop me from seeking treatment, but it did stop me from talking openly about my illness for over 15 years, because part of me felt that I didn’t deserve help.

I was first diagnosed with depression at 19, and it was another 13 years before a professional gave me a diagnosis of major depressive disorder (MDD). Within just the last few years, the phrase “high-functioning depression” came on my radar. Right away, it was something I could relate to, albeit only with a very literal interpretation: I was a high-functioning person with depression.

It’s pretty impossible to pinpoint where the phrase high-functioning depression originated. “I don’t think anyone knows,” psychologist Michael E. Silverman, Ph.D., associate clinical professor at the Icahn School of Medicine at Mount Sinai, tells SELF.

But it certainly has merit: “Clinically, depression is characterized as a time of reduced functioning, with the goals of treatment emphasizing symptom reduction,” Silverman explains. “However, this characterization is inadequate, or at least incomplete, when the person demonstrates a level of positive psychosocial functioning that exceeds the average level of non-depressed individuals.”

Depression comes in variations of severity, Silverman says, and it can be difficult to land on one specific diagnosis. “That is, some depressions result in severe disability and hospitalization, whereas other depressions are more akin to the ‘walking wounded,’ [meaning] the individual functions throughout their daily life but isn’t operating as efficiently or productively as they once did or believe they should.” He says a person who might identify as a high-functioning person with depression might describe feeling “as if they are constantly trudging through mud.”

Any discussion of high-functioning depression should acknowledge that this terminology isn’t a recognized clinical disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or used in research. What’s more, mental health professionals don’t all agree on whether use of the term “high-functioning” in regards to depression is a good or bad thing, or if someone who identifies as having high-functioning depression actually meets the diagnostic criteria for depression at all.

This is because high-functioning depression, depending on how the person using that terminology defines it, doesn’t necessarily require clinical intervention whereas a formal diagnosis like MDD does, Silverman explains. That doesn’t mean a person who identifies as having high-functioning depression couldn’t benefit from seeing a therapist, but MDD is a formal psychiatric disorder for which a professional would prescribe treatment, in the form of therapy and/or medication.

To better understand the many shades of depression, it can be helpful to first think about how all people have a typical baseline mood. “We tend to function close to our baseline at most times and, of course, have fluctuations that are both positive and negative,” Jamie McNally, psychologist and adjunct professor of psychology and owner of Sycamore Counseling Services in Michigan, tells SELF.

Most people have a general understanding of MDD, a mood disorder that interferes with an individual’s ability to function in everyday life. So someone with MDD has a baseline mood that is far below the average individual’s baseline. However, with PDD, the baseline mood for someone with PDD is less clear-cut, falling somewhere between the MDD baseline and a “normal” baseline, McNally explains.

Silverman explains that in the DSM-5, experts essentially collapsed two mood disorders—chronic major depressive disorder and dysthymia—into one: PDD. Before the most recent version of the DSM, PDD was known as dysthymia and used to help identify someone experiencing depressive symptoms for two years or more, but not enough symptoms or with enough severity to classify them as having MDD. (Today PPD and dysthymia are often used interchangably.) When MDD lasts for two or more years, it is typically then classified as chronic. So, while both PDD and chronic major depression both have a duration of two or more years in adults, they differ in severity.

The symptoms for the two disorders are somewhat different and can be confusing, Silverman says. (You can learn more about the very subtle differences here.) He also says that the DSM-5 and the associated diagnoses serve no real utility to the average person or patient, but merely provides a way for clinicians to speak efficiently with each other about an individual’s experience and current level of disability.

“However, in the case of MDD versus PDD, it’s not always efficient or clear,” he says. “For example, if I get a call from a colleague in California seeking assistance with a patient and he tells me Mr. Jones has a diagnosis of PDD, I still don’t know if the patient has dysthymia or if it’s a major depression that’s chronic. Another question becomes, which diagnosis trumps the other? That is, MDD or PDD? This is made even more confusing given that a small group of chronic cases that would meet the criteria for MDD would not meet the criteria for PDD.”

So given that, by the clinical definition, someone diagnosed with PDD in theory has symptoms that don’t necessarily impair their ability to live their life the way symptoms of MDD might, it’s possible that many people with PDD may refer to their situation as high-functioning depression.

But Silverman also points out that the psychiatric concept of “high-functioning” and the clinical characterization of depression both occur on a spectrum. “Whereas a clinical diagnosis of depression has a discrete DSM-5 characterization, the term ‘high-functioning’ has no meaningful clinically utility and is relative to different people across various situations,” he says. “For example, while a professional athlete with PDD is certainly considered ‘high-functioning,’ clinically speaking a person living with schizophrenia who can successfully navigate a typical work day may also be considered ‘high-functioning.’”

Shameka Mitchell Williams, licensed clinical social worker in Baton Rouge, La., tells SELF she believes the term high-functioning depression has also become so frequently used because it takes away some of the ambiguity associated with a label like PDD. “Who wouldn’t rather be considered ‘high-functioning’ even if depressed, versus persistently depressed?” she says. “There is a little less stigma attached if one can still manage to function.”

Less stigma surrounding those who consider themselves to be high-functioning can mean more blame, judgment, and misunderstanding for those who are not, and it could make people with depression question the legitimacy of their own illness.

10 Symptoms of High-Functioning Autism

Diagnosis rates for autism continue to rise, especially as parents and professionals become more familiar with the symptoms of high-functioning autism. Many patients are getting the assistance they need to live full, productive lives because their unusual behaviors are no longer seen as simple social awkwardness or eccentricity. As more caring medical and mental health professionals learn to recognize the most common symptoms of autism, the number of interventions available to people with autism will rise.

Emotional Sensitivity

Although often overlooked, sensitivity to emotions is a common issue for people on the high end of the autism spectrum. These individuals can function in day-to-day life but struggle to control their emotions the same way that neurotypical, or non-autistic people, are able to do. For example, a frustrating morning experience like running out of milk or being cut off while driving can cause irritability and difficulty concentrating for the rest of the day. People with autism may also have unusually intense emotional reactions compared to the rest of the population.

Fixation on Particular Subjects or Ideas

Continually discussing the same topics in conversation, obsessively playing the same song repeatedly, or reading every article written about a certain topic are some ways that autistic fixations can manifest. These interests can be negative if they take over the individual’s life or interfere with their relationships with others. Of course, these obsessive tendencies can also be helpful Dan Aykroyd, writer and star in the hit film Ghostbusters, was inspired by his focus on ghosts and the paranormal. Many other high-functioning autistic individuals have used their focus on mathematics, biology, or writing to inspire successful careers.

Linguistic Oddities

Children on the low-functioning end of the autism spectrum usually struggle with learning to speak, building vocabulary and holding conversations with others. Their counterparts on the higher end of the spectrum may start talking much earlier than normal and often display an impressive vocabulary. They may find conversations with others boring or difficult to follow and may avoid speaking with their peers. Many people with mild autism may simply seem eccentric during conversations as their diverse vocabularies, frequent interruptions or focus on particular topics seem like oddities rather than neurological symptoms.

Social Difficulties

Parents and teachers may notice that young autistics have problems interacting with their peers. These symptoms of high-functioning autism in children and teenagers can include a limited social circle, problems sharing toys or materials, and difficulty completing group work. Sometimes youth are considered shy, quirky or socially awkward when they are truly dealing with autism and in need of counseling services to help them learn social rules, as the problems with interacting with others usually stem from a lack of understanding appropriate behavior with peers. Early intervention from mental health professionals can help autistic youth learn the best ways to interact with their classmates and potential friends.

Problems Processing Physical Sensations

Many individuals with autism have sensory difficulties. They may find specific noises, tastes, smells, or feelings intolerable. Noisy public places can lead to emotional distress, as can uncomfortable clothing or unwanted touches. These issues can be disruptive and stressful, but according to the National Institute of Neurological Disorders and Stroke, autism symptoms can improve over time as children with mild autism learn to regulate their own behavior through work with professionals.

Devotion to Routines

People with high-functioning autism are typically devoted to routines. They may stick with routines developed for them by others, such as reading for exactly 15 minutes before going to bed or brushing their teeth exactly five minutes after eating a meal. Any sort of deviation from the routine, such as a parent needing to help a sick sibling at bedtime instead of reading to the affected individual could cause the person to become frustrated. The person with high-functioning autism may devote an exorbitant amount of time to performing their routines to the detriment of self-care, sleep, exercise, homework or learning.

Development of Repetitive or Restrictive Habits

Repetitive habits are another sign of high-functioning autism. Those habits could interfere with the person’s ability to do what they need to do or what others want them to do. One type of repetitive habit might be related to movement. The individual might have to tie and untie their shoes multiple times before they are satisfied and are able to start walking or leave the house. Some people develop restrictive habits that interfere with socially accepted living. For example, an individual might refuse to wear any other kind of shirt than a tee shirt. This could impact their health and well-being if they live in a place with cold weather.

Dislike of Change

A hallmark of high-functioning autism is a strong dislike of change. An individual might eat the same meal every day for breakfast, and they may eat it in the same quantity, on the same dish, and in the same place. Any disruption or change in the routine could cause an outburst in the individual. For example, if the usual brand of peanut butter has run out, and a different brand has been purchased instead, the person with high-functioning autism may have an outburst of anger or frustration. If someone has used their preferred dish, they may have a similar outpouring of volatility.

Focus on Self

People with high-functioning autism may have trouble developing deep social relationships with others. Part of this issue also includes an inordinate focus on self. A person with high-functioning autism may spend an excessive amount of time talking about themselves, not allowing another person to share a complete thought or response. This makes carrying on a conversation difficult. In the family or household setting, a person with high-functioning autism may only think of themselves when doing activities. For example, they might pour themselves a drink without asking if anyone else would also like a drink. They might take more than what others perceive as a fair share of a snack or treat, genuinely not thinking that others might also want some of the items.

Unusual Movement Patterns

A person with high-functioning autism may have unusual movement patterns. Toe walking is a common movement disorder. The person may walk on their toes or the ball and the toes of the feet without putting much bodyweight on the other parts of the foot. This can result in foot pain in the ball, hammertoe, or bunion from the excessive pressure. The shoes and socks may wear out in the forefoot area much faster than in the heel area. People who walk on their toes may experience more foot injuries, such as blisters, calluses, and corns on their footpads and toes. Toe walking is more common in young children and people with musculoskeletal, explains the American Academy of Orthopedic Surgeons.

Not all individuals with autism exhibit physical tics or an inability to maintain social ties. People with high-functioning autism usually present symptoms not originally associated with autism, and helping professionals must continue to push for recognition of the range of behaviors associated with the autism spectrum. Familiarity with these ten symptoms of high-functioning autism helps providers, parents, teachers and others coordinate the early treatment of a person with this condition.

What Is It Like to Have High-Functioning Anxiety and Depression?

People living with high-functioning anxiety and depression usually do not fit the stereotype of either disorder. In fact, many appear to be overachievers. The anxiety can serve as an energizer, driving the person towards achieving his or her goals. It’s later, when in private, that the symptoms of depression tend to emerge. Feelings of self-doubt and self-criticism, fatigue, helplessness or guilt, moodiness, and a desire to avoid interaction with others become intensified. Because the stereotypical image of depression or anxiety doesn’t match up with what people living with high-functioning anxiety and depression “look like,” it is hard to spot, even for sufferers to recognize in themselves. However, the symptoms of high-functioning anxiety and depression are the same as for non-high functioning anxiety and depression. The main difference is the ability to suppress or diminish the appearance of disruptions in life activities.

Many people living with high-functioning anxiety and depression are described as Type-A personalities or overachievers. They often excel at work or appear to be “super mom/dad” and seem to have it all under control. Other people may notice signs of high-functioning anxiety and depression but characterize the behaviors as “anal retentive” quirks or bad habits. And, many times, signs and symptoms of high-functioning depression and anxiety that others observe are given positive attributes, rather than being seen for what they are. For instance, anxiety and worry may be expressed as dwelling on minor details and viewed as perfectionism. What observers generally do not see are the private struggles with stress, sleeplessness, digestive issues, self-criticism, or feelings of sadness and gloom that had to be overcome to attain achievements.

Signs of High Functioning Anxiety

Often the signs and symptoms of high functioning anxiety seem to overlap on an emotional and behavioral level with other anxiety disorders such as specific phobias, social anxiety or panic disorders. People with HFA may feel that they have “the blues” or are depressed. While the melancholy of the blues lasts a few days or a couple of weeks, depression lasts longer and tends to be more severe, differing from anxiety.

Signs of high functioning anxiety include being unable to relax due to worry, being a workaholic, overthinking, overanalyzing tasks and second-guessing oneself. Other signs include scrupulosity, superstitious thoughts and behaviors. A person with HFA may feel an impending doom, but it is not the same as the impending doom emanating from clinical depression. Often those suffering from signs of high functioning anxiety don’t go to their physician for a mental health screening because they learn to live with its symptoms. Those who decide to reach out because something “just doesn’t feel right” or “I’m tired of feeling this way” usually find their symptoms treatable with counsel and medication.

How is Depression Different from Sadness?

What is the difference between depression and sadness? Given that the primary symptom associated with depression is sadness it can be hard to know how to make a distinction between the two psychological states.

But depression is more than just sadness, and not simply by a measure of degree. The difference doesn’t lie in the extent to which a person feels down, but rather in a combination of factors relating to the duration of these negative feelings, other symptoms, bodily impact, and the effect upon the individual’s ability to function in daily life.

Sadness is a normal emotion that everyone will experience at some point in his or her life. Be it the loss of a job, the end of a relationship, or the death of a loved one, sadness is usually caused by a specific situation, person, or event. When it comes to depression, however, no such trigger is needed. A person suffering from depression feels sad or hopeless about everything. This person may have every reason in the world to be happy and yet they lose the ability to experience joy or pleasure.

With sadness, you might feel down in the dumps for a day or two, but you’re still able to enjoy simple things like your favorite TV show, food, or spending time with friends. This isn’t the case when someone is dealing with depression. Even activities that they once enjoyed are no longer interesting or pleasurable.

What’s more, when you experience sadness triggered by a certain something you’re still able to sleep as you usually would, remain motivated to do things, and maintain your desire to eat. Depression, on the other hand, is associated with serious disruption of normal eating and sleeping patterns, as well as not wanting to get out of bed all day.

In sadness, you might feel regret or remorse for something you said or did, but you won’t experience any permanent sense of worthlessness or guilt as you might with depression. One of the diagnostic features of depression is this kind of self-diminishing, negative thought patterns.

Finally, self-harm and suicidal inclinations don’t arise from non-depressive sadness. Those struggling with severe depression may have thoughts of self-harm, death, or suicide, or have a suicide plan.

If you’re feeling suicidal or just need to talk, call the National Suicide Prevention Lifeline for free at 1-800-273-8255.

Multi-informant reports of psychiatric symptoms among high-functioning adolescents with Asperger syndrome or autism

The aim of the study was to examine psychiatric symptoms in high-functioning adolescents with autism spectrum disorders reported by multiple informants. Forty-three 11- to 17-year-old adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) and 217 typically developed adolescents completed the Youth Self-Report (YSR), while their parents completed the Child Behavior Checklist (CBCL). Teachers of adolescents with AS/HFA completed the Teacher Report Form (TRF). The informants reported significantly more psychiatric symptoms, especially withdrawn, anxious/depressed, social and attention problems, in adolescents with AS/HFA than in controls. In contrast to findings in the general population, the psychiatric problems of adolescents with AS/HFA are well acknowledged by multiple informants, including self-reports. However, anxiety and depressive symptoms were more commonly reported by adolescents with AS/HFA and their teachers than their parents, indicating that some emotional distress may be hidden from their parents.


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