What Is High Functioning Depression?

January 16, 2022

Nue Life

Nue Life

Top points

  • About 3% of the population experiences high-functioning depression (dysthymia), in which years of persistent symptoms cause ongoing suffering.
  • Talk therapy can help with high-functioning depression, but standard antidepressants may not be as effective as previously thought.
  • Ketamine provides a safe alternative to traditional antidepressants and it’s faster and more effective for many patients.

One of the lesser-known types of depression is high functioning depression or dysthymia. Despite its low profile, dysthymia affects nearly 3% of the population each year, and it often arises earlier in life than other forms of depression.

This breed of depression comes on slowly and stays for the long haul, making it difficult to detect, even for the person it affects. But, just like any form of depression, you can treat dysthymia and transform your mental health.

So today, let’s talk about high functioning depression. By discovering what it is, we can learn to identify it in ourselves and others to go and find effective treatment.

What Is Dysthymia?

Dysthymia, also known as high functioning depression or persistent depressive disorder, is a unique form of depression. Let’s take a look at some of the details.

The Onset and Duration

One of the distinguishing factors about high functioning depression is the gradual speed at which it comes on. Dysthymia often slowly enters a person’s life, typically during adolescence or early adulthood.

Dysthymia also has a much longer duration than any other form of depression. While normal depression presents itself in episodes that eventually fade and may resurface, dysthymia presents persistent symptoms that don’t fade away for months or even years. A doctor cannot diagnose dysthymia until symptoms have been present for two years.

The Symptoms

The symptoms of dysthymia are generally similar to major depression, but they tend to be a little milder. Symptoms may include:
Trouble sleeping
Decrease in energy
Low opinion of self
Difficulty concentrating
Feelings of hopelessness
Depressed mood

However, because these symptoms are slightly less severe than with major depressive disorder, people with dysthymia are typically able to function fairly well in their daily lives. They may perform well at work, do chores, and take care of their families without showing outward symptoms. This ability to perform is why dysthymia is often called high-functioning depression.

What Sets Dysthymia Apart?

But the real thing that sets this form of depression apart from the others is how it tricks your brain into thinking that this state of mind is normal. Because it comes on so slowly and then doesn’t change, it’s easy for your loved ones and even yourself to think that this is a typical state of being.

This just isn’t the case. If you have been feeling down, sad, or slow for a long time, you may be afflicted with this form of depression. And if that’s the case, you need to take the next step into the healing available to you.

Double Depression

Another aspect of dysthymia that makes it challenging to identify is that people affected by it often experience a major depressive episode on top of their dysthymia. Having two forms of depression simultaneously can negatively affect a person.

How Is It Treated?

Depression is an ailment that you can treat. And dysthymia is not an exception to that rule. Here are some methods of treatment that often help people with depression of all types.


Therapy is an incredibly important aspect of treatment for depression. Getting professional help can teach you healthy coping techniques to aid with processing your depression.

One of the most effective forms of therapy is Cognitive Behavioral Therapy or CBT. This highly recommended type of therapy can be very effective for various mood disorders, including depression.

In CBT, the focus is around analyzing your thoughts, patterns, feelings, and behaviors and how they work with each other. The therapist helps you identify your negative thoughts, where they come from, and how they influence your behavior.

By understanding your thought patterns in this way, you can learn to develop healthy coping mechanisms. This therapy method can work to alter your thought patterns and improve the functioning of your brain.

CBT can be effective for cases of mild to moderate depression. But if you suffer from severe depression, you may need further care.


Medication can also help treat depression. The most common antidepressants are called selective serotonin reuptake inhibitors, or SSRIs.

As their name suggests, SSRIs target the neurotransmitter called serotonin in the brain. This neurotransmitter is commonly associated with a happy mood. The theory is that by increasing the level of available serotonin, you can reduce the symptoms of depression.

Although this idea sounds reasonable, and some people experience success with antidepressant treatment, that isn’t the story for many people.

One recent study shows that antidepressants only improve symptoms in about 20 out of 100 people. And the relief took up to six or eight weeks to set in. Because of this, many people need another type of treatment.

A Better Solution

One new treatment option is the psychedelic therapy of ketamine. Ketamine has been used for years in anesthesia, but scientists have discovered that it has benefits for treating depression in recent years.

Serotonin and other neurotransmitters targeted by antidepressants only make up about 20 percent of the neurotransmitters in the brain. The other 80 percent are two neurotransmitters called GABA and glutamate.

Ketamine affects glutamate in a big way. By increasing glutamate production, ketamine increases your brain’s ability to form new neural pathways, increasing its neuroplasticity. This neuroplasticity allows people to develop new, positive thought patterns that replace the old, negative ones.

This form of treatment is quite effective, with over half of people receiving ketamine treatment seeing significant symptom relief within 24 hours of their first treatment. Ketamine can be an effective treatment for depression, especially in depression that is resistant to other treatments.


High-functioning depression can be a challenging ailment to live with. It can deprive you of energy, rob you of the joy you deserve, and hinder you from functioning to the best of your ability.

But dysthymia is a condition that you can treat with approaches like therapy or medication. Effective treatment like ketamine therapy can help you find wholeness and mental wellness again.

Nue Life offers at-home ketamine experiences that are virtually supervised so that you can have your treatment in the comfort of your own home. Each of our programs includes virtual integration sessions and one-on-one health coaching for personalized and community support. If you are looking to take your mental wellness to the next level, our programs could have the answer.


Cognitive Behavioral Therapy FACT SHEET | National Alliance of Mental Illness

Cognitive behaviour therapy for depression in primary care: systematic review and meta-analysis | PubMed

Depression: How effective are antidepressants? | Informed Health

Dysthymia: High Functioning Depression | Cumberland Heights Foundation

How New Ketamine Drug Helps with Depression | Yale Medicine

Types of Depression | Stanford University

Understanding Dysthymia | NAMI: National Alliance on Mental Illness

Dysthymia | Harvard Health

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