Depression is a mental health problem that can have a serious impact on patients' daily life. It can come in many different types and forms and influence people in different ways.
But have you heard of "high function" depression? In fact, high-function depression is an amateur term, sometimes used to describe the symptoms of experiencing depression, but from the outside, the patient looks "good" and does not seem to have much problem, said Professor Rong Xinqi, a psychologist at the new concept.
The fifth edition of the "Diagnostic and Statistical Manual of Mental Diseases" (DSM-5-TR) does not have the term "high-function" depression, which is a tool used by clinicians to diagnose mental health conditions. In fact, “high-function” depression is a popular spoken term in recent years used to describe hidden symptoms of depression that are not usually noticed by others and do not seem to harm daily functioning.
"High-functional depression" is not a recognized condition, but in some cases it may represent the actual clinical diagnosis of depression. You may look good because you can act like studying, working and living like a normal person. Unless you tell them, others may not even realize that you have depression. In other words, the so-called "high-function" depression can also be called "hidden depression" or "smile depression", Professor Rong said.
Next, Professor Rong will take a look at the symptoms, causes and diagnosis of "high-function" depression, as well as some treatment and coping strategies that may be helpful.
Symptoms of "high-function" depression
Depression can lead to emotional and physical symptoms, and "high-function" depression is no exception, including:
· Continuously feeling sad or empty;
· Feeling Despair or pessimism;
· feel guilty or worthless;
· feels irritable or anxious;
·Loss of interest in everything;
·Have far away from the people around you;
· feel tired and tired;
· speak or move slowly;
· finds sleep problems, such as insomnia, flirting Sleeping, etc.;
·Environmental and weight changes;
··Thinking of death, self-harm or suicide;
·Select physical symptoms, such as headache, spasm , pain and pain, and digestive problems that have no clear cause and cannot be improved after treatment.
Professor Rong stressed that "high-function" depression can occur at any severity (mild, moderate and severe), from mild to severe to cause self-harm or at risk of suicide. However, they often hide their symptoms from others.
Friends and relatives around you may notice obvious signs of depression such as fatigue, irritability, isolation and sadness, but many times, unless you speak it out yourself, others cannot really distinguish those symptoms that are easily overlooked.
If you have suicidal thoughts, please call 110 or the national 24-hour free psychological crisis consultation hotline at 800-810-1117 to seek support and help from professionals. If you or your loved one is in direct danger, call 110 directly.
Causes of "high-function" depression
Depression is usually caused by the joint action of multiple factors, such as:
· Brain Chemistry: Imbalance of certain neurotransmitters (brain chemicals) that regulate emotions can lead to depression.
·Genetics: Depression usually has genetic factors and can be transmitted in the family, so people with a family history of depression are more likely to suffer from depression.
·Life Events: Frustrating or stressful life events, such as the end of intimate relationships, unemployment or the death of a loved one, can all cause depression.
·Psychological Trauma: Experience psychological trauma or stress condition can lead to mental health problems such as depression, anxiety and Post-traumatic stress disorder .
·Social Diseases: If you suffer from physical diseases such as heart disease, diabetes , cancer, Parkinson's disease or chronic pain, you may be more likely to suffer from depression at the same time. It is important to report symptoms of depression to your attending doctor and seek treatment, as depression can worsen your physical illness.
·Medicaments: Certain drugs may also cause side effects of depression.
· Substance abuse: Alcohol, nicotine and addictive drugs can also cause or exacerbate depression.
·Personality: Certain personality traits may make you more susceptible to depression.
How to diagnose "high-function" depression?
Professor Rong said that it is important to note that "high-function" depression itself is not an official diagnosis. It is sometimes used to describe harsh mood , but it can occur in any type of depression.
Professor Rong combines DSM-5-TR and his clinical experience and has several types of depression and diagnostic criteria, such as:
·Major Depression (MDD): is also called clinical depression. Major Depression is a serious depression that lasts for more than two weeks.
·Sustaining Depression (PDD): is also called a harsh mood. Persistent Depression lasts for more than two years, and the symptoms are getting worse and worse.
·Seasonal affective disorder (SAD): was formerly called major depression with seasonal patterns. This is a depression that people often experience when there is less sunshine in winter. Seasonal affective disorders tend to subside in the summer and reappear in the winter.
·Perina Depression: is called a severe depression in DSM-5 that occurs during perinatal attacks. This is a kind of depression that some pregnant women may experience. It includes prenatal depression (depression during pregnancy) and postnatal depression (depression after pregnancy).
·Premenorrhea disorder (PMDD): Premenorrhea syndrome (PMDD) is a more severe premenstrual syndrome (PMS) with obvious emotional symptoms that people usually experience a few days before their menstruation.
·Biopolar depression: People with Biopolar disorder may alternate between periods of high mood and energetic (called mania) and periods of severe depression.
·Psychological depression: People with psychotic depression (called major depression with psychotic characteristics) can also experience psychotic symptoms such as hallucinations (seeing or hearing unreal things) and delusions (believing in unreal things).
If you have these symptoms of depression, you may still be "normal" to some extent, as if everything is good, but probably not. Professor Rong said that if you can hide it or still live well, it is likely to be a "high-function" depression.
Conceal the reasons why you have depression
Professor Rong believes that the following are some reasons why you may feel that you must hide your depression symptoms from others:
· You may be affected by family or cultural factors and dare not talk about mental or mental illness;
· You think it would be better to "get through" yourself;
· You are trying to avoid any impact on your work and relationships, and hope that depression will be relieved;
· You are a person who is unwilling to show weakness or perceived weakness;
· You think it is shameful to suffer from depression;
· If people find that you have depression, you think your life will fall apart and relatives and friends will abandon you.
How to treat "high-function" depression?
Although you may have "high function" depression, this does not mean you do not need treatment. Treatment of depression includes:
·Psychological therapy: Professor Rong said that cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and hypnotic therapy can all help you eliminate the shame or fear of depression. Psychological therapy can help you take a step back from the urge to hide depression from everyone. A psychotherapist will help you get out of your study, work, family, cultural background or other factors that affect your hidden depression.
·Medical treatment: Moderate to severe depression may help with antidepressants. These drugs control and alleviate depression symptoms by improving neurotransmitter levels in the brain. There are many different types of antidepressants, so you take the medication strictly as directed by your doctor.
·Helping and support from relatives and friends: If you are unwilling to talk about depression with other people in your life, you can confide in your trusted relatives and friends and seek their help and support.
Sometimes it is found that it is hard to believe that those who are optimistic and smiling all day may suffer from depression. However, it is important to remember that depression can affect anyone, even those who are wealthy, famous or successful, or those who seem to live in a relatively ideal environment.
Professor Rong believes that depression is neither a character flaw nor a weakness, nor a shameful thing.
If you are experiencing depression, it is important to get help so that you can start to feel better. Depression is one of the most treatable mental health problems and the possibility of successful treatment is very high. Treatment may also be helpful for having difficulty accepting the fact that you have depression or feel the need to hide from others that you have depression.
Reference:
1.Yatam S, Sivathasan S, Yoon R, da Silva TL, Ravindran AV. Depression, anxiety, and PTSD in youth in low- and middle-income countries: A review of prevalence and treatment interventions. Asian psychiatrist. 2018;38:78-91. doi:10.1016/j.ajp.2017.10.029
2.Rosenblat JD, Kurdyak P, Cosci F, etc. Depression is medicine. Aust NZJ Psychiatry. 2020;54(4):346-366. doi:10.1177/0004867419888576
3. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders Revised Edition, Fifth Edition.
