Silent Signs of High Functioning Depression at Work (and Evidence-Based Depression Treatment)
- Jeromy Deleff, MACP, CT, CCC, CCTP-II
- Sep 22
- 8 min read
Updated: Sep 30
Key Takeaways
“High functioning depression” isn’t a DSM diagnosis; it’s a useful lay term that often overlaps with persistent depressive disorder. Use it to notice patterns—not to minimize pain.
You can look engaged and productive while feeling flat, exhausted, self-critical, and detached—classic signs of depression that often get missed at work.
Small, science-based steps (behavioural activation, CBT skills, DBT emotion regulation, values-guided habits) can help restore energy, focus, and a sense of control.
If symptoms persist for two weeks or more or impair daily life, screening and treatment are available and effective.
Depression quietly reduces productivity more through presenteeism than sick days—another reason to address it early and compassionately.
Estimated Read Time: ~9 minutes
Before we go deeper, if you’re wanting tailored next steps, our page on Depression Therapy in Calgary walks through options and what support can look like.
You might also find these related reads helpful: Symptoms of Depression: 10 Signs and Evidence-Based Options, Trauma Depression Therapy: Phased, Trauma-Informed Care, and When Depression Feels Like a Fog: Finding Your Way With DBT.
Why “High Functioning Depression” Resonates—Especially at Work
You keep showing up. You lead meetings, send polished emails, hit deadlines—and still feel emptied out after small tasks. That’s the paradox of high functioning depression: outside, you look capable; inside, the day feels heavy and strangely far away.
Clinically, the phrase high functioning depression is not a formal diagnosis. It often maps onto persistent depressive disorder (PDD)—a lower-grade, longer-lasting depressed mood—or a pattern of recurrent, milder depressive episodes with brief reprieves. Think of it as a description of how symptoms show up—not a category in the DSM.
It’s also common to underestimate it because “you’re still functioning.” But functioning isn’t flourishing. Untreated, it can erode quality of life, relationships, and health—and workplace performance. Research suggests depression costs more through presenteeism (working while unwell) than through time off, which is one reason early depression treatment matters.
The Silent Checklist: Signs You Might Miss at Work
Use this as a compassionate self-scan—not a diagnosis. If several resonate most days for two weeks or more, consider a depression test (like the PHQ-9) and a conversation with a depression therapist or your primary-care provider.
Behavioural clues: You “over-function” at work to outrun poor moods, then crash at night. You volunteer for extra tasks to avoid feelings—unhelpful thinking patterns (“If I slow down, I’ll fall apart”) keep you sprinting. Routines (exercise, meals, sleep) feel inconsistent; weekends feel like recovery rather than life.
Cognitive & emotional clues: Quiet, persistent depressed mood; feelings of helplessness even when projects go well. Perfectionism and harsh self-talk; small mistakes trigger outsized shame. Emotional flatness: you “perform” warmth but feel detached from joy. Trouble concentrating, making decisions, or finding words in meetings—classic depression symptoms.
Physical clues: Heaviness, slowed pace, or restlessness; headaches, gut issues, or chronic pain that flare with chronic stress. Sleep swings (too little or too much) and energy dips that coffee can’t fix.
Interpersonal clues: Pulling back from healthy relationships; avoiding feedback or conflict. Masking emotion—“I’m fine!”—while resentment or numbness builds.
None of these alone prove clinical depression, but together they suggest a mood pattern worth attention.
What It Is—and What It Isn’t
What “high functioning depression” can describe:
A persistent, lower-intensity low mood with fatigue and self-criticism (often aligning with persistent depressive disorder).
Recurrent, goal-oriented coping (overworking, people-pleasing) that hides distress.
Periods where symptoms are alleviated, then return under stress or life transitions.
What it isn’t:
A lesser form of depression that you should “just push through.”
Proof you don’t need support because you’re still functioning.
A substitute for clinical terms like major depressive disorder or mood disorder categories used by mental health professionals for diagnosis and treatment options.
When Is It Major Depressive Disorder?
Clinicians look for clusters and duration. If you’ve had at least two weeks of low mood or loss of interest plus symptoms like sleep/appetite changes, low energy, guilt, poor concentration, or thoughts of death, you may meet criteria for major depressive disorder. Screening tools and clinical interviews clarify major depressive disorder symptoms and help tailor an approach to treatment.
It’s common to wonder about chemical imbalance. Current science sees depression as multi-factorial—biology, psychology, and environment all play roles—so comprehensive treatment for depression often blends therapy for depression, lifestyle shifts, and sometimes medication, based on severity and preference.
Why It Hides in High Achievers
Unhelpful thinking patterns: “I’m only worthy when I’m productive.”
Strengths turned up too high: conscientiousness, empathy, and reliability become self-sacrifice.
Workplaces reward visible output, not inner steadiness—so pain goes unseen.
Family history or a long history of depression can normalize persistent heaviness.
These patterns are understandable—and workable. You can build resilience and overcome depression without losing your drive.
What Helps (and Fits Real Life)
At Compassionate Central in Calgary, depression counselling for adults is warm, precise, and practical. We use research-based forms of treatment—especially cognitive behavioral therapy (CBT) and behavioural activation—because they’re proven effective for adult depression across settings. Therapeutic modalities like DBT skills, Internal Family Systems (IFS), and Compassionate Inquiry can be layered in, depending on goals. (Informational only; not medical advice.)
1) Behavioural Activation
Tiny, scheduled actions that give your nervous system new data: “I can move; life still has pockets of meaning.” Behavioural activation directly targets inertia and low motivation with structured, goal-oriented, science-based form of therapy steps (walk 10 minutes at lunch; message a friend Wednesday; prepare a simple breakfast). Over weeks, mood is nudged by action, not waiting for motivation.
2) CBT for Unhelpful Thinking Patterns
You’ll learn to spot mind-habits like all-or-nothing thinking and self-disqualification, then test them against evidence. This creates practical life skills for meetings, feedback, and difficult emails, and can be integrated into stress management plans for chronic stress.
3) DBT Emotion Regulation & Interpersonal Skills
When waves hit, you’ll practice tolerating distress, naming needs, and asking skillfully—key for relationship challenges at work or home.
4) Values-Guided Habit Design
We’ll align micro-routines with what matters—creativity, fairness, family—so change isn’t just symptom reduction; it’s personal development.
5) Strength-Based Approaches
We work with your existing strengths (reliability, empathy, discipline) and update the parts that are overworking. A solid therapeutic alliance with an experienced Counsellor or trained therapist is itself a predictor of improvement.
6) Thoughtful Collaboration on Medications
If symptoms are severe depression or persist despite skills work, you might consult your physician to discuss medication as part of a comprehensive treatment for depression. Many people find aspects of clinical depression alleviated with combined care.
Evidence Snapshot: Depression affects functioning, but treatment helps. Reputable health agencies outline effective options, Canadian sources describe how lower-grade, persistent patterns fit PDD, and workplace research consistently shows large presenteeism costs—another reason timely care protects people and teams.
A 7-Day Micro-Plan to Start Dealing With Depression (Quietly, at Work)
Day 1 (Mon): Name it. Write a one-line mood check: “Today my depressed mood feels like ___.” Choose one behavioural activation step (5-minute walk after lunch).
Day 2: Energy audit. Note one task that quietly drains you and one that gives a spark. Protect the spark with a 25-minute block.
Day 3: Thought spotter. Catch one self-criticism. Replace with a balanced statement (CBT style). Example: “This needs a revision” → “I can improve this draft in 15 minutes.”
Day 4: Body basics. Prioritize sleep routine and hydration. If chronic pain flares, add a two-minute stretch when you switch tasks.
Day 5: Social nudge. Send one honest text (“Work’s heavy; could use a walk this weekend?”). This supports healthy relationships even when you feel inward.
Day 6: Meaning minute. Two minutes to notice what mattered this week (helped a teammate, moved a project). This counters “nothing counts.”
Day 7: Re-aim. Choose one value (e.g., fairness) and one action that fits it next week (give credit publicly). Repeat.
This isn’t a cure; it’s a direct counselling approach you can start alone. In counselling sessions, we expand and adapt it to your life stages, life transitions, and specific workplace context so gains are durable.
How to Tell Whether You Need More Support
Symptoms persist two weeks or more, worsen, or interfere with work or home life.
You notice major depressive disorder symptoms (sleep/appetite changes, concentration problems, low energy, guilt, thoughts of death).
You’ve tried self-help and still feel stuck.
You’d benefit from a non-judgmental therapeutic space to recalibrate, practice life skills, and make a grounded approach to treatment plan.
Dealing with depression doesn’t have to be loud. Sometimes the bravest move is a quiet, first conversation.
Common Terms You’ll Hear (and How They Connect)
Major depressive disorder / clinical depression: Treatable with therapy for depression, lifestyle changes, and sometimes medication.
Persistent depressive disorder (dysthymia): Lower-grade, long-lasting depression—what many mean by high functioning depression.
Mood disorder: An umbrella term that includes MDD, bipolar disorder, and PDD.
Depression test: Brief screeners like the PHQ-9 help track symptoms and guide treatment options; they’re starting points, not final answers.
FAQs
Is “High Functioning Depression” a Real Diagnosis?
No. It’s a common phrase for a quieter presentation of depression, often aligning with persistent depressive disorder or milder, longer-lasting depressive episodes. Clinicians use DSM-5-TR categories like PDD and MDD to guide care. (Informational only.)
What’s the Best Therapy for Depression?
There isn’t a single best therapy for everyone, but CBT and behavioural activation are widely proven effective. DBT skills, IFS, and other approaches can help, depending on your goals and therapeutic alliance with an effective therapist.
How Do I Know If It’s MDD or PDD?
Major depressive disorder involves at least two weeks of symptoms that impair daily life; PDD is lower-grade but longer (often years). A clinician reviews signs of depression, duration, and impact, sometimes using tools like the PHQ-9.
Do I Need a Depression Test Before Counselling?
No. A brief depression test can be a helpful snapshot, but many people start depression counselling based on how they’re feeling and functioning. Screening can be done in or between visits to track change.
Is Depression Just a Chemical Imbalance?
Biology matters, but depression isn’t explained by chemistry alone. It’s a mix of biology, psychology, and environment—so treatment options often blend skills-based therapy, routines, and sometimes medication.
Can Therapy Help If I’m Still “Functioning”?
Yes. People with high functioning depression often respond well to structured, goal-oriented strategies like CBT and behavioural activation that fit real-world schedules—and a non-judgmental therapeutic space to practice them.
Ready to Take a Next Step?
If this resonated, you can book a free 20-minute phone consultation to talk through treatment options, ask questions about our depression counselling approach, and see if it’s a fit for your personal journey. We’ll discuss direct counselling approaches, set goal-oriented first steps, and look at how progress is measured so your quality of life is steadily alleviated and expanded—toward a more meaningful life and healthy relationships. (Informational only; not medical advice.)
Calgary Clinic Info
Compassionate Central: Counselling & Therapy
5940 Macleod Trail SW, Suite #500, Calgary, AB T2H 2G4
Phone: (587) 328-7732
Booking portal: Appointments, Directions
Services: Depression Counselling, Anxiety Counselling, Cognitive behavioral therapy, Internal Family Systems, and Dialectical Behavioural Therapy for adults; in-person sessions. Sliding-scale spots released periodically.
Accessibility: Elevator access; on-site parking; transit-friendly.
References (Selected)
National Institute of Mental Health. Depression. Available at: nimh.nih.gov/health/topics/depression
Patel RK, et al. Persistent Depressive Disorder. StatPearls (Internet). Available at: ncbi.nlm.nih.gov/books/NBK538165/
Public Health Agency of Canada. Depression. Available at: canada.ca/.../what-depression.html
Government of British Columbia. Major Depressive Disorder in Adults—Diagnosis & Assessment. Available at: gov.bc.ca/.../depression
Author
Gentle disclaimer: This article is educational and not medical advice. If you’re concerned about depression problems or safety (your own or someone else’s), please reach out to urgent supports above or consult your healthcare provider.
