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  • Leena A. Khanzode MD

"I'm okay, I have to be" - High Functioning Depression


Sharing another blog by our youth- Gowri Anupama, a freshman in College.


High functioning depression is not a clinical diagnosis per se, but rather it can be a term seen as a less formal description of a type of depression with which one may identify closely. The term stems from the idea of how depression can be invisible in some people, especially those who are seen as high functioning in society. To the outside world, depression does not seem to debilitate these individuals, or even really affect them. The reality is, depression is not always just crying, failing classes, struggling to maintain friendships, or skipping work. Depression can also be smiling through the struggles, achieving high goals, adding new successes, and getting along with people. This does not mean that depression doesn’t hurt or that it is easy. This definitely does not mean that people are okay. High functioning depression feels like, “I’m okay, I have to be”.


Everywhere you look, the media portrays mental illnesses in such an extreme manner, neglecting to address the fact that things like depression present themselves in very different ways among various individuals. Oftentimes, high functioning individuals force themselves to “be okay” in order to continue achieving and reaching great heights in their academic or professional platforms. I myself faced this issue, especially because I was afraid of what others would think of me. In fear of being perceived as weak, I would neglect to acknowledge my mental health, let alone take care of it. On top of that, I built up fear that those around me would assume I was faking it. Even I started to question myself for possibly faking it. The need to justify feelings only put more pressure on myself, sucking all the energy out of me. Attempting to hide all this only delayed reaching out for help until absolutely necessary. 


In the eyes of others, my “good days” were great and I seemed to be thriving. My “bad days” still looked like I was doing well, while in reality they were the most tiring and hardest to get through. Perfectionist thinking contributes to the struggles of depression, especially in someone who never feels like their best is enough for themselves. Constant competition with themselves to be better than the last time makes it difficult to rest, and the feeling of guilt begins to grow. Like I’ve explored in the past, an unhealthy ego makes it nearly impossible to avoid pushing yourself too hard. In my case, some recurring thoughts were: “get over it”, “stop being lazy”, “maybe you’re just a burnout”, etc. Growing up in the overly competitive Bay Area, did not make things easier. Seeing a doctor, going to therapy, and getting help are seen in a negative light in a community like this. 


Looking at recent World Health Organization (WHO) statistics, over 264 million people experience depression. These are just the diagnosed cases. So many people, like these high functioning individuals, go un-diagnosed and do not get help simply because of the “invisibility” of their depression and the stigma they face. Fearing that acknowledging mental illnesses will affect my ability to achieve backfired. Ultimately, neglecting to take care of myself is what got in the way of my life. The moment I faced the truth of how it felt and got help, things began slowly turning around. Yes, it is a winding road with ups and downs as well as steps backward, but taking that first step of accepting and reaching out at least gets that journey of recovery started.

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