High-functioning depression, or dysthymia. may be harder to detect than major depressive disorder (MDD) because the people living with it are often high achievers who make you think everything is all right all the time.
Over 6.7% of adults in the United States—16.2 million!—endure at least one major depressive episode annually. While the stigma against seeking mental health treatment is lessening, there remain some dangerous myths. Such as that if depression isn’t severe and persistent—involving frequent bouts of uncontrollable weeping, emotional paralysis, and suicidal thoughts—then there isn’t a real problem and one should just tolerate pain with stiff-lipped silence.
For people with high-functioning depression, the “invisible illness” aspect of the mental state can feel particularly searing. A few years ago, after shoulder surgery, my arm was in a sling. People fell over themselves to cluck with sympathy at my pain—socially sanctioned pain. It felt good to be the object of so much caring.
But on the days when listening to the sorrows of others exacerbates my own and I feel spent, I typically stay silent, not wanting to advertise my own vulnerability. Why is it so much easier to let others in on pain when it’s physical?
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