I’m OK: Recognizing High Functioning Depression & Addiction

People who suffer from depression are twice as likely to suffer from addiction compared to the general population, and can usually fare well at managing both disorders while also succeeding at their education, jobs, and family lives. But just like any other dual diagnosis, high functioning depression and addiction are difficult to manage behind the scenes, despite the apparent success of people who suffer from these conditions.

Many who suffer from a high functioning dual diagnosis will often continue navigating their daily lives without getting treatment help — putting their overall livelihoods at stake and increasing the risk for overdose, suicide, and related complications. But if you’re silently suffering from depression and addiction, understand that treatment is available to help you overcome both disorders.

Are you a high functioning addict who may also be suffering from high functioning depression? Here are signs you may be suffering from one or both disorders, along with what you can do to get help for a dual diagnosis.

What Makes Someone “High Functioning?”

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Ask people to describe what they think depression and addiction looks like, and many will probably tell you they imagine people who are always sad, tired, and unable to get out of bed every day, and who begin the day with drug and alcohol use. They may imagine people who neglect their personal hygiene, don’t have jobs, and who isolate themselves from friends and family so they can treat their depression symptoms in secret using drugs and alcohol. Though all these behaviors can be tell-tale signs and symptoms of depression and addiction, not everyone with a dual diagnosis acts this way.

People who are high functioning often give the impression their lives are going extremely well, and seem to be happy and successful despite their problems. High functioning individuals may be intelligent, friendly, outgoing, and extremely disciplined. They may have great jobs, lots of friends and family, and look as if they’ve got it all together. But high functioning people usually do everything in their power to give off the impression they’re doing fine, when in reality, they’re fighting and struggling to keep it together and survive each and every day.

Roughly 50% of people who suffer from substance use disorders are considered high functioning. Many of these people suffered from depression first, and used drugs and alcohol to self-medicate their symptoms. Some of these individuals may even have suffered from addiction first, and developed depression symptoms later on due to the effects of long-term drug and alcohol abuse on the brain. High functioning depression and addiction are more common than you might think, which is why it’s important to know the signs of both disorders so you or your loved one can get help as needed.

Signs of High Functioning Depression

High functioning depression is also known as persistent depressive disorder, or dysthymia. People diagnosed with this mood disorder generally don’t suffer the same levels of impaired functioning as other types of depression, which is often why high functioning depression can be difficult to spot. Those with dysthymia can usually get up, go to work, care for family, and perform other normal daily activities without seeming as if they’re depressed. Evidence suggests an estimated 1.5% of U.S. adults suffer from persistent depressive disorder.

From a clinical standpoint, high functioning depression is characterized by being in a depressed mood for most of the day on most days of the week, for at least two years. Symptoms of high functioning depression include overeating or lack of appetite, insomnia or hypersomnia, fatigue, low energy, low self-esteem, feelings of hopelessness, poor concentration, and problems with decision making. Unfortunately, many of these symptoms may only be detected by the person affected, and may not be so obvious to others.

Here are other common signs of high functioning depression.

Reduced Energy

Depression zaps your energy and can make it feel as though you barely have any physical, emotional, or mental capacity to make it through the day. But those who suffer from high functioning depression usually tend to make it through the day despite feeling drained and having low energy. Insomnia is one of the most frequent residual symptoms of depression, and can cause you to feel tired and fatigued on a consistent basis. Suffering from reduced energy all the time regardless of what you do to combat your fatigue is one of the most common signs of high functioning depression.

Inability to Feel Joy

People who suffer depression tend to have lower serotonin levels. Serotonin is a brain chemical that regulates sexual desire, memory, mood and social behavior, and many other important functions — including the ability to feel joy. If things in your life that once made you happy are no longer able to bring you joy, or you feel as if some of these things are more burdensome than enjoyable, you may be suffering depression.

Unjustified Irritability

Depression is linked to an imbalance in brain chemicals including serotonin, GABA, and dopamine, among several others. This imbalance can lead to severe mood swings and irritability at any given time, even when it’s unwarranted. If you find yourself constantly getting angry, upset, and irritable about little things, or tend to blow things out of proportion in relation to the event, it’s possible your unjustified irritability is a sign of high functioning depression.

Constant Self-Doubt

People who suffer from high functioning depression tend to put enormous amounts of pressure on themselves to succeed in various areas of their life. At the same time, they also tend to experience self-doubt, and constantly worry about whether they’re doing the right thing and making the right life choices. While it’s normal to experience self-doubt at times you face certain challenges in life, dealing with constant self-doubt isn’t healthy and can indicate depression.

Always Seeking Perfection

Perfectionism is impossible to achieve, but those with high functioning depression tend to strive for perfectionism to the point it leads to mental anguish and general dissatisfaction with life. It’s not uncommon for people to fall prey to perfectionism, especially when society puts pressure on people to do well in school, go to college, hold down an amazing job, and raise a healthy family. But some people allow these unrealistic demands to take over their lives, which makes them more susceptible to depression. If you’re constantly working toward achieving goals that may be unrealistic, this may be a sign of high functioning depression.

Using Drugs and Alcohol to Cope

Symptoms of depression can be highly difficult to cope with, and can often be lessened temporarily by using drugs and alcohol. Evidence suggests that self-medicating your depression using drugs and alcohol can actually worsen depression and lead to long-term problems with dependence and addiction. If you feel as though the only way to cope with your problems is to use drugs and alcohol — such as at the end of every busy workday — it’s possible your high functioning depression could trigger a high functioning addiction and lead to a dual diagnosis.

Signs of High Functioning Addiction

High functioning addiction works similarly to high functioning depression, except those who suffer from high functioning addiction are able to maintain relatively successful lives while being dependent on drugs and alcohol. These individuals may use drugs and alcohol throughout the day at work or school, or while spending time with their children and other relatives. They may also use drugs and alcohol as a way to cope with stress, depression, and anxiety at the end of every day.

Here are other common signs of high functioning addiction.

Spending Time with Drug-Using Peers

Those with high functioning addiction may spend more time with drug-using peers who don’t judge or make them feel bad about their addiction. These people may be coworkers, friends, and other people who spend time in the same environment as your loved one who struggles with addiction. If you notice your loved one has been spending more time away from home and with new people you don’t know, it’s possible they may be suffering from addiction.

Viewing Drugs as Rewards

Some people view their drug and alcohol use as a much-deserved reward after a hard day’s work. High functioning addicts may insist alcohol is the best relaxation remedy after a long, stressful day on the job, or buy themselves party drugs like MDMA or ketamine to celebrate academic success or a promotion at work. If you’ve heard justifications like these coming from your loved one in response to your concerns about their drug use, it’s possible they’re navigating life as a high functioning addict.

Obsessive Thoughts About Drug Use

Being constantly preoccupied with thoughts about drug use is one of the most common signs you may be suffering from addiction. If you’re a high functioning addict, you may think about drugs relentlessly until the moment you’re able to obtain and use them. If you suspect your loved one is suffering from high functioning addiction, take note of whether they’ve been talking more frequently or excessively about obtaining and using drugs and alcohol.

Making Excuses for Drug Use

Those who suffer from addiction tend to use a number of excuses to justify their drug and alcohol use. In addition to viewing drugs as a reward, these individuals may say drugs are essential to helping them excel at their profession, or that their peers influence them to use drugs and alcohol at lunches, work events, and parties. For instance, your loved one may say they need cocaine and other stimulants that boost their concentration and help them stay focused at school so they can get closer to earning their college degree.

The Presence of Enablers

Enablers are people in the addict’s lives who allow the addicts to continue using drugs and alcohol without consequence, or without being held responsible for things they do while under the influence. Since those with high functioning addiction tend to be financial providers, enablers may be spouses, partners, children, and other family members dependent on the addict’s success. Have you and other family members been witnessing your loved one abuse drugs and alcohol without intervening, and without holding them accountable for their addiction? If so, it’s time to stop being an enabler and help your loved one seek addiction treatment.

Inability to Stop Using Drugs and Alcohol

Drug dependence and addiction changes a person’s brain in ways that make it nearly impossible for them to stop using drugs despite trying to quit. The inability to stop using drugs and alcohol can be caused by using substances with a high risk for dependence like heroin and painkillers, and by compulsive urges to use on behalf of psychological addiction. Those who suffer from high functioning addiction may suffer drug cravings and withdrawal symptoms when abruptly stopping the drug of abuse.

Getting Help for Depression and Addiction

A dual diagnosis for depression and addiction can be safely and effectively treated using detoxification, behavioral therapy, medication therapy, and other evidence-based therapies for these disorders. A drug detox helps you overcome physical dependence on drugs and alcohol, while behavioral therapy helps you identify and overcome the root cause of your depression and/or addiction. Many addiction treatment centers use medication therapy to treat depression and other persistent drug withdrawal symptoms like anxiety.

Those who need help overcoming a dual diagnosis for depression and addiction can benefit from receiving treatment at an inpatient drug detox center, where patients are monitored 24/7 by trained medical staff who reduce the risk for complications such as seizures, delirium tremens, and suicidal ideation. Treatment programs that last a minimum of 90 days are recommended for patients with a dual diagnosis, since 90 days allows for enough time in which to complete detox and receive education surrounding how to manage stress, avoid triggers, and achieve a successful, happy, and fulfilling lifestyle without the need for drugs and alcohol.

Visit our online directory to locate the nearest drug detox center in your area, or call 800-996-6135(Who Answers?) to discuss your available treatment options.