High Functioning Depression: When Success Masks Suffering

We were zipping along to our next meeting with an agency, the taxi precariously weaving through traffic, me precisely applying lipstick when my colleague quipped, “Your house can be on fire and you’ll still have lipstick on, right?”

I laughed. It was true. That glossy red tube was my finishing touch—polish, perfection, and a mask for the turmoil within.

This was twenty years ago. I was leading marketing communications at a major telco, excelling at a young age. Confidence was my veneer. Everything looked perfect.

Depression? Not on my radar. Even when I hid, crying in bathroom stalls at work, I chided myself: You’re not incapacitated. You’re not missing deadlines. What depression?

Then I discovered high-functioning depression—and the invisible came to light.

The Paradox of High-functioning Depression

Why is high-functioning depression so invisible? The term itself is an oxymoron–a paradox even. How can someone seemingly so stable and successful be struggling? So much so that it confounds even those of us living in it, many completely unaware that the mask of overachievement is hiding our unacknowledged issues.

And unlike burnout which can usually be managed by addressing identifiable external stressors such as a heavy workload and overwhelming commitments, high-functioning depression often stems from internalised pressure—this need to perform really comes from within, the need to be strong, perfect, or to escape pain.

Achievement becomes the fuel. We feed off our victories, perfectly in sync with a society that loves over-achievers, rewarded in a vicious cycle of do great, get more responsibility, do even greater, get even more responsibility.

We congratulate ourselves for not crumbling, for being the strong ones, for our resilience. At least, that’s what I did. My armour was shielding the truth that I was struggling.

For me, my behaviour was the result of growing up the “well” sibling of a brother with schizophrenia. The invisible child in a household where everything was focused on dealing with his illness. Learning at a young age that it’s better to silence my feelings, and worse, that they did not have the right to exist in a family where everyone else’s problems seemed bigger and legitimate. Learning to be perfect and hyper-independent, to not add any further burden to the parents.

High-Functioning Depression in Collectivist Cultures

The clutches of high-functioning depression aren’t reserved only for siblings. Especially in collectivist cultures, even a trauma-free family can have members silently suffering. Why?

We recognise that “face” matters in Asian cultures, and the mere thought of someone in the family dealing with mental health issues can bring unwanted shame. 

Intergenerational considerations matter, too. Our grandparents and parents may have grown up in times where mental health awareness was non-existent, not while they were physically trying to make ends meet. Idealising resilience and fortitude, we can understand how they may see emotional distress as weakness. So we go about our business as usual; after all, we don’t want to disappoint our families.

Because in collectivist cultures, we are bound as a family unit. Yet, many of us feel distanced and alone in this unit. This is especially so for women. Assumptions and presumptions abound regarding a woman’s role as the nurturing one. We are supposed to be there for others, how can we possibly show any sign of our own struggles? Throw in the concerns about being seen as selfish and you silence yourself. The family grapevine will do that to you.

What is the Impact if Everything Seems Okay?

After all, we are excelling, aren’t we? But there is a cost, that’s for sure. Mine was insomnia, emotional dysregulation and headaches, neckaches, pretty much aches everywhere. 

I was trapped in a cycle of perfection and self-criticism, extending high expectations to colleagues and friends—I’m pretty sure I was a source of stress to them at times; some bridges have been burned.

Being unable to disengage from work is a sign, too. Ironically, I wore this as a badge of honour and was proud of my work identity. Once, upon returning from a two-week vacation to Spain, the first thing I did when I hopped into the cab was to call my staff (at 6pm, mind you) and tell her that I was back. And asking for updates. And planning my day ahead, all this before even stepping foot back into the office!

Looking back at this cab incident makes me laugh and groan at the same time—why was I so obsessed with work?

Clearly, work was filling an emotional void; a constructive escape, if you will.

Stigma, Self-awareness and Seeing the Light:

What makes it worse is that we are unable to share, especially in workplaces. I didn’t know I was being impacted. But even if I had known, I would not have shared. I was a young, female manager; I felt I had to put up the persona of confidence and competence. Anything else, and I thought I would be viewed as weak or undependable. Worse, I believed that to be true. Self-stigma is real.

Still, if we are aware and brave enough to share, the conversations are likely to deal with burnout. Solutions such as reducing workloads, off-days and company-wide wellness workshops are mooted, all of which are great for managing burnout and reducing stigma. However, in dealing with high-functioning depression, the underlying causes need to be treated. And trauma is often the root.

Self-awareness is the first step. But how did I even realise that all was not well in the first place? After all, decades of storing unexpressed emotions in my body, dealing with aches and insomnia, unwarranted emotional outbursts and fractured relationships still did not make me see the light.

I only saw it when my depressive instances were increasing in frequency in my mid-forties. For someone who had appeared to be doing well and believed herself to be doing so, I shocked myself when I told my husband this: “I cannot remember the last time I was happy.”

As the statement rolled off my tongue, I thought to myself, this can’t be right. And this was the moment when my husband suggested that I should consider seeing a professional because “I don’t want you to be still struggling with these emotions when you are seventy. I want you to be happy and I want to grow old and happy with you.”

The empathy, the desire, the power of his love, this was the impetus for me to finally go for therapy. And it was enlightening and validating in so many ways. I saw how my childhood trauma connected with the depressive episodes and anxiety.

Workplace support can help, but at the end of the day, it is up to us.

While there is increasing sensitivity to mental health matters at the workplace with some companies offering time-off, mental care reimbursements and creating a less punitive/judgemental culture, more can be done regarding this invisible depression. Leaders and colleagues can be trained to spot signs: overwork, perfectionism, emotional withdrawal and learn how to help someone kickstart their mental health journey.

That said, there is only one person who can take care of our own well-being, and that is us. We need to be able to recognise when we are struggling mentally and be brave to seek the support we need.

For me, with therapy, healthy habits like mindfulness and meditation, and a commitment to boundaries and values, my mental well-being has improved. I am no longer an invisible slave to this form of depression.

About the author: Yasmeen @lifeofyasmeenhc shares raw, personal insights on mental well-being through her speaking engagements and blog, Not a Pretty Picture. She is currently completing her memoir about growing up as the invisible sibling of a high needs individual.