High-functioning depression: when life looks fine and the joy is gone
Psychiatrist Judith Joseph describes people who meet every deadline while feeling empty and names anhedonia as the tell, and Senator John Fetterman, Terry Bradshaw, Will Sasso, the Botez sisters, Greg Lukianoff and Rachel Platten each recount being depressed while performing at a high level. Their accounts show why this form of depression is missed by doctors, colleagues and the person living it, and what finally got each of them help.
What is high-functioning depression? Show answer
Depression in someone who still meets every obligation. The life looks fine from outside and the joy is gone.
What is anhedonia? Show answer
The loss of pleasure, or diminished joy, in things that used to feel good. It is the central sign to look for.
Why does the medical system miss these patients, according to Judith Joseph? Show answer
Diagnosis looks for impairment and distress, so people who are still functioning are told to come back when worse.
Why do people fail to see it in themselves? Show answer
They picture a depressed person as someone in bed all day crying, and their role leaves no room to be depressed.
How does busyness fit in? Show answer
Work and caring for others let a person avoid feelings, and those are also the things everyone praises.
How may depression look different in men? Show answer
Often without sadness. They may be irritable, angry, checked out or drinking after work.
What does John Fetterman's story show? Show answer
Success does not protect. His depression got far worse after he won, and hospital treatment helped.
What does Fetterman mean by an emergency brake? Show answer
Something that stops you at the worst moment. For him it was his children.
Why did nobody suspect Terry Bradshaw? Show answer
Depression does not steal your personality, so people assume a funny, successful man cannot be depressed.
What belief does Joseph ask people never to hold? Show answer
That they are a burden. The people who love you want you to ask for help.
Is a low mood a signal or a liar? Show answer
Both. It may point to something that needs attention, but its conclusions about your worth and future cannot be trusted.
What should you do if you recognize yourself? Show answer
Talk to a doctor or licensed therapist, and contact a crisis line or emergency services for thoughts of self-harm.