Depression in teenagers can sometimes be hard to detect, especially when it doesn’t fit the more recognizable patterns of severe sadness or withdrawal. High-functioning depression doesn’t always present with the classic symptoms, such as sadness, hopelessness or a lack of interest in activities. Instead, teens experiencing high-functioning depression may appear to be high-achieving, successful and even cheerful on the outside. While this may be their exterior, on the inside, they may be struggling with underlying feelings of sadness, emptiness or worthlessness. Their depression symptoms interrupt their day-to-day life either mildly or not at all. 

High-functioning depression is a term that can be misleading, as it’s not a formal diagnosis in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5-TR). The DSM-5-TR is a manual that qualified professionals use to diagnose and explain mental health conditions to their patients. While teens experiencing high-functioning depression may appear to be “doing fine,” they are constantly battling the emotional weight that affects their mood, energy and overall well-being. They may not experience extreme emotional breakdowns, but high-functioning depression can still have long-term impacts on their mental health, personal development and their ability to cope with life’s challenges. 

Common symptoms of high-functioning depression

While symptoms of high-functioning depression can vary, some common symptoms, according to Cleveland Clinic, can include:

1. feeling hopeless, helpless or sad
2. loss of interest in things that they used to enjoy
3. changes in eating habits
4. changes in sleeping patterns
5. difficulty concentrating
6. negative thoughts about themselves or others

The exact cause behind high-functioning depression and depression isn’t exactly known but may include factors such as:

• brain chemistry
• hormones
• family history
• early childhood trauma
• learned patterns of negative thinking

In addition to these factors, certain risk factors can make teens more susceptible to developing teen depression:

• having low-self esteem
• experiencing other mental health conditions
• having a learning disability or attention-deficit/hyperactivity disorder
• having a chronic illness
• misusing substances or drugs
• being a part of the LGBTQIA+ community in an unsupportive environment

How to support your teen experiencing high-functioning depression 

If you suspect that your teen may be experiencing high-functioning depression, it’s essential to offer them support and encouragement. Here are some steps you can take to support them:

• Have open communication — The first and most important thing you can do as a parent or guardian is to have an open line of communication with your teen. Let them know you are there to listen to them without judgment and encourage them to share their feelings. Your teen may not realize they are experiencing depression because they don’t fit the typical image of someone who is severely withdrawn or feeling hopeless. Being there for them and helping them to realize that it’s OK not to feel OK, even when they are managing their daily tasks, can be a huge relief for them. 

• Practice active listening — When your teen turns to you to open up about their feelings, it’s essential to practice active listening. This means you give your teen your full attention, listen without interrupting them and show them that you’re truly engaged in what they have to say. You can do this by nodding, keeping eye contact and giving verbal cues such as, “I understand” or “I’m here for you.” Active listening shows your teen that you genuinely care about their feelings and want to understand what they’re experiencing. Don’t immediately jump to offering solutions; they may just need to feel heard. Ask if they want help problem-solving and then give advice if needed.  

• Validate their emotions — Your teen may feel guilty or confused about their emotions because they don’t “look” depressed. It’s crucial to validate their feelings by letting them know it’s OK to feel how they feel, no matter how confusing or overwhelming it may seem. You may say something like, “I can see that you’re going through a lot right now, and it’s OK to feel sad or overwhelmed even if everything seems fine on the outside.” Validating your teen’s emotions can help reassure them that their feelings are real and worth addressing. Reassurance can help them feel less isolated and more understood. 

• Encourage healthy habits — Depression, even in its high-functioning form, can take its toll on your teen’s physical and mental health over time. Encourage your teen to adopt healthy habits to help them manage their emotional well-being. A few important areas to focus on include getting enough quality sleep, doing physical activity, eating a nutritious and balanced diet, practicing mindfulness and relaxation exercises, and staying socially connected. 

• Seek professional help — If your teen’s symptoms are severe or persistent, you may want to consider seeking help from a mental health professional. Therapy can provide your teen with valuable tools for coping with depression. A mental health professional can help your teen:

• understand their feelings
• develop healthy coping skills
• identify any underlying issues

This support is crucial in helping your teen manage their high-functioning depression and begin their journey toward healing.

Complications of untreated depression

If left untreated, even high-functioning depression can have serious consequences, including:

• relationship challenges and family conflicts
• family conflicts
• academic performance decline
• substance use
• suicidal thoughts or behaviors
• development of other mental health conditions

Tailored mental health support for your teen with Embrace U

At Embrace U, we were founded to help address the mental health crisis facing adolescents aged 10 to 18 in Middle Tennessee. We understand the unique challenges teens face and know that sometimes they need extra support than traditional weekly sessions can provide. Our intensive outpatient programs are offered after school to help ensure that care fits seamlessly into your teen’s life. We believe that caring for their mental health shouldn’t come at the expense of living their life to the fullest. Our culture is built on kindness and acceptance, with a strong focus on diversity, equity and inclusion. We are committed to creating a safe and welcoming environment where every adolescent feels a sense of belonging, empathy and security on their journey toward healing.

Contact our team today for more information or to schedule an initial appointment.