High-functioning depression in high-achievers

It’s time we address our narrow definition of depression

During my AS year of high school, I studied the equivalent of five A-Levels. Looking back, it was pretty stupid of me. I needed a maximum of three for any prospective course I wanted to apply for, but my 16-year-old self had a perfectionist’s pipe-dream of studying at Cambridge and, well, five A-Levels (in my mind) looked better than three.

I had one free period per week in which I crammed as much homework as humanly possible, while most other students around me chatted for fifty minutes on a Friday afternoon. Eventually, my workload caused me to adapt to the following routine: sleep from around 4:30pm until anywhere from 9pm to 2am, reheat the dinner I missed, do my homework, work on any impending coursework deadlines, study for any upcoming tests and then travel to school again at around 9am. This daily schedule lasted for around six months: school, sleep, schoolwork, and repeat.

This worked, of course, until I had the inevitable mental breakdown during the Easter holidays. Until then, I’d managed – if only just – to meet my deadlines and maintain the grades I needed. Unfortunately, this was unsustainable and was instead replaced with a plethora of depression symptoms I had come to suppress until my balloon of a body had popped under the pressure.

My attendance spiralled, as did my mental health. I missed class, and even some exams. I can’t remember how long this lasted – depression has a tendency of turning any length of time into this hazy fog. However, what I do remember is that without my friends, family, and teachers being so supportive, I wouldn’t be at university today. Unfortunately, not everyone is as lucky as I was.

This is the deceptively destructive truth of high-functioning depression, or dysthymia. People with this disorder tend to be, but are not always, high achievers. This high level of functionality and productivity tends to mask the symptoms we typically associate with typical major-depressive disorder. However, the constant striving for success leads to low levels of self-esteem, confidence, and also a perpetual self-doubt. This intense desire for perfectionism sits as a debilitating knife at the throat of those affected, at times paralysing them from making any progress.

You may be wondering what happens if someone doesn’t live up to their own expectations. If they don’t have a breakdown from sheer exhaustion, any performance that is even a smidgen below their high self-expectation can act as a trigger, resulting in an array of symptoms like self-punishment, both mentally and physically. This can be intrusive, self-deprecating thoughts, or even self-harm, justified as a punishment for failure. It can also cause a complete mental breakdown.

Until my depression developed into major-depressive disorder, I was in denial about being depressed. I didn’t fit the “depressed” archetype as we have come to understand it as a society. Due to this preconceived notion of what depression is, I repressed my own symptoms and didn’t seek professional treatment.

We must broaden our narrow definition of what we count as being “depressed”. Rather than a static, one-box-fits-all term, depression acts more as an umbrella term for multiple mood disorders: major-depressive disorder, seasonal affective disorder, and post-natal depression to name but a few. If we do this, those suffering will be more able to identify with what it means to suffer from depression, despite differing symptoms. This will tackle the alienation people feel in regard to identifying with their mental illness, reducing the stigma around fitting the prescribed idea of what it is to be depressed. With any luck, this will facilitate self-acceptance and self-awareness, aiding those suffering in seeking treatment.