Today is ‘World Mental Health Day’ which seems like a good time to write this post. For the last decade I have been struggling on and off with what is frequently referred to as ‘high functioning depression’. It’s a term coined to describe depression that doesn’t match the stereotype of the illness, of those not able to get out of bed, unable to take care of themselves, struggling to maintain relationships. Many people with high functioning depression will still go into work, have some kind of social life, stay on top of the essentials of life. It’s sometimes called ‘smiling depression’ because those struggling with it can appear happy to the outside world.
But for those with this illness the smile is masking a lot of pain, they’re often screaming on the inside. They may appear okay yet they are still battling a significant and dangerous mental illness. They could still be struggling with suicidal ideation or destructive coping strategies. We often see the tragic headlines of someone who took their own life after seemingly going about life as normal the day before.
Countless times over the years, when I’ve been struggling with my mental health, I’ve been asked ‘what can we do help?’ It’s a question that I’ve rarely had a good answer for, it’s easy to just default to ‘nothing’ or ‘I’ll let you know if I think of anything’. Articulating what you need is hard when you’re in the midst of a depressive episode and believing you deserve the help of other people is even harder. But after a decade of experience with this illness, I’ve learnt a lot about what is and isn’t helpful. Some of these things may be unique to me as an individual, depression manifests differently in different people. However, I imagine there will also be common ground here that I share with others with high functioning depression.
So how can you support someone with high functioning depression?
1. Listen and don’t take them at face value
We are part of a society that judges by appearances and we can easily fall into that trap when assessing how a loved one is doing. When confronted with an immaculately dressed, seemingly successful person in their tidy home it can be easy not to hear them when they say they’re not okay. It’s tempting to tell them of all the reasons why they are fine, reeling off achievements and evidence. But in doing so you have inadvertently invalidated their feelings and left them feeling unheard.
If your loved one says they’re not coping and are struggling, you need to take that seriously. There may be little you can do to help, apart from offer friendship and signpost them to professional support. But don’t underestimate the power of listening and showing someone you care. The very fact that they have trusted you with this information shows that they consider you a safe person in their life. Try and hold that safe space for them where they can be vulnerable, free from judgment, knowing you love them regardless.
2. Stay in touch
When you’re struggling with depression, communicating with friends and family can be difficult. I often find all of my energy goes into holding it together at work and the basics of self care. Weeks can go by without me managing to initiate communication even by something as simple as sending a text message. If you, as someone who loves someone with depression, are able to make the effort to check in and keep the lines of communication open then please do. Don’t assume that no news is good news.
On a similar theme if someone with depression reaches out and asks for your time then try and respond promptly. Saying no is absolutely fine but by saying your no quickly you give the person time to ask someone else. When my mood was really low I would struggle with how to fill a weekend to protect myself from too much alone time. It was important for me to have enough human contact each day so I would try and make arrangements. If I heard back from friends quickly that they weren’t free I could make other plans. However, there have been times where the ‘no’ came through too late and I ended up with a weekend that was too empty.
Obviously everyone is going through their own stuff so sometimes responding to messages can fall by the wayside. But if you can make an extra effort then it could make a huge difference.
3. Help with the ‘impossible tasks’
Depression can make seemingly every day tasks feel impossible. For those with lower functioning depression these could be everyday tasks like brushing teeth, getting out of bed, leaving the house. With high functioning depression we tend to have the basics down but there will still be tasks that feel impossible which will vary from person to person.
For me in the past these have been things like ringing up the dentist to see if they’re taking new patients, which took me several years to do. Or researching and buying a new laptop. These days it’s things like cutting my hedge or getting quotes for some building work I need. I know they should be possible and I know I’ll feel better when they’re done but most of the time I can’t even contemplate doing them.
So if you have time and capacity try asking your loved one with high functioning depression what their ‘impossible tasks’ are and offer to lend a hand.
4. Kind words for unkind days
The thing with high functioning depression is that you always pay a price for keeping going. There will be times when you are no longer functional and find yourself crumbling. For me I would hold it together all day and then fall apart in the evenings when I was alone. Those would be the times where my mood would plummet even further and I would struggle to see the point of keeping going. I find it incredibly difficult to reach out at those moments, with so little left in the tank for communication.
One thing I cling to on those nights is the words of love and encouragement from those who care about me. I have a box where I keep things that may help ground me in those darkest moments. Most helpful of all the things in there are cards and letters from loved ones, telling me what I mean to them, that I am loved and valued. Words I can come back to time and time again.
Depression tells you a lot of lies and makes you believe you are too much, that you lack any redeeming qualities and that people will be better off without you. Memories of kindness fade and become difficult to recall, but it’s harder to argue with words there in black and white. Sending someone with high functioning depression a card or letter with kind words for those unkindest of days can help remind them that there is light beyond the current darkness.
5. Look after your own mental health
And lastly but by no means least it is important you take care of your own mental health. Supporting someone with mental illness, high functioning or not, is hard work and can be emotionally draining. It’s easy to give out more than you can afford to and neglect your own wellbeing. But your loved one doesn’t want you to suffer from carrying too much of their pain. You have to put on your own oxygen mask before you can help anyone else. Work out how much time and energy you can commit and communicate those boundaries kindly but clearly. Good mental health is a precious resource to be protected at all costs, it’s so hard to get back once lost.
If you’re reading this and know me personally then I have no doubt you will have done one or more of these things for me over the years. Thank you. It’s the people you share life with that makes it worth living. Mental illness is a tough road to navigate yourself or walk alongside someone else. There may be little you can do practically to support someone with high functioning depression but don’t underestimate the difference your love makes.
“The world is indeed full of peril, and in it there are many dark places; but still there is much that is fair, and though in all lands love is now mingled with grief, it grows perhaps the greater.”JRR Tolkien