Individuals who appear to be high-functioning may have persistent depressive disorder. Here are some of the common symptoms:

• Low self-esteem
• Changes in sleep habits (sleeping too much or too little)
• Changes in appetite (overeating or decreased appetite)
• Difficulty concentrating
• Trouble making decisions
• Feelings of hopelessness

In order to qualify for a diagnosis, the symptoms must be present for two or more years. Consequently, many individuals who have these symptoms have learned to function despite them.

They might convince themselves their depression isn’t that bad:

• They minimize their issues. They could be less likely to gain emotional support from others if their depression goes undetected. Additionally, someone with high-functioning depression might feel guilty about getting help.
• They feel they shouldn't be depressed. They might tell themselves that since they can still function, they should be happier. These thoughts may prevent them from asking for help.
• All types of depression can lead to an increased risk of suicide.