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I Have A ‘High-Functioning’ Mental Illness — No, It’s Not as Great as You Think

I was first diagnosed with depression when I was 15 years old. At the time, I didn’t know much about it or my symptoms. I knew it was an illness — a mental illness — and one that affected almost every aspect of my life, but beyond that, my knowledge was limited.

The only thing I knew about depression was what I saw on TV or in antidepressant commercials. That said, I quickly learned I wasn’t the “normal” depressive patient; I was a straight-A student and a member of the drama club, the history club, choir and the National Honor Society, and I had a part-time job. I also had a semi-normal social life and several very good friends. As such, I wasn’t the stereotype. I didn’t fit into the “sick” or “crazy” kid mold.

Doctors told me I was lucky — things weren’t, and I quote, “that bad” — because I was a high-functioning individual. Because I could live a relatively carefree life. But after having (and fighting) said illness for 19-plus years, I can tell you with absolute certainty that having a high-functioning mental illness isn’t a blessing. Not really. In fact, it is just as dangerous, just as damaging and just as scary as regular depression if not more so.

You see, every day, I wake up and get out of bed. I get my daughter dressed, make her breakfast and take her to school, and then, I head out to work, but I struggle: to think, to feel, to function.


I struggle to be present and alive.

Of course, you wouldn’t know it. I slap on a smile and laugh a fake laugh. I carry on conversations like everyone else. But inside, I am yelling. I am screaming. I am crying. I am consumed by emotion or completely empty and numb.

And while I don’t act this way because I want to, I do it because, subconsciously, I feel like I have to; because it is my way of standing up and fighting back. It is my way of taking control… or so I like to pretend.

Or so I believe.

Unfortunately, this facade is exhausting. It is isolating and makes me feel lost and alone. It also means my mental illness isn’t always taken seriously when I do reach out because people see me as strong and productive and happy. They don’t understand the pain that sits behind my paper-thin mask.

And that? That may be the most dangerous part of having a “functional” illness: No one knows when I am breaking down or falling apart.

Of course, I could tell someone. I could simply say, “I am not OK.” But part of having a functional illness also means I feel immense guilt when I am struggling; I feel like my problems aren’t big problems. I have no right to complain because I am still living. Because I am able to carry out my life. And because I am #blessed.

I feel as though I have no right to write this article because there are people worse off than me. So I sit back, I shut up, and I suffer in silence — until I am at or near a proverbial breaking point. I rarely admit I am struggling until I am suicidal (which, unfortunately, is a thought I experience all too often).

Of course, this isn’t a good thing or a healthy thing — I know it, my family and friends know it, and my psychiatrist knows it; he knows that by time I call him I am already teetering on the edge — but I can’t help it.

I do it every single time.

So, what can you do if, like me, you are a “high-functioning” individual? What should you do? Well, I don’t know. I really don’t. But I know that for me, a big part of conquering my depression is accepting I have depression and viewing mental illness as a real illness.

Just because you are one definition of “functional” doesn’t mean you are any less sick.

What’s more, you should ignore the bullshit and the labels, because whether you are high-functioning or low-functioning doesn’t matter. Everyone is worthy of help and love.Does that mean things will be any easier? Will acceptance make your illness any more manageable or any better? Maybe. Maybe not. You may still feel lost, crazy and alone. But it is something — and that’s a start. That is half the battle.

If you or someone you know is struggling with depression, text “START” to 741-741 to speak to a trained counselor at Crisis Text Line and/or call the Substance Abuse and Mental Health Services Administration at 1-800-662-HELP (4357).

A version of this essay was printed November 2018.

Looking for an easy way to give a bit more attention to your mental health? Here are a few of our favorite mental health apps:

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