Ask A Therapist
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Ask A Therapist
High-Functioning Depression (Ep. 18)
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High-functioning depression doesn’t always look like sadness. Sometimes it looks like showing up, providing, supporting everyone else—and falling apart quietly behind the scenes.
In this episode, we explore what it means to live with high-functioning depression, particularly as a man who’s expected to be strong, steady, and emotionally unshakeable. We talk about the pressure to be “the rock” for others, and how that expectation can make it harder to acknowledge your own pain—or even recognize it.
This conversation pulls back the curtain on the hidden exhaustion, isolation, and emotional numbness that so many carry while appearing fine on the outside. It’s about naming what often goes unspoken and creating space for honesty, support, and healing.
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Find Kenzie at therapy-with-kenzie.com or @therapywithkenzie
Find Carli at carlikingtherapy.com or @carlikinglmft
Hello and welcome. I'm Kenzie. And I'm Carly. And this is Ask a Therapist.
SPEAKER_01Each week we explore life's most relatable questions from relationships and boundaries to burnout and self-worth, all through a therapist lens.
SPEAKER_00We're licensed therapists, but this isn't therapy. It's a place for insight, reflection, and a little humor along the way. Your questions, our insights, ask a therapist.
SPEAKER_01This podcast is intended for entertainment and educational purposes only. The content shared should not be considered a substitute for professional mental health care, diagnosis, or treatment. We strongly encourage listeners to seek help from a licensed mental health professional for any personal or psychological concerns.
SPEAKER_00Any advice or commentary offered is based solely on the information provided. As such, we cannot guarantee any specific outcomes, and the feedback given should not be interpreted as professional mental health advice. If you are experiencing a mental health crisis, please call 911-988 or 211. All right.
SPEAKER_01Hi, everybody. Welcome back to Ask a Therapist. This is episode 18, and this week we are focusing on depression, specifically high-functioning depression. We want to share a quick reminder that while our questions are specific to listener submissions, the insight and response we share are meant to be supportive and applicable to anyone who may be listening. So please tune in. And if you're experiencing any of these same feelings, please know you don't have to navigate them alone. We're excited to explore this with you all. So let's get started. Carly, I've got our icebreaker for this week. And it is just like a silly, fun, easy one. But would you rather give up alcohol or coffee for the rest of your life?
SPEAKER_00The rest of my life. My answer probably would have been very different in my early 20s, let me just say. But today, I would absolutely hands down, 17 times over, give up alcohol versus coffee.
SPEAKER_01Yeah.
SPEAKER_00I am definitely a coffee girly. I typically have it every morning, although I have tried to like, you know, not be so dependent on it. But, you know, alcohol, I can go weeks and not even notice that I haven't touched alcohol. But coffee, if you take that away from me, that's gonna be, I'm gonna notice that every day. And you will probably notice it pretty quickly as well. So definitely I'm I'm giving up the alcohol. What about you?
SPEAKER_01Yeah. Yeah. Well, this this question's a little bit tough for me. I don't drink coffee. I don't drink coffee, I don't drink ke tea, I don't drink any kind of caffeine. Um, not because I'm like, oh, I don't want caffeine. I just like I never have. I just haven't gotten into it. And so I kind of feel like, all right, I don't really want to feel like I need something um to serve the day. So I so I don't drink coffee. But I also don't feel like I need alcohol either. Like I uh have just over the years been like this is not adding anything to my life, and it doesn't make me feel good. And so I like kind of rarely drink at this point, but I do like a cocktail every now and then. I do like maybe like a glass of champagne every now and then at like an event or something like that. And so I'm gonna say I'm gonna give up coffee just because I already don't drink it, but not because I like need alcohol, just because it's fun every now and then to have a a drink.
SPEAKER_00Yes, fair enough. I love how we often differ on our responses. So that's fine. Fine with me. I for years did not drink coffee. It is, I mean, caffeine, it is absolutely a drug. And so then once you start it, yeah, it can be very hard to let go of, which I know from personal experience. So yeah.
SPEAKER_01Yeah, yeah, absolutely. And I will say I'm not I do not have boundless energy. Like I definitely get that afternoon crash, but I usually like because our schedule, I don't know what your schedule looks like, Carly, but like my schedule is kind of right now, I've got like sessions in the morning, a little break, and then sessions in the evening. And so I usually have time for like 20, 30 minute, like mid-afternoon nap. And so then I'm like good to go after that.
SPEAKER_00But that's see, I can't cat nap. Like if I'm gonna take a nap, I'm asleep for two hours. Like, I can't do my brain. By the time my brain even shuts down for a nap, it's like time to wake back up. I wish that I could nap and just like gather a little bit of energy, but when I lay down, I'm like, I'm out. Done.
SPEAKER_01I've done there was one time I I literally had eight minutes and I was like, I'm just setting an alarm. I'm gonna close my eyes for eight minutes, and I woke up and I was like, I felt so much better after. I wish.
SPEAKER_00I wish the skill. Yes. Okay, well, let's jump into today's question. I'm really, really glad that this listener wrote this question because I think a lot of people are going to be able to relate, but it is also something that I could understand is maybe a little bit challenging to talk about openly. Um, so let's jump in. It says, Hi, Kinzie and Carly. I've been thinking about writing this letter for a while now, but the voice in my head tells me no one wants to hear me complain and no one cares. Today, I don't care. So here it goes. I'm a single man in my 30s, I have a good job in tech, people who depend on me, and from the outside looking in, life probably looks fine. That's part of what makes this hard to explain. People assume being depressed means staying in bed all day. In my case, it looks like doing all the normal things people expect, then going home and feeling empty. I wake up already tired, simple things like responding to a text, making a decision, etc., can feel overwhelming, so I just avoid it. I wonder why I can't just be grateful and why things seem to bother me more than other men. I don't talk to family about it because they view me as the steady rock who's always there for everybody else. I have friends, but bringing this up while we watch the game just seems like a downer no one needs. I don't do drugs, I drink socially, and I'm not suicidal. But most days I question if this is just how life is. I tried therapy once in my 20s, maybe it wasn't a good fit, but I remember feeling like it was a waste of time. The most I took away was that I'm probably depressed. I'm doing my best to keep going, but not sure if that's enough. Even if you don't use this for the show, any advice is appreciated.
SPEAKER_01Man, I first just want to say thank you to this listener for your vulnerability for submitting this. Challenging yourself, it sounds like, in a way, to to push through the like, this might not get used or people might not care about this, because I I think that a lot of people, like you said, Carly, are going to relate to this. And I definitely think that people care about it. And so I first just want to acknowledge that. Like I am happy that we get to talk about this and explore this a little bit. And I also just want to highlight that what you're describing is a very common presentation of depression, especially in men, where you know you're functioning, you're being reliable, you're showing up, and you're feeling exhausted and empty and disconnected, and you are holding a lot. And it sounds like you've been holding a lot on your own for a long time. And um, that's something that I kind of touched on and we can get into a little bit more. But Carly, what are your initial thoughts?
SPEAKER_00Yeah, so I was so glad to hear this letter. Obviously, not because the the listener sounds to be in pain, but I think this is so much more common than anyone might realize. And it it does make me think about the privilege that like we have as women because just even the idea that someone would care that you're feeling depressed, I don't feel quite as maybe disconnected from the idea that someone would care about that. And I can imagine that as a man, there's so much conditioning, probably from the time that he was a young kid of just like, you know, don't cry, like thing, emotions and things are not really validated in young boys or teenage boys for that matter.
SPEAKER_01Yeah.
SPEAKER_00So it makes me just think like this impression that he has that nobody wants to hear him complain and he just kind of needs to keep going, just kind of shows the value that we place on like production and like being providers and a sense of security for men, but like not quite as much value on their emotional experience and their mental health and well-being. And so I love the courage that it took to write this letter. Um, and I guarantee you you're not alone in this.
SPEAKER_01Yeah, absolutely. Um, I think we talked about it in a previous episode, but like sometimes you just get like a sense of like like a feeling that comes from some of these letters. And I think that one of the feelings that came from this letter for me was this idea of like a little bit of like resigned defeat of like, I, you know, which again makes sense. Like you have been holding on to this on your own for so long, and there might be a little bit of a lack of faith of like people don't care about this, I can't turn to anybody for this. I don't know that it's going to get like quote unquote better. And for whatever reason, I I don't think that the listener said this specifically, but it's kind of the the sense or the feeling that I got from the question. And so I ran with with that a little bit of this idea of what does better look like? You know, you're showing up, you're doing all of these things, and you're just feeling so empty. Um and so I wanted to one say like when someone goes through this for so long, it can be hard to have hope for change. It can it can be hard to feel like to want to expect anything to get better and then be let down. And so it can feel safer to just kind of accept like this is the way that things are, and I'm gonna, I'm gonna keep it to myself because if I open up and people um and I'm a burden to people or people don't respond in the way that I want to, or I go to therapy and it's not what I'm hoping to get out of it, like that feels more like a letdown. But I am wondering if there's a little bit of an opportunity to like redefine that so it doesn't feel like such a a challenge to your safety and security. And so that can look like can you can you approach how you're feeling? And instead of saying, like you, you know, you wake up tired and instead of saying, like, I should be grateful, that's something that was put in there, like I should be grateful, or I should be waking up and feeling like so happy and so excited to go to work, or I should be able to be this rock for my family and not have to like put anything on them or feel any of these negative emotions or feelings. Can you reframe that? Can you change that in a little way where it's just a little bit easier? Can you can you try to look at it and say, like, all right, I might not wake up and feel like, oh, I'm so excited to tackle this day, but can I feel like I have 10% more energy? Can I work towards that next goal? Can I look at therapy as this is a space where I can take for myself and I can have somebody hear me in a in a gentle, safe environment? And that's my goal for right now. Can I look at like I should be grateful and instead just kind of say, like, can I accept where I'm at right now? And that opens the door for some of these bigger steps for allowing a little bit more hope in a safe way. I'm not sure if that makes complete sense, Carly. What are your thoughts on that?
SPEAKER_00Yeah, no, I think it does make sense. I like the idea of kind of breaking down the goal a little bit and like making it more attainable. It also, you know, so I'm jumping back here just a little bit, but I'm thinking about his experience in therapy and feeling like it didn't do much for him. And so feeling like a little bit discouraged about it. And I really empathize with that because not everyone has great experiences in therapy. I wish that that, you know, were not the case. But and so part of me just wants to encourage the possibility that like you could have a different experience, maybe a different therapist, maybe you're in a different space with in your life. One of the areas where therapy has helped me personally is in understanding the value of emotions. So, you know, I hear the listener saying, like, well, you know, on paper, I have all the things. I have the job, you know, I have people in my life. No one would know from the outside looking in that I'm feeling depressed. And almost judging himself, it seems like, you know, why, why do I feel this way? It kind of doesn't make sense. And so I like that you were kind of pushing toward that acceptance of can we accept that this is how you feel? Because my guess is there's some sort of message in those emotions that you could learn something from. Like maybe there is an area of your life that you decide you want to change, or maybe you discover that there's something that you've not addressed. It could be a trauma from the past, it could be some area of your life that you're not finding fulfilling. Maybe you have a good job, but you don't really particularly enjoy your work, or maybe you don't really feel like you have a sense of like connection with your purpose or why you're here. There's no like meaning beyond that. And so emotions are kind of like these like indicator lights that go off and are alerting you that something is off. And so that is the frame that I would offer to this listener is we can get upset that the emotions haven't gone away and that they feel, you know, really like a downer and discouraging, or we can take that as a sign that there's something going on there that needs to be addressed. And we may not know exactly what that is. I do think therapy can be helpful in discovering that and exploring that so that you have someone there to kind of help you navigate like what is causing this. But I think that can be a really, really useful way to approach just even your thinking about it. Let's accept that the feelings are what they are and maybe try to understand what's driving them so that we can address the issue.
SPEAKER_01Yeah, I like that too. And hopes are in the frame of like, you know, for this listener, maybe they can use that. Cause I was thinking about there's a couple areas of communication that we can touch on in this question. But one of them being bringing that, like if you decide to go back to therapy, one, like that experience that you had, I think that unfortunately it can happen. It does happen. That does not mean that therapy is not right for you or that it's not going to be beneficial for you. It could have just been a bad connection or relationship or just a maybe not the right time in life. But having clear communication with a therapist, if you go back of kind of like, this is the experience that I had before, this is what I'm looking for. And even using that of like, I'd like to understand my emotional experience better. You know, I feel like I'm doing all of the right things and showing up and I'm still feeling this way. And so getting a little bit more insight into that could be super beneficial. I like that a lot.
SPEAKER_00I also think like defining what your experience can be helpful. Sometimes labels get in the way just a little bit because they can cause us to like stigmatize. And so, you know, saying that what you took away was like, I'm probably depressed. That is only as helpful as you know what to do if you're depressed, right? Just kind of like labeling yourself like, oh, I guess I'm just depressed, if we don't really know what to do with that, um, is maybe not quite as helpful. And so the the frame that I heard, like even in all the symptoms that this listener described, this sounds to me like high functioning depression, which is very different than like the vision that I think maybe most of us get when you think of someone being depressed, it's like can't get out of bed, very mopey, very sad, crying all of the time, um, maybe like overeating or under-eating or, you know, things like that. And while that can absolutely be a part of depression, high functioning depression is essentially when you're still doing all of the things that, you know, normal person would do or a non-depressed person would do. I think the closest thing that we have to it in the DSM five is persistent depressive disorder. And that is usually when it's lasting for a long period of time. So you may not be like not able to get out of bed, but it, you know, it's an extended period of time, I believe like two years or more of these symptoms. And so if these are things that came up in their 20s and now they're in their 30s, I think, you know, there's probably enough evidence there that this is more of a persistent form of depression. And it is identified by some of the very things that he said. I'm just gonna read a few of them, constant low-level sadness or empty feeling, not really feeling joy in the hobbies and not really being able to feel a sense of pleasure. Because it sounds like they have a social life, they hang out with friends, but they kind of don't want to be the downer that's like, hey guys, so by the way, I'm actually feeling pretty crappy most days, you know, irritability or low, like not really being able to tolerate frustration, fatigue, self-doubt, sleep changes, appetite changes. And there are so many things that can cause andor influence a depressive state. And so I just want to normalize that experience, that this is an actual thing, that like you're not the only one who's who's dealing with it, but also kind of back to the getting to the why, there can be so many things that are contributing, right? That there can be biological factors, trauma can be a factor, there can be hormonal factors, brain chemistry, like personality traits, and so many things that can contribute to why you might see this form of persistent depression. And so sometimes unpacking that, you might need a little bit of help, like really kind of sorting through um how you landed here.
SPEAKER_01Yeah. Yeah, absolutely. I'd love to talk about like how to go about that because if you have been dealing with this on your own for so long, it can feel really scary to address it, to ask for help around it. You know, there's um, I think that both of us are pointing towards like working with a professional, working with a therapist could be really beneficial here, which, you know, could look like just trying to find somebody working on getting an an initial uh consultation to be able to work with someone and address this. But I also want to touch on like this sense of isolation with these feelings. There is wanting to be the rock for a family, not wanting to like bring people down while watching a game. And so I think that there are some things that I thought about were some like like practical steps that you can take to open up about this in a way that doesn't feel like it's it's going against a part of your identity. So something that I uh had mentioned or had had written down, it does seem like there's an element of like of being vulnerable that challenges a sense of identity, either as a man or the rock of the family. And so I wanted to highlight some ways that they could open themselves up to support without it feeling like they're emotionally unloading or in a way that feels uncomfortable. And so that can be like information sharing. It doesn't have to be emotional unloading. It can be something to the point of saying, like, yeah, things are honestly, things are feel feeling pretty hard right now. Like I've got a lot that's going on. It can be short, it can be concise, it can be to the point, it can be one sentence. You can put up boundaries around it. You can say, I'm okay, I'm figuring it out. I just wanted to be honest about it. And that gives you a little bit of space to open up and to share without feeling like this is too much. I'm asking too much. This feels too much, too fast, this is too hard. It can be a small step into opening up to somebody that can help get some of those needs met without it feeling like so foreign to what you're used to.
SPEAKER_00Yeah, I I really like that because one of the initial things that I'm probably gonna talk to every client about at some point. It there's typically like four core areas that I'm gonna encourage you to look at. And that sense of connection or your relationships is absolutely one of them. It's a critical piece of just health in general. People, we are social beings. We are meant to be connected to other human beings. Of course, because of differences in like personality and preference, you may not, some people may like having like a lot of friends and a lot of support and like talking and opening up a lot, and other people may just have like a small circle, but feeling like you are not alone in this world and someone sees you and understands you is a very, very important part of just mental health in general.
SPEAKER_01Yeah.
SPEAKER_00So I see that as one of the four prongs that is like essential to just health and wellness. Yeah. The other ones are relatively simple and they are things that you can, you know, just kind of take a look at yourself and very practical. It is your diet, your movement, your sleep, and then your relationships, right? So just like even if you're not at a place yet where you're open to trying therapy again, um, I think that can be a really, really good starting point. It sounds so basic, and that's because it is, but these are key things that have been proven to contribute to just our sense of well-being. So, how much sleep are you getting? You said you wake up tired. That stood out to me, right? Because are you waking up tired because you're not sleeping well? Are you going to bed really late? Or are you getting like what might be considered an adequate amount of sleep and you're still feeling tired? What type of food are you fueling your body with? Right. Like, are you making decisions that actually help your body to thrive and have energy? And, you know, gut health is so, so critical. But like, what things are you putting into your body that may be contributing to this heaviness and this feeling of isolation and depression versus things that maybe uh just give you energy, help you to feel lighter. How much movement are you getting? Everybody thinks like going to the gym and that's great, but like walking, um, and there's so many forms of exercise, right? Like you could pick up a sport, you can play pick up basketball, you can try golf if you have the time for that. Like you can try boxing. Like, there's so many different ways to Just get movement, but having like that physical um exertion of energy absolutely impacts um our mood and our like management of these feelings. So just from a basic, like let's kind of go back to the basics. I think looking at those four areas, connection and relationships being one of them is like step one of addressing this on your own.
SPEAKER_01Carly, I love that so much. I couldn't agree with that more. Those four pillars, like I so important. And and you're right, like it feels like it's basic, but people talk about going back to the basics for a reason. Like focus on those basics, focus on those basics and then, you know, assess, see how you feel and and add on from there if you can, if you want to. But even just hitting those basics are can like dramatically improve so much of functioning and well-being. And to that like point of the importance of connection, this comes up all the time, but but people sometimes feel like they are protecting other people. Like, I don't want to put something on somebody else. I don't want to be annoying. I don't want to ask too much of somebody. I don't want to be a burden. And something that I just want to remind this listener and other people who are listening to this is honest moments, opening up to somebody, connecting to somebody, they're so rarely seen as burdens and they were so often seen as connections. Like if you open up to somebody or if somebody opens up to you, you feel a sense of like, they trusted me with something. I feel connected to this person. I feel closer to this person. And so when you do that, when you allow yourself to open up to somebody else, they feel that with you too. So it's it's, you know, that idea in your mind of this is putting too much on somebody. That really is just your own worry or fear being projected. It is rarely ever interpreted as that. Um, and carrying everything on your own doesn't protect others as much as it isolates you.
SPEAKER_00I am glad you said that because I really think that is that is a weight that he's carrying that he probably doesn't even realize. Other people, if if he's the strong one in his family, like talking to like the strong one here, you'd be shocked how many people would feel so honored to have the opportunity to show up for you, especially if you're one who's always showing up for other people.
SPEAKER_01Yeah.
SPEAKER_00And so I would just challenge that idea that no one wants to hear it, no one cares, I'm there for everyone else. I do think finding safe spaces to ask for help, or you don't want to be vulnerable with people who are in a space and have the capacity to hold that for you. Yeah. But I think that he might be surprised by the responses that he receives, especially if he has people in his life who he knows cares about him, that he cares about them. They might actually jump at an opportunity to show up for you in a way that you're not expecting. And just because I want to touch on this, he did say I'm not suicidal. And I appreciate that. Like he's acknowledging it's not at that point, but we don't have to wait until it gets there to address this, right? We want to address this way, way, way before. And so by addressing it before things escalate to the point of a crisis, yeah, you may actually be like essentially setting yourself up to continue to be a support to others. Like, in other words, if you go down, think about all the people who are connected to you that you care about, who rely on you, who then have to kind of figure things out without you. And so even if you have to do it from a space of, I need to take care of myself so that I can be there for others, let's use that, right? Because we don't want to wait until it gets to a point that it almost can't be reeled back in. Yeah. And then you, as the strong one in the pillar, you fall and everyone connected to you falls. So we want to, we want to get at this way before it gets to that point. Right.
SPEAKER_01Yeah, absolutely. I'm glad that you touched on that as well. And I think that that's a good thing for this listener to hear too, is you can address it now. You can open up now, you can ask for help now. And I think that you touched on this too, Carly, but choosing somebody that feels safe, choosing somebody that you feel like is going to be able to hear what you're saying or be there for you in a way that feels safe and supportive. You know, you don't have to open up to everybody. You don't have to open up to everybody all at once. You can choose one person you can share in a way that you feel comfortable with, even if that's limited. Um, and it might feel nice just to have somebody, you know, even if that person says, like, yeah, you know, man, I've I've been feeling the same way. Or to say, like, what is it that you're going through or what is it that you're struggling with, or anything along those lines, if if they do open up that door for a little bit more information or a little bit more connection, be prepared for that too. And, you know, know that it's okay to open up a little bit more if you if you feel like you can.
SPEAKER_00Yeah. Yeah. I think one of my final thoughts is like kind of responding to the is this just how life is question. And I want to say emphatically, no. It doesn't, it certainly doesn't have to be. It is how a lot of people have lived and maybe continue to live their lives, but you can make a different choice. And there's more than one way to go at this. That's why we're talking about like practical things you can do on your own, ways to lean on your community, the consideration of therapy, maybe a conversation with your doctor where like it's possible that medication is would be a helpful tool here, here. But there is more than one way to um approach this or or address this. And so I would say like start where you are with whatever you're willing to try. Like just, just start, you know, and hopefully you can find almost like that right combination of tools that helps you to carry this load differently, to shift your mentality about it, to change your relationship with your emotions, to understand yourself better, to even understand what is contributing to this. But start where you are with what you are willing to do. And then let's see if we can like build on that.
SPEAKER_01Yeah. Yeah, I love that. And that emphatically, no, doesn't like there's such a sense of hope in that, right? Like there's there's no kind of like shame in that or not feeling that right now. There is such a sense of hope of it doesn't have to be this way. And so I love that you said that. And the only thing that I want to follow up with and kind of go back to is, you know, at the beginning, I was kind of talking about like managing those expectations, trying to kind of make those expectations a little bit smaller so that you can open up the door to some hope. And I just wanted to touch on that I say that not because you don't deserve this huge transformation or or that it won't happen. I say that like start small so that it can give you some space to allow that hope in a safe way, so that you can get to that place of saying, like, you know, right now it might not feel like you believe that life can look any different or can feel any different, and to go from this place where you feel like this has been functioning for maybe over 10 years at this point, to like life looking so different. It can feel like such a leap and such a jump. And so to to get comfortable with working on how can I can I try to just get a little bit better? How can I open myself up a little bit to this? And again, it's not because that big transformation can't or won't happen. It's because it just gives you some space to allow for that hope and it can create some room for you to keep growing and to keep pursuing and to keep feeling like this is possible for you.
SPEAKER_00Yeah, I love that. And honestly, you don't know how many people you may have helped just by writing this letter. Uh-huh. So, you know, offering help to others, not in a not in a way that you've kind of described where you're the rock that everyone leans on, but like creating a safe space for other people to talk about what they're struggling with can actually be incredibly healing. And so I hope even just by writing this letter and the fact that we did use it for the show, and so then other people get to hear it, I hope that even gives you a sense of just like hope and not feeling alone and that you've already helped someone just by your break. So kudos to you for that. 100. Um, if you'd like to hear our thoughts on a topic that matters to you, email your question to info at ask a therapistpod.com. We'd also like to hear your thoughts on today's topic. What resonated, what didn't, what did we miss? If you have advice for today's listener, please share it. You may just hear it on a future episode. Follow us on Instagram and TikTok at ask a therapist underscore pod. Emails and DMs are always welcome. Also, if you'd like to connect with me or Kinzie and learn more about the services we offer in our private practices, check the show notes for ways to reach us directly. With that, we're signing off. Thanks for listening, and remember, don't wing it, just ask a therapist.
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