What Is High-Functioning Depression–and Could You Have It?

Here's what to do if you’re missing out on family, friends, or fun because you're blue or fatigued.

To the outside world, you’re a productive citizen. Some might even say you’re highly successful. But when the workday is done, your internal resources are spent. You beg off dinner with friends because the best you can do is plop onto the couch or dive into bed so you’ll be ready to take on tomorrow.

That’s what life is like when you have what’s sometimes called high-functioning depression. You make do, you get by, you appear to be handling things just fine–but you’re suffering inside.

High-functioning depression isn’t a true medical diagnosis; you won’t find it listed in the Diagnostic and Statistical Manual of Mental Disorders, the bible of the mental health profession. But it is popping up on treatment center websites and health blogs as a way to characterize people with low mood, low energy, and anxiety, experts say.  Read more from Karen Pallarito in Health Magazine.


Why Isn’t There a ‘Gym’ for Mental Health?

by Alexa Meyer

Back in March 2017, I decided I wanted to seek out a therapist in San Francisco. I felt unsure, uneasy, and pretty overwhelmed with the whole process. Was therapy even something I needed? Why was it so hard to find a therapist? Why isn't there just a space I can drop into (like a walk-in clinic) when I feel like talking to someone? I felt incredibly frustrated that there wasn’t dedicated space for mental health so I started my company, Orchid and began to host Mental Health Pop Ups across the country.

The Mental Health Pop Up makes it easier for people who are wondering if therapy is right for them, want to learn to better manage their emotions, or just those who are seeking a quiet space to unwind.

What happens at the Mental Health Pop Up?

  • Try and Find a Therapist - curious about therapy or wondering if it’s right for you? Meet with a therapist to try it out!

  • Group Workshops - improve your mental clarity and decision making in a guided group workshop

  • Tea & Kombucha Lounge - unwind in a relaxing space with unlimited tea, kombucha, and reading material

The next Mental Health Pop Up is on February 7th at WeWork Civic Center. I hope you’ll join us to try therapy, or just attend a workshop and unwind in relaxing space for the day.

Space is limited. Register today with the discount code “2minutemindcheck”.

About Alexa:

Alexa Meyer

Alexa Meyer

Alexa Meyer is the founder of Orchid - a company that makes it easier for people to try and find a therapist in their city. She also is the creator of the Mental Health Pop Up -- a dedicated space for mental & emotional health where people can try therapy, participate in group workshops, and unwind in quiet space. Alexa was formerly Head of Marketing and Growth at Keen IO, a Sequoia-backed analytics startup, where she took the company through Series A and B. Prior to that she worked to deliver brand strategies for Fortune 500 brands at Interbrand.  She's a proud Canadian currently living in San Francisco. Learn more:

Three Things Every Entrepreneur Needs To Remember When Dealing With Depression

Author Chris Myers writes in Forbes:

In the past two weeks alone, I’ve received over ten emails from people around the globe seeking advice for how to deal with the emotional roller coaster that is entrepreneurship.

With that in mind, I thought it might be an appropriate time to share an excerpt from my latest book, “Enlightened Entrepreneurship,” in the hope that it provides solace to fellow entrepreneurs who might be suffering from fear, depression, and anxiety.

Depression is a huge problem among entrepreneurs, and it's time we did something about it. I hope that sharing a few things I’ve learned along my entrepreneurial journey can help others navigate difficult situations as well.  Read More

It takes 2 minutes.

It takes 2 minutes.

Stress Resilience Toolkit: 6 Practices for Preventing Depression with Dr. Elissa Epel

On December 13th, the 2-Minute Mind Check hosted an important event at WeWork on Survival Tips for Beating the Holiday Blues featuring renowned mental health experts Elissa Epel, Ph.D., Professor in the Department of Psychiatry, at UCSF, and Philippe Goldin, Ph.D., Associate Professor at UC Davis & Clinical Neuroscientist. As one of many high-functioning, high-tech depressed people, I had the extreme honor of moderating this insightful talk.

As we all know, depression affects 16 million Americans and 75% of adults report experiencing moderate to high levels of stress on an ongoing basis. Both stress and depression can be particularly brutal during the Holiday Season and can take a great toll on our minds and bodies. In this blog, I’ll share a few key takeaways from Dr. Elissa Epel that might be helpful for you during this season. In my next blog post, I’ll share more tools for depression relief from Dr. Philippe Golden.

                     Dr. Elissa Epel

                     Dr. Elissa Epel

Dr. Elissa Epel is a health psychologist focusing on stress pathways and stress resilience. She shared that we’re more likely to get depressed after a period of certain kinds of stress, especially social stress. To that end, it’s important to weed out relationships that make us feel badly about ourselves, and instead, surround ourselves with supportive allies. Since we can’t control stressful events that happen to us, we want to focus instead on our response to life’s inevitable curveballs. Bring on stress resilience! Building stress resilience requires a few things: a) understanding the mind; b) understanding how we respond to stress mentally and biologically; and c) learning how to work with our minds so that we respond to stress in ways that enhance our mental and physical health.

What is stress exactly and why does it go on and on and on??  Stress is a natural response to a life event. Biologically, we actually need the cortisol and body responses that naturally occur in order to help us respond appropriately to given situations. HOWEVER, as humans, we tend to prolong the stress response with our thinking (see #1 above - understanding the mind.) We project things before they happen, and we worry about things that never happen. Often, after a peak stress event, we’re still thinking about it ala rumination causing stress to live on in the body longer than it needs to. With rumination, these sneaky thoughts disguise themselves as addictive “problem solving”, when in actuality they are simply keeping the stress alive in our minds and bodies. Clearly, this rumination takes us out of the present moment in our lives, making it hard to meaningfully connect with others. And prolonged stress simply isn’t good for us. In fact, it can lead to disease - such as depression - not to mention premature aging, and lower quality of life.

So, how can we foster a healthier stress response? Instead of chronic unease and vigilance, imagine feeling low anxiety. Then, only when we need to deal with an active challenge, we activate a burst of a stress response to give us the energy to cope with the challenge, followed by a quick recovery to a more relaxed baseline! According to Dr. Epel, that is the picture of a resilient emotional and physiological stress response. And, because we’re smart human beings, we can learn to build that!

Luckily, Dr. Epel gave us a helpful Stress Resilient Toolkit with six specific practices that support both the body AND mind.

Body Up Bolsters! Depression and chronic stress wear on our circadian rhythm (energy and sleep patterns), setting us up for further depression and illness. We can build our “reserve capacity” with these protective practices:

   1. Establish Daily Rhythms: Go to bed and wake up at the same times every day budgeting for at least 7 hours of sleep.  

        WIND DOWN GENTLY: Develop a bedtime wind down ritual to support maximum rest and restoration. If applicable, have your partner do this with you. We need this more than ever now that we have stimulation from screens (and blue light) during the time we need melatonin.  

        WIND UP WITH JOY:  The first thing you do in the morning really matters! Waking up anticipating negative things gives a jolt to our cortisol. Therefore, instead of reaching for your phone, or watching the news, take a few minutes to set yourself up for a positive mindset and trajectory for the day. Use the first precious waking moments to think of positive things — things you are grateful for, or something you are looking forward to. Elissa’s research has found that positive waking states relate to healthier cortisol and anti-aging profiles.

   2. Build a Mind-Body Habit: Adopt a mind-body ritual to give the body a restorative break. This is missing from most people’s routines and it is especially important for those of us prone to depression. Try Yoga, Tai-Chi, Qi Gong, Mantra or Mindfulness Meditation, breathing exercises or really any body-mind practice that suits you. They are different, so try some on, but they have the same fundamental effects on our breathing, physiology and mind.  Even if it’s just for 5-10 minutes a day, it will help.

   3. Regular Exercise: Sometimes called nature’s antidepressant, depression can both prevent and treat depression. If you’re at risk of depression, any type of exercise will help, it just requires that you do it. So find something you enjoy, and if it helps you stay consistent, find an accountability exercise partner!

The second essential item in the Stress Resilient Toolkit is practices for the mind.

Mind the Gap! There are valuable moments that occur between the stressor, any negative event, or even negative thought, and our response to that event or thought. That moment — the GAP — is where we can be empowered to respond in a way that supports our best mental health. We must be paying attention to our mind to notice and use the gap.

    4. Label the Stressful Emotion: Simply noticing and naming emotions as they pass reduces their negative impact.  

    5. Cultivate Distance and Perspective: There are many ways to gain distance from painful thoughts and emotions.  For example, when you are in the thick of it, take a few breaths and ask yourself, realistically, will this situation really impact your life in one year? In one month? Usually the answer is no!

    6. Take a Mindful Minute:  When we are prone to depression, our negative thoughts and feelings stick together, spiraling us into sadness or anxiety.  We can break this network up with an attentional exercise. Dr. Epel offered a short practice to support our effort in minding the gap, the three minute breathing break. You can download her recorded version of this practice, from “Mind Body Tips” on her book website.  

Since we’re talking specifically about depression prevention, it might help to keep an eye out for stressors that can specifically lead to depression. There are many intense stressors that can lead to depression, for example loss — such as the loss of resources, jobs, relationships etc. As it turns out, social and interpersonal stress affect us even more than work-related stress. The toughest issues are those that cause us to feel rejection, social shame, humiliation, or embarrassment. These are the stressors we really need to monitor carefully. And, they can run rampant during the holidays when we’re put into many social situations, especially with family members who can unconsciously trigger high (and often historic) stress in our nervous systems. I remember hearing famous Buddhist Meditation Teacher, Jack Kornfield remark that there’s a reason it’s called the “Nuclear Family!” Holidays can create the conditions for a nuclear emotional event! But, now that you know you have agency in your response to those events, you can use Dr. Epel’s Stress Resilient Toolkit to cultivate a successful, nurturing, and even joyful Holiday Season.

We’re incredibly grateful to Dr. Elissa Epel for volunteering her time to share her expertise and wisdom with us! Many of the tips she shared during the presentation are in her book, The Telomere Effect: A Revoutionary Approach to Living Younger, Healthier, Longer.  Dr. Epel is the director of the Aging, Metabolism, Emotions Center (AME), and she has generously put the stress chapter of her book, along with the distancing exercises and others for free on her AME website. Her current newsletter conveniently includes links to two of her upcoming retreats at the new Multiversity in Santa Cruz, focused on building these stress resilience skills, as well as a link to the website resources. If you can make the time, retreats have been extensively researched and are powerful ways to reduce levels of stress and depression and learn new skills.

Again, a huge thanks to Dr. Epel for sharing her brilliance with us. Stay tuned for the next blog with Depression Relief tools offered by associate professor at UC Davis, Philippe Golden, PhD.

Until then, I wish you a resilient and peaceful Holiday Season filled with self-love, acceptance, care and nurturing.

P.S. Don’t forget that you can check out more helpful blogs, as well as free depression tools and resources here at 2-Minute Mind Check.

About the author:

Emily Hine is a social entrepreneur who serves as Vice President, Business Development for Meru Health, a digital therapeutics company for depression. Emily spent many years in Corporate Philanthropy at Microsoft, and over the course of her career has raised over $150 million for nonprofits worldwide. After 9/11, Emily quit her job at Microsoft in order to increase compassion and reduce suffering in the world. This commitment led her to work with Global Luminaries such as The Dalai Lama and Archbishop Desmond Tutu. Emily is a Certified Mindfulness and Compassion Teacher from Stanford University. And, she is an inspirational speaker and writer at Holy Sit.

Most Depressed Adults in the U.S. Remain Untreated

Scientific American magazine ...A Reuters Health reports indicates that only 28.7% of those who screened positive for depression received any treatment during the survey year

About 1 in 12 adults (8.4%) screened positive for depression, but the prevalence varied widely from 18% among adults in the lowest income group to 3.7% in the highest income group.

Only 28.7% of those who screened positive for depression received any depression treatment during the survey year, although 78.5% of those with screen-positive depression who received no depression treatment made at least one medical visit during that time, according to the August 29th JAMA Internal Medicine online report.  Read more in Scientific American.