Reported by NPR Health
Some people with clinical depression can't get out of bed. But what about those who exhibit other signs of depression who never stop moving, and may double down on their work?
Psychiatrist Dr. Judith Joseph says the second group often goes unnoticed, even by the people living it. She calls it "high-functioning depression": people who keep meeting their obligations at work and at home while quietly losing the ability to feel pleasure.
"When you are joyful, you have better physical health, you have better relationships, you have better productivity at work," Joseph said in an interview for the Your Turn podcast . "So why don't we prioritize it?"
More from the original report
At the center of Joseph's work is anhedonia: a reduced ability to feel joy, pleasure or interest in things that once brought those feelings. Joseph describes it as "the silent sister" of depression.
"One sister is depressed, and crying, and not getting out of bed, and getting all the attention," she says. "The other one is quiet and numb." Anhedonia may not seem like a crisis in the classic sense, Joseph says. "But it is an existential crisis, and it's not something to ignore."
In a peer-reviewed study published in the journal Cureus, Joseph and colleagues interviewed adults using a set of questionnaires designed to assess high-functioning depression, trauma and anhedonia.
The results supported the researchers' hypothesis that people with high-functioning depression have increased levels of anhedonia and trauma. Participants with higher anhedonia scores also had higher high-functioning depression scores.
Parents and caregivers had the highest anhedonia and high-functioning depression scores in the study.
The authors note that high-functioning depression is not an official diagnosis in the DSM-5, the manual clinicians use to diagnose mental health conditions. They say that is part of the problem: people who keep functioning may not recognize their symptoms or seek treatment until they reach burnout.
Joseph says she often sees the pattern in women who are the steady presence for everyone around them. They are so focused on their responsibilities at work and at home that they don't realize they are burned out, or close to…