Avoid the Term “High-Functioning Depression”
“High-functioning depression” is not a real clinical subtype of depression, but it may be tempting to use this term as a descriptor for a person we suddenly discover suffered with the disease and took his or her own life. Such was the case with beauty pageant queen and attorney Cheslie Kryst, whose suicide was widely reported in the national news recently. As with alcoholism, symptoms of depression can be very real but masked or unseen by others, except possibly by those who are close associates, friends, or loved ones. Every person’s presentation of symptoms is unique. Some loved ones may play a role in minimizing or protecting the victim, which allows us, the public, to believe all is well. The ill person may complement this enabling with denial, along with minimizing symptoms as the illness grows worse. Mustering this willpower can only last so long, however. The Kryst tragedy brought to national attention the importance of avoiding terms like “high functioning” in describing chronic diseases or, in this case, falsely portraying a different type of depression that is unlike the “normal” depression others experience. Just as “functional alcoholic” also enables continuation of the disease by reinforcing denial, the phrase high-functioning depression signals a special case exception that can fuel denial, resistance to self-diagnosis, and delayed treatment.