How to Spot the Hidden Signs of High-Functioning Depression (Before It Gets Worse)

May 28

You answer emails. You meet deadlines. You show up to work. People might even say you're “killing it.” But deep down? You feel off. Numb. Disconnected. Like you're performing in your own life instead of actually living it.

This isn’t just stress. And it’s not because you’re being dramatic.

It might be high-functioning depression.

And if that phrase hits a little too close to home, you’re not alone. Psychiatrist Dr. Judith Joseph, who spoke about this in depth on The Rich Roll Podcast, calls it one of the most overlooked mental health conditions in high achievers today.

What Is High-Functioning Depression?

High-functioning depression isn’t a formal diagnosis, but it’s widely recognized in clinical practice. It typically overlaps with Persistent Depressive Disorder (also called Dysthymia), a chronic low-level depression that lasts for at least two years.

But the term “high-functioning” adds a twist. People with high-functioning depression don’t shut down. They keep going. They overcompensate. They look fine. Which is exactly why it flies under the radar.

As Dr. Judith Joseph puts it, “You’re functioning, but not actually feeling.”

Signs of High-Functioning Depression

Here’s what this often looks like in real life:

You’re exhausted, even when you’ve had enough sleep.
You keep moving, but nothing feels rewarding.
You’re emotionally flat - neither happy nor deeply sad, just meh.
You’re irritable or zoned out more often than not.
You dread your day before it starts.
You second-guess whether you're “allowed” to feel this way.
You tell yourself: I have no reason to be this unhappy.

Spoiler: You don’t need a dramatic backstory to be depressed.

According to Dr. Joseph, people with high-functioning depression often have what she calls "smiling depression”, they're outwardly composed, internally disconnected. It’s the emotional equivalent of putting on a show every day while secretly feeling like you’re fading out.

Why This Happens (and Why It’s Easy to Miss)

Your brain’s main job is to keep you alive. So when you're under emotional stress for long periods, your system starts to prioritize logic and survival over connection and reward.

The prefrontal cortex (task management & problem-solving) steps up, while the limbic system (emotion & pleasure) quiets down. Over time, this creates what’s called emotional blunting or anhedonia, you stop feeling pleasure or meaning, even in things you used to enjoy.

Dr. Joseph notes that this is particularly common in people who are “performing wellness.” You’re doing the yoga, checking the boxes, drinking the green juice….but none of it feels like it’s landing.

And let’s be honest, our culture loves a high-functioner. If you’re still working and productive, people assume you’re fine. Hell, you probably assume you’re fine.

But productivity doesn’t equal mental health. You can be high-functioning and still deeply unwell.

The 5 V’s Framework (via Dr. Judith Joseph)

In the Rich Roll Podcast, Dr. Judith Joseph introduces a powerful framework to help people address high-functioning depression. She calls it The 5 V’s, and it’s refreshingly practical for people who aren’t interested in toxic positivity or vague advice.

1. Validation

Acknowledge what you’re feeling without minimizing it. Stop telling yourself “It’s not that bad.” Depression doesn’t need your permission to exist.

2. Venting

Talk it out. Or write it out. Suppressed emotion doesn’t just disappear, it leaks out in symptoms (whether emotional or physical). Giving voice to what’s going on inside reduces emotional congestion.

3. Values

Reconnect to what actually matters to you, not what earns praise or approval. A meaningful life isn’t one that just looks good, it has to feel right in your body.

4. Vitals

Check your physical health. Are you sleeping? Moving? Eating actual food? Your mental health is deeply connected to your physical rhythms - and when they’re off, everything suffers.

5. Vision

Create something to look forward to. Not a to-do list. Not a performance goal. Something that gives you a sense of purpose. Even a tiny one. It rewires your system toward hope.

What I See in My Practice

As a therapist, I work with a lot of high-achievers and perfectionists, people who are “doing fine” on the outside but feel hollow and lonely underneath. They’re praised for being dependable and productive. They rarely complain. And they’re exhausted.

One of the biggest lies high-functioning depression tells you is: “This isn’t serious. You’re just being dramatic.”

But you don’t need to hit rock bottom for your pain to count. If you're emotionally checked out, constantly tired, and can't feel joy even when you're supposed to? That's not "just stress." That’s a system stuck in survival mode.

You’re Not Lazy, You’re Disconnected

If you’re still functioning, but everything feels off… that’s not weakness. That’s adaptation.

Your brain learned how to keep going at all costs. Now it’s time to reconnect with yourself, not just to survive, but to actually live.

Dr. Judith Joseph’s 5 V’s give us a grounded roadmap to start. These aren’t fluffy tips, they’re science-backed ways to help you feel something again.

And if you’re the kind of person who is more comfortable with logic than emotion? That’s okay. You’re still human underneath all that performance.

Final Thoughts

High-functioning depression is real. It’s treatable. And it deserves attention, even when you’re still “holding it together.”

If this sounds like you, I hope you take this post as permission to stop minimizing what you’re going through. You don’t need to “look depressed” to get support.

I talk about this and more on my YouTube channel, where I share mental health insights without the fluff. Check the video linked in this post if you want to go deeper into the signs, science, and solutions.

And to Dr. Judith Joseph, thank you for saying the quiet parts out loud. Your work is helping people feel seen in ways they didn’t know they needed.