I’ve been living with PDD, and I actually get offended when people call me “high-functioning”. I still am dealing with poor concentration (sometimes brain fog), hypersomnia and fatigue. I join classes and go to work just because it is “scheduled”. I leave classes with nothing in my head, and it shows in my exam. I barely can keep up with my study. Often I miss my assignment due-dates because of physical and mental exhaustion. See? I’m not “high-functioning” at all, but I still do things I’m supposed to do because I have to.
Here's my thing; Mental health is unfortunately treated a lot like physical health in that we only intervene when there's a crisis. High-functioning folks, that is to say people who aren't neurotypical but can at least live their lives without significant impact are still struggling, still in pain, still experiencing the symptoms. And the fact that there isn't a distinction between a person who has suicidal ideation and who is plagued by it versus someone with suicidal ideation who has lived with it long enough to consider it mundane is that it might not register or be detected during screening. When asked about it, one might answer that they haven't felt suicidal ideation in a while when what they mean is that they haven't felt *overwhelming* suicidal ideation for a while. This is how it was for me, I'd have episodes when I had a moment to myself which had me sobbing on the floor, where the thought of being dead just felt comforting, like a release from all the pain I was feeling, rather than just this background noise that floated around in my brain. Often, at the point of intervention it's just so late. There's a lot of pain and suffering that could have been avoided if we just caught it earliee.
I relate to this sentiment. I find that what others perceive to be my "worst" days, where I am screaming and crying out of frustration and despair, or lying motionless on the floor for extended periods, do not subjectively feel to me to be all that different to a day where I am functioning "regularly" in terms of the severity of the negative sensations. Those just happen to be the days where the pain has mounted enough for me break under its weight. I find it frustrating that people around me like my family will ask what caused such a "drastic change" from one day to the next, as from my perspective, the day before may have actually been worse because I didn't get the release of a breakdown and the excuse to give into it. Those breakdowns aren't really the result of me feeling so horrible on that particular day, but the natural result of years of unending anguish on "regular" days where I have to learn to get up and get on with things despite it. The crisis days are some of the most satisfying because they are the only days when I feel like my external behaviour truly matches the pain I'm experiencing inside, and people around me seem to actually understand how bad things are. I can't spend every minute of every day projecting to the world how horrible I feel, often it takes less energy to act like things are okay, and the things I want in life require that I learn to push through, but it can be frustrating feeling like most of the time nobody realises how much of a struggle just a "regular" day is, and it takes a meltdown for them to see.
A lot of people don’t consider you depressed unless your home wailing and crying daily. a lot of us are able to live daily lives and put on a mask in front of people that we only have a “surface relationship “ with (coworkers, etc ) but the people we live with see the cracks and the ugly stuff and we’re not always easy to live with. It takes a tremendous amount of energy some days to maintain the mask and that’s why a lot of us become loaners. Perhaps the term high function depression isn’t a great clinical term, but I think it might help to explain or for people to understand that just because you’re able to interact with society, doesn’t mean you don’t need help.
This resonates with me. 8 years ago when I first got my mental health diagnosis I was on many psychiatry waiting lists to see a clinician because I am "high functioning." I ultimately ended up checking myself into a psych ward when nobody would see me but it was most definitely preventable.
I’ve been dysthymic (in the classic sense...maybe PDD) for 15 years. I have a job, a girl and hobbies...but the sky is gray every single day. I’m not suicidal and I’m functional but I don’t experience happiness as I knew it when in my youth. I can live like this but it would be nicer if I didn’t have to.
I have the same problem. there is a huge amount of things to talk about it. I think we should create a community, there is a lot of confusion in science about it , and about other disorders. we should discuss it, as a patient from many years and an engineer I have my own theory and I will share it online . for now I could ask the same thing of E.S.Sic.. which pharm do you take eventually?
@Dustin Void i know the feeling,and the lack of actual feeling that comes with it. One can climb the highest mountain and accomplish the greatest feat,but i didn't feel like i did,then i may also have never happened. There is no depht,no nuance,everything is so "flat". I would advice to see someone ,maybe that can help on the both the short and long term. It can be better,if there is one thing that i learnt,that sometimes there are events that are capable to clear your head and make you feel like years ago,if only for a while.
I got my Lamictal increased and it took me out of my depression. I still have baseline depression but at least i can function daily without wanting to not be here anymore. Bipolar disorder sucks and i mostly have depression than hypomania. Im on SSDI but i can still maintain part time work and take care of my responsibilities. The key to maintaining a high functionality for me is to push myself to do things even when i dont want to. ALSO, staying clean and sober and exercising and eating right is key. This all didnt happen overnight though ive had this mood disorder since 15 and im 44 now. Thank you for your expertise Dr. Grande you are highly intelligent i dont know how you store all your knowledge much less convey it so well to the public. Its amazing.
I'll be 60 in November. Been dealing with this since my earliest memories. Everyday the merry go round or should I say, the misery go round. I'm so tired of it.
I am a clinician..quite educated...currently at the tail end of a PhD...and suffer from bouts of MDD...the "high functioning" label is a double edged sword..On the one hand, I feel I haven't gone to total shit. I am "high-functioning." On the other, maybe I'm fine..a "realist" if you will. Maybe life is totally hopeless and will never improve. From a cognitive perspective, this is "black and white" thinking. But it can feel quite real, (I still question if it is not) despite one's educational level. It may also be that the area most affected by depression is that which is hidden to most. Thanks so much...this provoked meaningful thought.
I though psychomotor retardation was a fundamental component of MDD. If that is true, how can someone with psychomotor retardation be high functioning?
@@GuitarMan1117a I have MDD and I can have the psychomotor retardation during one episode. Mostly, I get restless and fidgety. It maybe because I also have an anxiety disorder. If I'm not wrong, in the criteria for MDD people can have either psychomotor retardation or restlessness. No two people experience all the same symptoms at any given time. There are several "either or's" in MDD. (i.e. sleep too much or not enough; loss of appetite or increased appetite...)
I feel the exact same yet I think its my anxiety causing all the problems and connecting it to overthinking. Then again I am a realist as well, thinking wtf is going on.
Thank you for the informative video Dr. Grande. I was diagnosed with MDD 15 years ago. I was given a 30 day supply of antidepressants and told to go volunteer. I'm glad there is a better understanding of the condition today.
I was diagnosed with MDD at 16, then BP2 at 19 and most recently I’ve been told the BP2 was incorrect and I actually have PDD and GAD. It’s been hard adjusting especially since I’m no longer on medication and I’m currently on the waiting list for CBT. However I wanna say thank you for this video. From all the articles I’ve read and videos I’ve watched, this one has been the easiest for me to understand. I was told this all when I was recently rediagnosed but it was hard to take it all in and remember it word for word so I’m glad I’ll have this video now to reference and better articulate myself when I want to explain my mental health to others. 💜
Thanks for your great comment dear friend. May God be with you and show you His wonderful kindness and grace. May the love of His Son Jesus surround you and embrace you warmly. Please take care.
I'm confused I can go to school and fuction I can get my work done but I'm still depressed every day I have thoughts of suicide and feeling worthless I'm just so confused I'm just trying to understand more the feeling for me is constent and I've lost most Interest and most things I use to enjoy I'm just confused
I'm not the psychologist here but from what dr. Grande said it sounds like you have pdd + a specifier. I have all the symptoms of pdd except for poor appetite, but I also have the suicidal thoughts (symptom of mdd). I work a full time job, I've even had 2 and 3 jobs before so I know how you feel. Hang in there.
I’ve had suicidal thoughts since I was 15, which I retrospectively believe is when my depression started. I was diagnosed with ADD (inattentive ADHD) at 12 yrs old, and wish I had been informed of my higher risk of developing depression (up to 50% of people with ADD have depression). I hid my depression for years as it slowly got worse while I told by my parents (and eventually myself) I wasn’t depressed I was just too sensitive, or my mum would accuse me of acting when I would hyperventilate as thoughts of suicide would run through my head. It took until my third year at uni for me to break after an argument with my parents, where I drove to a place an hour away while genuinely didn’t know if I was about to act on those thoughts. My parents had called the police but I had knocked out the battery of my phone (so my parents couldn’t call) which meant they couldn’t triangulate my location. I ended up lying on the roof of my car on a freezing night, for 4 hours trying to calm down as I watched satellites pass overhead, until I was ready to drive home. Because the police had been called they had to take me to the hospital for a mental health assessment, they had me under observation for 3 hours and the mental health professional suggested I go to a psychologist as it sounded like I had been suffering from chronic depression for the last 5 years. I got a new psychiatrist who specialises in ADD and depression, and got put on antidepressants, but after I had another major depressive episode when the medication stopped working I started seeing a clinical psychologist as well. I’m on a new antidepressant now and doing cognitive behavioural therapy (CBT) and am feeling better than I have felt for the last 7 years of my life. My advice is get professional help earlier than I did, I made my life so much harder than it had to be by trying to convince myself that my symptoms were not severe enough to be depression. Try to see a clinical psychologist, if you need medication they can recommend a psychiatrist, don’t hope on things getting better by themselves, you need support and care as well as the tools to work on these things.
I was in the same place as you for 20 years at least and while I'm not a psychologist (and I'm not even 100% sure what my own dx is), I can say from some experience that if you do seek out help from a GP or counsellor these minute distinctions won't make a lot of practical difference to their willingness to help you out. Before I started on antidepressants I was fully functional most days at work, and able to get up in the morning just fine (to the extent that anyone is fine with a 6 am alarm clock every weekday!) But at the same time I would wake up every morning with my first thought being "I want to die" ... and be thinking similar things through much of the rest of the day. To an extent, the specificity of your dx is really a side issue if asking for help would get you the help you need, and I really *really* think you should find someone to ask.
Number one, that is exactly how I feel . Number two, my managing my depression means fighting everyday with myself not to give up. I personally don't expect it to go away for myself but being engaged as best you can and seeking help is the next best thing. But you are definitely not along and need to remember that.
Joseph I'm sorry you are suffering. You are not alone in this. The depression I suffer is painful too. Please find a professional to talk with. Get some help. It can get better.
I'm sorry you are hurting. You're not alone. Please find a professional to talk with. It can get better. There are those who genuinely care about others.
Joseph, one of my favorite quotes is “Before you diagnose yourself with depression or low self-esteem, first make sure that you are not, in fact, just surrounding yourself with assholes.” Hang in there, learn to love yourself and embrace your weirdness, and don’t give a d@mn what anyone else thinks of you!
Thank you again I’m mid 60’s just recently started dealing with my issues. This helps me a lot letting me know I’ve not been alone. I can accept my depression when it happens now
This provides neurological evidence of the dulling of emotion that individuals with dysthymia have learned to use to protect themselves from overly strong negative feelings, compared to healthy people.
I was diagnosed with major depressive disorder. I take an SSRI for it, but I have “flares.” I call them such because I go to patient homes and give them infusions for autoimmune diseases and they use the term “flares” when their condition is causing moderate to severe symptoms that interrupt their daily functioning. I’ve seen docs write in their notes a term called “acute on chronic,” meaning the person is having an acute episode of a chronic condition. I’ve been having a flare for the last three months, the longest I’ve ever had. Usually it will last a week where I can’t get out of bed, because I don’t have the will to nor do I care to. Other than that I have that dark cloud following me but I go to work, clean the house, take care of my pets and hide that dark cloud and put on a smile. To be honest, it’s exhausting and yesterday I had a very quick thought of driving my car into a tree and I told myself that’s the depression talking, that’s not what I want. I’m in therapy once a week using CBT and challenging my own negative self talk and I think it’s working because I challenged my own thought about the car and the tree. Edit: Dr. Grande, I really like the dark background with the information put up to see
I think it offers value in that it helps laypeople to more quickly identify the disorder in themselves. i'm not sure if everyone with PDD would qualify as 'high functioning' but perhaps they do. I never thought of myself as having MDD because it was always just a general malaise rather than acute episodes, although I've always had suicidal ideation. I am pretty well versed in psychological concepts and think I saw dysthmia but it didn't really resonate with me, and it's also not a commonly used term. 'high functioning' on the other hand, has some positive connotations, and I think that helps people like me put up less of a wall towards having the disorder, and more willing to seriously consider acknowledging and getting help for it. I would've liked if you could've gone into some of the correlational research on people with PDD. I've heard HFD correlates with people who are high achieving, intelligent, irritable, hyper critical of self and others, creative, and they all describe me (except creative), but I'm not sure if that's just because I particularly like the 'positive' traits, ya know?
Thanks for the video! Can you please make a video, discussing the reasons why someone should consider finding a new therapist, or maybe even filing a formal complaint?
As someone who has MDD, the term high functioning depression makes me feel weak. Since I feel like I can’t function well at all during episodes, it seems like I’m not strong enough as compared to those who are high functioning.
It’s just a term, the intensity or severity of the symptoms are different, they are related but still two different disorders. There is no need to torture yourself thinking like that. On the other side, I feel that MDD is taken more seriously because the symptoms are evident contrary to PDD. People most of the time don’t believe or don’t really understand how you feel inside and life demands are still the same as everyone else.
I have dealt with depression many times in my life. But recently I was thinking about suicide. I told my husband about it, and at first he took it seriously. I am on antidepressants. After a week or so, what I expressed to my husband wasn't taken as seriously. He began telling me ways to push it away, and a honest and caring way. But when I get depressed, it feels like it's from outside myself. It's like something is happening to me that I cannot control. It's not situational. This is what is difficult to explain to people. It does come and go. Thank you for your videos and your calm manner. It's comforting, intelligent, and not condescending.
i think what matters is that coping strategies can make there disorder invisible to themselves and others. If a person with one leg or arm is able to function with a prosthetic to the point that know one can tell, it doesn't mean that they don't have to apply a disproportional amount of effort.
Thanks that you clarified the modifiers of mild, moderate and severe with PDD. High functioning depression for me is still is disability and it might be where I am at now with TRD MDD. A good question for my psychiatrist. Thanks for making the definitions meaningful.
This is such a comprehensive explanation. Your channel is a tremendous source of reliable information with a level of excellence that is truly unparalleled. Thank you for all that you do.❤️
Could you speak to the depressing circumstances we face knowing the environment is being ruined and extinction is a real possibility? The future looks bleak and more people are coming to this realization.
I think of this often...we live in a crazy world with loads of suffering- wouldn’t depression and feelings of hopelessness be considered appropriate, considering the reality.
I think the pandemic increased a lot of people's depression and anxiety. This video is pre-pandemic. A lot of people say they're doing well - and I generally don't believe them. Some days I'm barely hanging on and talking with neighbours "okay" is the ceiling limit for how we're all doing.
Dysthymia is very frequently used in my area! I've been bounced around being diagnosed with MDD and "Dysthymia" (PDD) because I have rather a combination of both. I'm pretty sure currently my chart says NOS now.
High functioning can be temporary, and absolutely does not exclude the diagnosis of MDD, depends on the length of being high functioning of course. I think that for MDD, specifically more in the first episode, during the beginning phase of the episode, "meeting necessity obligations" functioning can still occur(specific example - like still going to school or work). it could even last for several months like this. but slowly and slowly(even during those first few months), being able to bare those obligations, will start to deteriorate, until eventually, you will not be able to bare them anymore, and will become "low functioning". high functioning shouldn't mostly or just refer to how much you meet necessity obligations like going to work. it should just as much if not more, look closely on how well can you do them. the term high functioning, and it's relation to diagnosing PDD, should only be made when "high functioning" occurs for an extensive and long period of time(maybe even as long as the criteria for PDD length), and when obligations are performed and met relatively well, and do not noticeably deteriorate with time.
I'm still pissed off at the person who told me I was full of shit the first time i suggested that I might need help, because they stopped me from plucking up the courage to ask again for over *twenty* more years. Especially considering how much better life is with happy pills.
I have PDD and had an episode of MDD a few months ago. I hate myself I can't do easy stuff. Every time I have an exam, I suffer to study. I can't finish all lectures even if there aren't that much to read. It feels like hell I want to end it but it's just there forever and I hate how much it drives me away of my dreams and ambitions.
Sounds relatable. Although I haven't been diagnosed because I haven't done anything about it yet - it feems so similar. I don't even dread exams, they're just there and I can't care enough to study. I also feel undecisive and worried a lot. When were you first diagnosed?
super useful! the specifiers make such a difference, both the episodic part of mdd and the correlation of the terms major and severe had me doubting my experience and kept me from seeking treatment for a long time, finally encountering the pdd diagnosis gave me clarity and hope, i agree high-functioning isnt a helpful label that for me personally fed my habitual negative self-talk
Please use proper term that place your shoes on the survivors'. It's not high functioning at all, we do function in some ways but we can barely there. We suffer a lot: poor concentration, procrastination, low willingness, hopelessness, low self-esteem, extremely pessimistic, and some of us are struggling with suicidal ideation and poor self hygiene. Our struggles are real.
Oh, I was just diagnosed with PDD. And Schizotypal Personality Disorder, but I basically knew that already. It was nice to get confirmation of it from a professional though
I think I have dysthymia, but I can't help but think that most people probably feel this way. Is it severe enough to be a disorder? Is feeling unhappy a disorder? Is being happy the only healthy state? In other words, is "happy vs unhappy conflict" most of what psychology deals with? And is being unhappy the only necessity to "qualify" for some sort of a disorder and decide you need professional help? If not, what's the difference between an unhappy person with a disorder and an unhappy person without a disorder? I have similar questions about personality disorders. Do we view certain combinations of personality traits as unhealthy only because they tend to make people unhappy? It's much easier for me to conceptualize schizophrenia, for example, since, unlike personality disorders, it has physiological reasons and symptoms that make a schizophrenic person different from most people. But can we really consider something that most people experience as "abnormal"? Also, as I understand it, you can technically have traits of a personality disorder, but if they don't bother you, or you can function as well as any other person and are happy, you would not be considered as someone with a disorder. (Being impulsive, having self-image issues, having fear of abandonment - for borderline personality disorder, for example) Maybe my way of thinking about this is completely wrong, I don't know. But these questions always come to mind, so I would appreciate if someone could offer their perspective on this.
I don't think it is severe enough to be a disorder. Especially with the personality disorders. They don't give pills to you to be happy, they give it so you can function. The only reason you would be pathologised is due to if you can work or not. It's also a social thing. If you know why you can't function in different situations there is something wrong and when it comes to psychiatry my experience is that you pretty much have to diagnose yourself, because the doctors don't know you enough like you do. Unless obvious traits. It could also be burnout. So really, if you want pills you say you are depressed, otherwise it is no use to diagnose. Diagnosing is for insurance payments. When it comes to personality disorders they stem from traumas in childhood.
This was quality information on depression and the symptoms associated with it. There was information expressed in this video that was new to me, and I am glad I learned.
I got diagnosed with depression and anxiety 23 years ago, just bog standard. And I spent so long feeding so alone because all I ever heard was these miracle recovery stories. I’d have some time where I was ok then go into the depths of despair, medication means I don’t think about suicide 24/7 but I’m still not totally ok. Still get really down sometimes, it can be bad enough I have to take time off work because I can’t focus and I have extreme impending doom overcome me. I never got a very detailed diagnosis, I don’t know how people get them in the UK at least. I get a GP who gives very little detail and that’s it.
My heart goes out to you because I've been living in my own depressed hell for so long. I can't pick up a phone to try and get help because of my anxiety. I'm not caring a word about what dude is saying. I just needed to whine . Much love and luck to you.❤
This video helped me to distinguish between Major Depressive Disorder, Persistent Depressive Disorder, and high functioning depression. It was interesting to learn that MDD clients must have met symptoms for two weeks, vs. PDD clients needing to meet the symptom criteria for two months. I also learned that MDD and PDD can be comorbid.
Yea I did it for years, played sports, games, skateboard, school and work I just keep going they don't help. It's not emotional in BPD sense but psychotic-like, insomniac, mild physical depression and neutral that emerges through social networks and isolation with continental divides over petty activity or autistic protocal. It's called psychotic depression.
This was really useful. Thank you for posting. Here in the UK it takes a long time to get an official diagnosis and treatment. It's something like 18 months at the moment. If you get private treatment it is much faster but very expensive. A National Health payment is taken from our wages each month (or week) that is each person's contribution to the National Health Service (NHS).....so going private for me means paying twice. Why should I go private when I have already paid ? Why should I wait all this time when I pay each month ? Sorry to go off topic but it's quite unfair here.
That is due to MH services being massively underfunded, and lack of staff (I saw a range of locums, who were retired pyschs called back in to plug gaps) Actually whole NHS needs better funding. But from experiences of those in insurance based systems - if you can't function enough for a job that comes with medical cover, then the monthly cost is as high or higher than any NI contribution rate (which actually covers pensions, the NHS more funded from general taxes). And then your insurance expects a 'co-pay' like your car insurance excess, for every visit to the dr. Assuming they accept pre - existing conditions. Not to say the waits in UK suck and system needs fixing especially MH - just that the grass isn't greener elsewhere - just different.
I never thought of high functioning to be a specifier just more of a general perception. High functioning depression could be someone who does well at their job and responsibilities but feel anhedonic without it being overt. High functioning anxiety on the other hand I would associate with catastrophizing or being able to cope with the anxiety and possibly even use it as motivation. Also My theory is would be high functioning would be associated more with personality disorders instead of mental disorders. Back to catastophizing/rumination I believe it’s a pattern of negative thinking over the course of years and excessive complaining causes one to be depressed with possibly less insight. They’re always expecting the worst and the anxiety comes in from worrying about confirming either their worst case scenarios or letting petty things keep them from being happy. I call this “Conditional Happiness” because the good days they do have when they’re was no resistance and their many conditions were met basically out of luck. They are the cause of their own distress because they essentially say “I will only have a good day if 1 of these 50 things don’t happen today. Their happiness resides in how much control they have. I know this because this is the person I used to be before realizing the power of thinking positive was real and not just some cheesy cliche. The fact that I could affect the outcome of my own destiny just because I was blindly optimistic defied all logic in my eyes but now my eyes are open to how to construct your own happiness. I wake up for work and maybe I’m still really sleepy or my head or neck hurts and I just wanna get back in bed I push forward. Tell myself it’s gonna be a great day and a lot of the time I start feeling better by the time I get to work and I can be productive and I like going to work. I’m not quite perfectionist/ocpd levels but I do share the love of productivity, routine and order but not to the point of putting before people’s feelings. I do feel empathy for people a lot actually sometimes at random times. I’m a very generous person. I gladly help people in little ways I can and consider myself an ambivert on the scale of extroversion, I’m open to experience, In the middle agreeableness, because I can be non conforming and I’m really high on both conscientiousness and neuroticism. Psychology is one of my greatest interests
I would argue that the terminology has a use in wider society as it spreads awareness and understanding that individuals can seem to be functioning normally whilst actually be suffering underneath from a mental health issue. As such it may lead to less dismissive society which in an of itself can exacerbate the situation and diminishes the probability that someone will receive or even seek out the treatment they require. It is not relevant that the terminology has no use in the clinical setting.
Good to know that besides my BPD I'm PDD, considering it's with me 10 years+ as is my anxiety. Although my symptoms change. Sometimes I eat too much, other times I don't have the energy to even eat and am disgusted to eat. Then again I was able to work with it for two years before I snapped. Edit: Although now after my suicide attempt and hospitalisation I'm not functioning well
Why does spiritual awakening look like this. I'm going through this now. I just don't align with the same people in my life anymore. So I could be diagnosed as this. This only started this year starting in the pandemic.
The idea of this never going away is scary. I have had severe PDD with episodes of MDD since adolescence and nothing has helped. Medication was a nightmare (not just saying that lightly), therapy has been ok or bad but never super helpful. Do you think chronic depression is more likely to indicate a personality disorder? Lately I’m not so sure I should be calling myself AvPD. Just feels like it puts too much blame on me for what has really been a real bad ride.
I have been having PDD as well, for all my llife. I have a huge amount of things to talk about it. I think we should create a community, there is a lot of confusion about it, but for me it's very clear, at least for many aspects. for now i can just ask something, which Pharmaceuticals have you got prescribed?
Celexa was a nightmare for me, I've done the best on effexor xr. And when I say "I've done the best..." I mean I have almost no side effects and it keeps me stable.
Very interesting topic! Since the term "High functioning depression" could be used as moderate major depressive disorder or moderate persistent depressive disorder I don't think the term is needed
I have been watching your videoes. I appreciate the information that you provide; you get right to the point! Can depressetion hurt your. Body ? I know i have depression and i hurt all the time! Is that part of it?
My Gastro specialist "can find nothing physically wrong" following biopsies and scopes, and attributes the source of my problems to depression and anxiety. My therapist kind of agrees.
I've been diagnosed by 3 seperate teams of psychs over a time period of 7 years as PDD! Either Dr. Grande is wrong or I'm misdiagnosed as a PDD, cause 4 symptoms that should be missing in PDD are and have been there for the last 12 years.
I know that you know the answer to your question. Stress obviously impacts us, and living with a depressed person is definitely quite stressful. It can feel rather hopeless when your tomorrow is wrapped up in another's stagnation.
Sometimes they can become toxic from rage, but normally having a relationship with someone who is depressed can go really well, and you can be their therapist.
Here in the UK there is a diagnosis of high functioning autism, which means a person who is self aware enough to know they are different from the majority but have learnt ways to hide it and get by in society. However, they remain autistic and suffer behind closed doors. Cannot the same thing apply to some depressives? There is an individual behind all these dysfunctions and we react to the cards we've been dealt in very different ways. Tick box diagnosis is too simplistic.
I am feeling on thi fase now. I just confused. I can talk and active with people there outside. but when i come back to home. I feel so tired, easyli cry and have insomnia in the night. Should i go to psycolog to find solution?
My god! I'm sitting here fucking crying for no reason. I'm a non functioning depressed failure who can't even make myself get help because of my wretched anxiety. I used to love so many things. Now, I try and learn how much helium I need .
Thanks for this video, recently found out about the popular term and really relate to it. seriously thinking about seeking a diagnosis and therapy if thats the case. I didnt know dysthymia was an old term by the videos ive been watching and to see the 2 depressive disorders did clear thing sup although the abbreviations got a little confusing for a bit there.
I think high functioning mental disorders are much more difficult to detect. By that, it deserves a separate classification as otherwise it may be overlooked.
I found this very helpful but it is confusing. I received my training with the DSM-IV and things changed quite a bit with the V. I also miss the Axis. I thought it was a good way to compartmentalize.
Dr Todd do you offer supervision for those pursuing those license from remote? I know the bbs just updated their terms but you can do it with a contracted letter. I would love to have some hours from someone with a PhD if you’re accepting new supervises please send me contact info!
I believe that major depression can be like a side effect of being exposed often to malicious and grandiose narcissists. One of my neighbor’s (at least) is malignant narcissistic to women. Women don’t last very long in this area unless they are covert or buying drugs for maliciously narc. However there are select women nearby who are really grandiose and intermittently histrionic according to drugs or sometimes under maintenance (in jail) for the outcomes of decisions. Ps -I really like your suit and tie.
At 18 yrs old my mother left the household, at 19 my father passed away, in my 20s my brother was in a fatal accident, in my 30s then my mother died, in my 40s, my sister. What do I have ?
Too funny! How the hell can anyone make a correct dx. With all these variables for both types. Its like batting open a pinata and grabbing a hand full of candy symptoms and deciding a dx .
But the real question is - how to seek help? Together with all these symptoms comes another one - SHAME. You think that, OK, I'm in a rut, time to call someone, and then you feel ashamed of yourself how weak you are.
I’ve been living with PDD, and I actually get offended when people call me “high-functioning”. I still am dealing with poor concentration (sometimes brain fog), hypersomnia and fatigue. I join classes and go to work just because it is “scheduled”. I leave classes with nothing in my head, and it shows in my exam. I barely can keep up with my study. Often I miss my assignment due-dates because of physical and mental exhaustion. See? I’m not “high-functioning” at all, but I still do things I’m supposed to do because I have to.
Nail on head.
@Dustin Void why you don't just give up in life? I mean you better turn off yourself ☺️ none would give a dime anyways
Like crawling naked thru broken glass...
Here's my thing; Mental health is unfortunately treated a lot like physical health in that we only intervene when there's a crisis. High-functioning folks, that is to say people who aren't neurotypical but can at least live their lives without significant impact are still struggling, still in pain, still experiencing the symptoms. And the fact that there isn't a distinction between a person who has suicidal ideation and who is plagued by it versus someone with suicidal ideation who has lived with it long enough to consider it mundane is that it might not register or be detected during screening. When asked about it, one might answer that they haven't felt suicidal ideation in a while when what they mean is that they haven't felt *overwhelming* suicidal ideation for a while. This is how it was for me, I'd have episodes when I had a moment to myself which had me sobbing on the floor, where the thought of being dead just felt comforting, like a release from all the pain I was feeling, rather than just this background noise that floated around in my brain.
Often, at the point of intervention it's just so late. There's a lot of pain and suffering that could have been avoided if we just caught it earliee.
I relate to this sentiment. I find that what others perceive to be my "worst" days, where I am screaming and crying out of frustration and despair, or lying motionless on the floor for extended periods, do not subjectively feel to me to be all that different to a day where I am functioning "regularly" in terms of the severity of the negative sensations. Those just happen to be the days where the pain has mounted enough for me break under its weight. I find it frustrating that people around me like my family will ask what caused such a "drastic change" from one day to the next, as from my perspective, the day before may have actually been worse because I didn't get the release of a breakdown and the excuse to give into it. Those breakdowns aren't really the result of me feeling so horrible on that particular day, but the natural result of years of unending anguish on "regular" days where I have to learn to get up and get on with things despite it. The crisis days are some of the most satisfying because they are the only days when I feel like my external behaviour truly matches the pain I'm experiencing inside, and people around me seem to actually understand how bad things are. I can't spend every minute of every day projecting to the world how horrible I feel, often it takes less energy to act like things are okay, and the things I want in life require that I learn to push through, but it can be frustrating feeling like most of the time nobody realises how much of a struggle just a "regular" day is, and it takes a meltdown for them to see.
Agreed!
True. I go to work (and I'm a teacher, suoer hard to be faking all day), I shower, I cook and I can still be thinking all day about kms.
A lot of people don’t consider you depressed unless your home wailing and crying daily. a lot of us are able to live daily lives and put on a mask in front of people that we only have a “surface relationship “ with (coworkers, etc ) but the people we live with see the cracks and the ugly stuff and we’re not always easy to live with. It takes a tremendous amount of energy some days to maintain the mask and that’s why a lot of us become loaners. Perhaps the term high function depression isn’t a great clinical term, but I think it might help to explain or for people to understand that just because you’re able to interact with society, doesn’t mean you don’t need help.
This resonates with me. 8 years ago when I first got my mental health diagnosis I was on many psychiatry waiting lists to see a clinician because I am "high functioning." I ultimately ended up checking myself into a psych ward when nobody would see me but it was most definitely preventable.
I’ve been dysthymic (in the classic sense...maybe PDD) for 15 years. I have a job, a girl and hobbies...but the sky is gray every single day. I’m not suicidal and I’m functional but I don’t experience happiness as I knew it when in my youth.
I can live like this but it would be nicer if I didn’t have to.
Are there pills we can take to help with this? Thank you.
I have the same problem. there is a huge amount of things to talk about it. I think we should create a community, there is a lot of confusion in science about it , and about other disorders. we should discuss it, as a patient from many years and an engineer I have my own theory and I will share it online .
for now I could ask the same thing of E.S.Sic.. which pharm do you take eventually?
@@amedeocristiano4181 Hello, I am not taking anything.
@@EEEBA1 me neither
@Dustin Void i know the feeling,and the lack of actual feeling that comes with it. One can climb the highest mountain and accomplish the greatest feat,but i didn't feel like i did,then i may also have never happened. There is no depht,no nuance,everything is so "flat". I would advice to see someone ,maybe that can help on the both the short and long term. It can be better,if there is one thing that i learnt,that sometimes there are events that are capable to clear your head and make you feel like years ago,if only for a while.
Dr. Grande, you do grand justice for mental health awareness. Simply thank you on behalf of many.
I got my Lamictal increased and it took me out of my depression. I still have baseline depression but at least i can function daily without wanting to not be here anymore. Bipolar disorder sucks and i mostly have depression than hypomania. Im on SSDI but i can still maintain part time work and take care of my responsibilities. The key to maintaining a high functionality for me is to push myself to do things even when i dont want to. ALSO, staying clean and sober and exercising and eating right is key. This all didnt happen overnight though ive had this mood disorder since 15 and im 44 now. Thank you for your expertise Dr. Grande you are highly intelligent i dont know how you store all your knowledge much less convey it so well to the public. Its amazing.
if you still have baseline depression, it sounds like your medication is not optimal.
I'll be 60 in November.
Been dealing with this since my earliest memories.
Everyday the merry go round or should I say, the misery go round. I'm so tired of it.
I am a clinician..quite educated...currently at the tail end of a PhD...and suffer from bouts of MDD...the "high functioning" label is a double edged sword..On the one hand, I feel I haven't gone to total shit. I am "high-functioning." On the other, maybe I'm fine..a "realist" if you will. Maybe life is totally hopeless and will never improve. From a cognitive perspective, this is "black and white" thinking. But it can feel quite real, (I still question if it is not) despite one's educational level. It may also be that the area most affected by depression is that which is hidden to most. Thanks so much...this provoked meaningful thought.
I though psychomotor retardation was a fundamental component of MDD. If that is true, how can someone with psychomotor retardation be high functioning?
@@GuitarMan1117a I have MDD and I can have the psychomotor retardation during one episode. Mostly, I get restless and fidgety. It maybe because I also have an anxiety disorder.
If I'm not wrong, in the criteria for MDD people can have either psychomotor retardation or restlessness. No two people experience all the same symptoms at any given time. There are several "either or's" in MDD. (i.e. sleep too much or not enough; loss of appetite or increased appetite...)
I feel the exact same yet I think its my anxiety causing all the problems and connecting it to overthinking. Then again I am a realist as well, thinking wtf is going on.
@@GuitarMan1117a it's not even one of the defined criteria in the dsm, so I wonder why you think this to be the case(?)
I totally hate that statement. I wish it would be changed or altered.
Thank you for the informative video Dr. Grande. I was diagnosed with MDD 15 years ago. I was given a 30 day supply of antidepressants and told to go volunteer. I'm glad there is a better understanding of the condition today.
Yikes, the exact same thing happened to me almost 7 years ago.
I was diagnosed with MDD at 16, then BP2 at 19 and most recently I’ve been told the BP2 was incorrect and I actually have PDD and GAD. It’s been hard adjusting especially since I’m no longer on medication and I’m currently on the waiting list for CBT.
However I wanna say thank you for this video. From all the articles I’ve read and videos I’ve watched, this one has been the easiest for me to understand. I was told this all when I was recently rediagnosed but it was hard to take it all in and remember it word for word so I’m glad I’ll have this video now to reference and better articulate myself when I want to explain my mental health to others.
💜
Thanks for your great comment dear friend.
May God be with you and show you His wonderful kindness and grace.
May the love of His Son Jesus surround you and embrace you warmly.
Please take care.
I'm confused I can go to school and fuction I can get my work done but I'm still depressed every day I have thoughts of suicide and feeling worthless I'm just so confused I'm just trying to understand more the feeling for me is constent and I've lost most Interest and most things I use to enjoy I'm just confused
Wyatt Ventura agreed.
I'm not the psychologist here but from what dr. Grande said it sounds like you have pdd + a specifier. I have all the symptoms of pdd except for poor appetite, but I also have the suicidal thoughts (symptom of mdd). I work a full time job, I've even had 2 and 3 jobs before so I know how you feel. Hang in there.
I’ve had suicidal thoughts since I was 15, which I retrospectively believe is when my depression started. I was diagnosed with ADD (inattentive ADHD) at 12 yrs old, and wish I had been informed of my higher risk of developing depression (up to 50% of people with ADD have depression). I hid my depression for years as it slowly got worse while I told by my parents (and eventually myself) I wasn’t depressed I was just too sensitive, or my mum would accuse me of acting when I would hyperventilate as thoughts of suicide would run through my head. It took until my third year at uni for me to break after an argument with my parents, where I drove to a place an hour away while genuinely didn’t know if I was about to act on those thoughts. My parents had called the police but I had knocked out the battery of my phone (so my parents couldn’t call) which meant they couldn’t triangulate my location. I ended up lying on the roof of my car on a freezing night, for 4 hours trying to calm down as I watched satellites pass overhead, until I was ready to drive home. Because the police had been called they had to take me to the hospital for a mental health assessment, they had me under observation for 3 hours and the mental health professional suggested I go to a psychologist as it sounded like I had been suffering from chronic depression for the last 5 years. I got a new psychiatrist who specialises in ADD and depression, and got put on antidepressants, but after I had another major depressive episode when the medication stopped working I started seeing a clinical psychologist as well. I’m on a new antidepressant now and doing cognitive behavioural therapy (CBT) and am feeling better than I have felt for the last 7 years of my life.
My advice is get professional help earlier than I did, I made my life so much harder than it had to be by trying to convince myself that my symptoms were not severe enough to be depression. Try to see a clinical psychologist, if you need medication they can recommend a psychiatrist, don’t hope on things getting better by themselves, you need support and care as well as the tools to work on these things.
I was in the same place as you for 20 years at least and while I'm not a psychologist (and I'm not even 100% sure what my own dx is), I can say from some experience that if you do seek out help from a GP or counsellor these minute distinctions won't make a lot of practical difference to their willingness to help you out.
Before I started on antidepressants I was fully functional most days at work, and able to get up in the morning just fine (to the extent that anyone is fine with a 6 am alarm clock every weekday!) But at the same time I would wake up every morning with my first thought being "I want to die" ... and be thinking similar things through much of the rest of the day.
To an extent, the specificity of your dx is really a side issue if asking for help would get you the help you need, and I really *really* think you should find someone to ask.
Number one, that is exactly how I feel . Number two, my managing my depression means fighting everyday with myself not to give up. I personally don't expect it to go away for myself but being engaged as best you can and seeking help is the next best thing. But you are definitely not along and need to remember that.
I have major depression. It’s hard for me to leave my house and do basic things. I hate my life
lol
Look Behind You -
Why do you find someone’s suffering a reason to laugh? That is just cruel.
Joseph I'm sorry you are suffering. You are not alone in this. The depression I suffer is painful too. Please find a professional to talk with. Get some help. It can get better.
I'm sorry you are hurting. You're not alone. Please find a professional to talk with. It can get better. There are those who genuinely care about others.
Joseph, one of my favorite quotes is “Before you diagnose yourself with depression or low self-esteem, first make sure that you are not, in fact, just surrounding yourself with assholes.” Hang in there, learn to love yourself and embrace your weirdness, and don’t give a d@mn what anyone else thinks of you!
Thank you again I’m mid 60’s just recently started dealing with my issues. This helps me a lot letting me know I’ve not been alone. I can accept my depression when it happens now
This provides neurological evidence of the dulling of emotion that individuals with dysthymia have learned to use to protect themselves from overly strong negative feelings, compared to healthy people.
Thank you for this articulate clarification.
I was diagnosed with major depressive disorder. I take an SSRI for it, but I have “flares.” I call them such because I go to patient homes and give them infusions for autoimmune diseases and they use the term “flares” when their condition is causing moderate to severe symptoms that interrupt their daily functioning. I’ve seen docs write in their notes a term called “acute on chronic,” meaning the person is having an acute episode of a chronic condition. I’ve been having a flare for the last three months, the longest I’ve ever had. Usually it will last a week where I can’t get out of bed, because I don’t have the will to nor do I care to. Other than that I have that dark cloud following me but I go to work, clean the house, take care of my pets and hide that dark cloud and put on a smile. To be honest, it’s exhausting and yesterday I had a very quick thought of driving my car into a tree and I told myself that’s the depression talking, that’s not what I want. I’m in therapy once a week using CBT and challenging my own negative self talk and I think it’s working because I challenged my own thought about the car and the tree.
Edit: Dr. Grande, I really like the dark background with the information put up to see
I think it offers value in that it helps laypeople to more quickly identify the disorder in themselves. i'm not sure if everyone with PDD would qualify as 'high functioning' but perhaps they do. I never thought of myself as having MDD because it was always just a general malaise rather than acute episodes, although I've always had suicidal ideation. I am pretty well versed in psychological concepts and think I saw dysthmia but it didn't really resonate with me, and it's also not a commonly used term. 'high functioning' on the other hand, has some positive connotations, and I think that helps people like me put up less of a wall towards having the disorder, and more willing to seriously consider acknowledging and getting help for it.
I would've liked if you could've gone into some of the correlational research on people with PDD. I've heard HFD correlates with people who are high achieving, intelligent, irritable, hyper critical of self and others, creative, and they all describe me (except creative), but I'm not sure if that's just because I particularly like the 'positive' traits, ya know?
Thanks for the video! Can you please make a video, discussing the reasons why someone should consider finding a new therapist, or maybe even filing a formal complaint?
Yes, I can - I will add your idea to the production list.
@@DrGrande Thank you so much!!!
As someone who has MDD, the term high functioning depression makes me feel weak. Since I feel like I can’t function well at all during episodes, it seems like I’m not strong enough as compared to those who are high functioning.
It’s just a term, the intensity or severity of the symptoms are different, they are related but still two different disorders. There is no need to torture yourself thinking like that. On the other side, I feel that MDD is taken more seriously because the symptoms are evident contrary to PDD. People most of the time don’t believe or don’t really understand how you feel inside and life demands are still the same as everyone else.
The problem with depress people is that they think too much, stop thinking and act, simple as that
I have dealt with depression many times in my life. But recently I was thinking about suicide. I told my husband about it, and at first he took it seriously. I am on antidepressants. After a week or so, what I expressed to my husband wasn't taken as seriously. He began telling me ways to push it away, and a honest and caring way. But when I get depressed, it feels like it's from outside myself. It's like something is happening to me that I cannot control. It's not situational. This is what is difficult to explain to people. It does come and go. Thank you for your videos and your calm manner. It's comforting, intelligent, and not condescending.
i think what matters is that coping strategies can make there disorder invisible to themselves and others. If a person with one leg or arm is able to function with a prosthetic to the point that know one can tell, it doesn't mean that they don't have to apply a disproportional amount of effort.
Thanks that you clarified the modifiers of mild, moderate and severe with PDD. High functioning depression for me is still is disability and it might be where I am at now with TRD MDD. A good question for my psychiatrist. Thanks for making the definitions meaningful.
Thank you! You're videos are always interesting and helpful.
This is such a comprehensive explanation. Your channel is a tremendous source of reliable information with a level of excellence that is truly unparalleled.
Thank you for all that you do.❤️
Thanks Grandayyy
Life with PDD is so exhausting and never ends...I've had it for 21 years and I'm tired.
Could you speak to the depressing circumstances we face knowing the environment is being ruined and extinction is a real possibility? The future looks bleak and more people are coming to this realization.
I think of this often...we live in a crazy world with loads of suffering- wouldn’t depression and feelings of hopelessness be considered appropriate, considering the reality.
I think the pandemic increased a lot of people's depression and anxiety. This video is pre-pandemic. A lot of people say they're doing well - and I generally don't believe them. Some days I'm barely hanging on and talking with neighbours "okay" is the ceiling limit for how we're all doing.
Dysthymia is very frequently used in my area! I've been bounced around being diagnosed with MDD and "Dysthymia" (PDD) because I have rather a combination of both. I'm pretty sure currently my chart says NOS now.
High functioning can be temporary, and absolutely does not exclude the diagnosis of MDD, depends on the length of being high functioning of course.
I think that for MDD, specifically more in the first episode, during the beginning phase of the episode, "meeting necessity obligations" functioning can still occur(specific example - like still going to school or work). it could even last for several months like this. but slowly and slowly(even during those first few months), being able to bare those obligations, will start to deteriorate, until eventually, you will not be able to bare them anymore, and will become "low functioning".
high functioning shouldn't mostly or just refer to how much you meet necessity obligations like going to work. it should just as much if not more, look closely on how well can you do them.
the term high functioning, and it's relation to diagnosing PDD, should only be made when "high functioning" occurs for an extensive and long period of time(maybe even as long as the criteria for PDD length), and when obligations are performed and met relatively well, and do not noticeably deteriorate with time.
I'm still pissed off at the person who told me I was full of shit the first time i suggested that I might need help, because they stopped me from plucking up the courage to ask again for over *twenty* more years. Especially considering how much better life is with happy pills.
I have PDD and had an episode of MDD a few months ago. I hate myself I can't do easy stuff. Every time I have an exam, I suffer to study. I can't finish all lectures even if there aren't that much to read. It feels like hell I want to end it but it's just there forever and I hate how much it drives me away of my dreams and ambitions.
Sounds relatable. Although I haven't been diagnosed because I haven't done anything about it yet - it feems so similar. I don't even dread exams, they're just there and I can't care enough to study. I also feel undecisive and worried a lot. When were you first diagnosed?
super useful! the specifiers make such a difference, both the episodic part of mdd and the correlation of the terms major and severe had me doubting my experience and kept me from seeking treatment for a long time, finally encountering the pdd diagnosis gave me clarity and hope, i agree high-functioning isnt a helpful label that for me personally fed my habitual negative self-talk
Please use proper term that place your shoes on the survivors'. It's not high functioning at all, we do function in some ways but we can barely there. We suffer a lot: poor concentration, procrastination, low willingness, hopelessness, low self-esteem, extremely pessimistic, and some of us are struggling with suicidal ideation and poor self hygiene. Our struggles are real.
Oh, I was just diagnosed with PDD. And Schizotypal Personality Disorder, but I basically knew that already. It was nice to get confirmation of it from a professional though
I think I have dysthymia, but I can't help but think that most people probably feel this way. Is it severe enough to be a disorder? Is feeling unhappy a disorder? Is being happy the only healthy state?
In other words, is "happy vs unhappy conflict" most of what psychology deals with? And is being unhappy the only necessity to "qualify" for some sort of a disorder and decide you need professional help?
If not, what's the difference between an unhappy person with a disorder and an unhappy person without a disorder?
I have similar questions about personality disorders. Do we view certain combinations of personality traits as unhealthy only because they tend to make people unhappy? It's much easier for me to conceptualize schizophrenia, for example, since, unlike personality disorders, it has physiological reasons and symptoms that make a schizophrenic person different from most people. But can we really consider something that most people experience as "abnormal"?
Also, as I understand it, you can technically have traits of a personality disorder, but if they don't bother you, or you can function as well as any other person and are happy, you would not be considered as someone with a disorder. (Being impulsive, having self-image issues, having fear of abandonment - for borderline personality disorder, for example)
Maybe my way of thinking about this is completely wrong, I don't know. But these questions always come to mind, so I would appreciate if someone could offer their perspective on this.
I don't think it is severe enough to be a disorder. Especially with the personality disorders. They don't give pills to you to be happy, they give it so you can function. The only reason you would be pathologised is due to if you can work or not. It's also a social thing. If you know why you can't function in different situations there is something wrong and when it comes to psychiatry my experience is that you pretty much have to diagnose yourself, because the doctors don't know you enough like you do. Unless obvious traits. It could also be burnout. So really, if you want pills you say you are depressed, otherwise it is no use to diagnose. Diagnosing is for insurance payments. When it comes to personality disorders they stem from traumas in childhood.
When I was six years old my stepmother left me in a doorway with a note saying not wanted.....
That’s is horrible! I’m very sorry to hear that happened to you. That wicked stepmom with so wrong, you are wanted and very valuable to God and to me.
This was quality information on depression and the symptoms associated with it. There was information expressed in this video that was new to me, and I am glad I learned.
I also learned a lot of new information, including how to properly write down the correct diagnoses when MDD and PDD are comorbid with one another.
I got diagnosed with depression and anxiety 23 years ago, just bog standard. And I spent so long feeding so alone because all I ever heard was these miracle recovery stories. I’d have some time where I was ok then go into the depths of despair, medication means I don’t think about suicide 24/7 but I’m still not totally ok. Still get really down sometimes, it can be bad enough I have to take time off work because I can’t focus and I have extreme impending doom overcome me.
I never got a very detailed diagnosis, I don’t know how people get them in the UK at least. I get a GP who gives very little detail and that’s it.
My heart goes out to you because I've been living in my own depressed hell for so long. I can't pick up a phone to try and get help because of my anxiety. I'm not caring a word about what dude is saying. I just needed to whine . Much love and luck to you.❤
I live as a high functioning depressed person daily! I am so tired of pretending I’m ok
Very good clinical analysis. Thank you
I’ve never heard this term before and I also don’t think it’s necessary if there are other terms that can be used. Very informative video. Thank you!
Thanks for the clarification. I did find this helpful. I suspected it was somewhat of a buzz word.
This video helped me to distinguish between Major Depressive Disorder, Persistent Depressive Disorder, and high functioning depression. It was interesting to learn that MDD clients must have met symptoms for two weeks, vs. PDD clients needing to meet the symptom criteria for two months. I also learned that MDD and PDD can be comorbid.
Yeah. It's real. And yeah. We need the term.
From being highly sensitive and anxious doctors put me on so many meds. I’m spiritually dead my memory of myself isn’t even there
Read The Empath Guidebook. Search the remedy Natrum Mur...it's a homeopathic remedy for empaths.
Yea I did it for years, played sports, games, skateboard, school and work I just keep going they don't help. It's not emotional in BPD sense but psychotic-like, insomniac, mild physical depression and neutral that emerges through social networks and isolation with continental divides over petty activity or autistic protocal. It's called psychotic depression.
This was really useful. Thank you for posting. Here in the UK it takes a long time to get an official diagnosis and treatment. It's something like 18 months at the moment. If you get private treatment it is much faster but very expensive. A National Health payment is taken from our wages each month (or week) that is each person's contribution to the National Health Service (NHS).....so going private for me means paying twice. Why should I go private when I have already paid ? Why should I wait all this time when I pay each month ? Sorry to go off topic but it's quite unfair here.
That is due to MH services being massively underfunded, and lack of staff (I saw a range of locums, who were retired pyschs called back in to plug gaps) Actually whole NHS needs better funding. But from experiences of those in insurance based systems - if you can't function enough for a job that comes with medical cover, then the monthly cost is as high or higher than any NI contribution rate (which actually covers pensions, the NHS more funded from general taxes). And then your insurance expects a 'co-pay' like your car insurance excess, for every visit to the dr. Assuming they accept pre - existing conditions. Not to say the waits in UK suck and system needs fixing especially MH - just that the grass isn't greener elsewhere - just different.
I never thought of high functioning to be a specifier just more of a general perception. High functioning depression could be someone who does well at their job and responsibilities but feel anhedonic without it being overt. High functioning anxiety on the other hand I would associate with catastrophizing or being able to cope with the anxiety and possibly even use it as motivation. Also My theory is would be high functioning would be associated more with personality disorders instead of mental disorders. Back to catastophizing/rumination I believe it’s a pattern of negative thinking over the course of years and excessive complaining causes one to be depressed with possibly less insight. They’re always expecting the worst and the anxiety comes in from worrying about confirming either their worst case scenarios or letting petty things keep them from being happy. I call this “Conditional Happiness” because the good days they do have when they’re was no resistance and their many conditions were met basically out of luck. They are the cause of their own distress because they essentially say “I will only have a good day if 1 of these 50 things don’t happen today. Their happiness resides in how much control they have. I know this because this is the person I used to be before realizing the power of thinking positive was real and not just some cheesy cliche. The fact that I could affect the outcome of my own destiny just because I was blindly optimistic defied all logic in my eyes but now my eyes are open to how to construct your own happiness. I wake up for work and maybe I’m still really sleepy or my head or neck hurts and I just wanna get back in bed I push forward. Tell myself it’s gonna be a great day and a lot of the time I start feeling better by the time I get to work and I can be productive and I like going to work. I’m not quite perfectionist/ocpd levels but I do share the love of productivity, routine and order but not to the point of putting before people’s feelings. I do feel empathy for people a lot actually sometimes at random times. I’m a very generous person. I gladly help people in little ways I can and consider myself an ambivert on the scale of extroversion, I’m open to experience, In the middle agreeableness, because I can be non conforming and I’m really high on both conscientiousness and neuroticism. Psychology is one of my greatest interests
Being considered high functioning makes me feel good about myself. If I am going through a lot and still able to function I feel strong.
Wow 😲 so I am strong too
I would argue that the terminology has a use in wider society as it spreads awareness and understanding that individuals can seem to be functioning normally whilst actually be suffering underneath from a mental health issue.
As such it may lead to less dismissive society which in an of itself can exacerbate the situation and diminishes the probability that someone will receive or even seek out the treatment they require.
It is not relevant that the terminology has no use in the clinical setting.
In the case of a psychopath, could suicidal ideation manifest instead as homicidal ideation?
Good to know that besides my BPD I'm PDD, considering it's with me 10 years+ as is my anxiety. Although my symptoms change. Sometimes I eat too much, other times I don't have the energy to even eat and am disgusted to eat. Then again I was able to work with it for two years before I snapped.
Edit: Although now after my suicide attempt and hospitalisation I'm not functioning well
Why does spiritual awakening look like this. I'm going through this now. I just don't align with the same people in my life anymore. So I could be diagnosed as this. This only started this year starting in the pandemic.
The idea of this never going away is scary. I have had severe PDD with episodes of MDD since adolescence and nothing has helped. Medication was a nightmare (not just saying that lightly), therapy has been ok or bad but never super helpful. Do you think chronic depression is more likely to indicate a personality disorder? Lately I’m not so sure I should be calling myself AvPD. Just feels like it puts too much blame on me for what has really been a real bad ride.
I have been having PDD as well, for all my llife. I have a huge amount of things to talk about it. I think we should create a community, there is a lot of confusion about it, but for me it's very clear, at least for many aspects.
for now i can just ask something, which Pharmaceuticals have you got prescribed?
Celexa was a nightmare for me, I've done the best on effexor xr. And when I say "I've done the best..." I mean I have almost no side effects and it keeps me stable.
I sometimes feel okay, almost happy, but fatigue follows me everywhere and my concentration is always really bad
Wow,Great information.
Very interesting topic! Since the term "High functioning depression" could be used as moderate major depressive disorder or moderate persistent depressive disorder I don't think the term is needed
I love learning and i love your channel
Its a high compliment from one with bpd since we seldom listen to others
@@brusselsprout5851 smart :)
I have been watching your videoes. I appreciate the information that you provide; you get right to the point! Can depressetion hurt your. Body ? I know i have depression and i hurt all the time! Is that part of it?
My Gastro specialist "can find nothing physically wrong" following biopsies and scopes, and attributes the source of my problems to depression and anxiety. My therapist kind of agrees.
I've been diagnosed by 3 seperate teams of psychs over a time period of 7 years as PDD! Either Dr. Grande is wrong or I'm misdiagnosed as a PDD, cause 4 symptoms that should be missing in PDD are and have been there for the last 12 years.
Is it possible that living with someone who has mdp or other mental health issues impacts our own mental health?
I know that you know the answer to your question. Stress obviously impacts us, and living with a depressed person is definitely quite stressful. It can feel rather hopeless when your tomorrow is wrapped up in another's stagnation.
@@Holly-sq5uv indeed
Yes, it can. If you live with someone with a mental health or substance use issue, it's a good idea to seek out support for yourself too.
Sometimes they can become toxic from rage, but normally having a relationship with someone who is depressed can go really well, and you can be their therapist.
Here in the UK there is a diagnosis of high functioning autism, which means a person who is self aware enough to know they are different from the majority but have learnt ways to hide it and get by in society. However, they remain autistic and suffer behind closed doors. Cannot the same thing apply to some depressives? There is an individual behind all these dysfunctions and we react to the cards we've been dealt in very different ways. Tick box diagnosis is too simplistic.
I am feeling on thi fase now. I just confused. I can talk and active with people there outside. but when i come back to home. I feel so tired, easyli cry and have insomnia in the night. Should i go to psycolog to find solution?
Been there. Done that. The answer to your question is, yes.
Great video Dr Grande! I was wondering, does psychotic depression present differently in PDD than in MDD?
My god! I'm sitting here fucking crying for no reason. I'm a non functioning depressed failure who can't even make myself get help because of my wretched anxiety. I used to love so many things. Now, I try and learn how much helium I need .
Thanks for this video, recently found out about the popular term and really relate to it. seriously thinking about seeking a diagnosis and therapy if thats the case. I didnt know dysthymia was an old term by the videos ive been watching and to see the 2 depressive disorders did clear thing sup although the abbreviations got a little confusing for a bit there.
Yes, It Is!
I was diagnosed with mmd but I remember being depressed for years why didn’t I get pdd?
I was first diagnosed with Major depression now im being labled bipolar
Very good, thank you.
I think high functioning mental disorders are much more difficult to detect. By that, it deserves a separate classification as otherwise it may be overlooked.
I need to know if I can cure myself, I can't keep on like this.
Very informative video.
I found this very helpful but it is confusing. I received my training with the DSM-IV and things changed quite a bit with the V. I also miss the Axis. I thought it was a good way to compartmentalize.
Thank you Dr Grande ❤️
Excellent video!
Not sure I've had 2 years when I haven't been 'a bit depressed.' Sometimes, very.
i feel like i have this.. but i also have traits from bpd.. its so confusing..
Sooo I DON’T have a mental disorder then?
Dr Todd do you offer supervision for those pursuing those license from remote? I know the bbs just updated their terms but you can do it with a contracted letter. I would love to have some hours from someone with a PhD if you’re accepting new supervises please send me contact info!
You forgot to tell us to comment below.
I was born with this!!!
I believe that major depression can be like a side effect of being exposed often to malicious and grandiose narcissists. One of my neighbor’s (at least) is malignant narcissistic to women. Women don’t last very long in this area unless they are covert or buying drugs for maliciously narc. However there are select women nearby who are really grandiose and intermittently histrionic according to drugs or sometimes under maintenance (in jail) for the outcomes of decisions. Ps -I really like your suit and tie.
What is a major depressive episode?
At 18 yrs old my mother left the household, at 19 my father passed away, in my 20s my brother was in a fatal accident, in my 30s then my mother died, in my 40s, my sister. What do I have ?
Bad luck?
@@OrthodoxChristian809 lol, funny ! , see I can still laugh.
@@russellstone6390 I'm sorry, I couldn't pass it up. I hope you're feeling better soon x
@@OrthodoxChristian809 bur it was funny, thanks
Life
Attempted suicide Nov of 2019....didn't work....
Is go tim for sathik
NO ! you don't have a clue how it is to be a high-functional depression , don't judge it , its my friend , the only friend i have in this world 🌍
Do you believe in Bipolar dr?
When I said to my therapist that i am think i have pdd she told me that there isn't such thing XD
PDD..........mmm 🤔 from 12ish to 60ish its my baseline............with sprinkles of MDD through the decades............ βρήκα
I’m short:
High-functioning = mild
How do you determine whether a person has mild, moderate or severe MDD?
Get a diagnosis from a psychiatrist.
High functioning depression? Sounds like a “push.”
Never heard of high-functioning depression until Miss USA Cheslie Kryst’s suicide.
Bert helpfull
if i'm not into drugs (don't do shit for me) does that make me lowfunctioning
@Marc Goozen it was a joke as in high functioning = being high on drugs
@Marc Goozen but also i get bored on drugs
Too funny! How the hell can anyone make a correct dx. With all these variables for both types. Its like batting open a pinata and grabbing a hand full of candy symptoms and deciding a dx .
Its all just words. No help available anyway unless you are rich, unemployed or aboriginal
But the real question is - how to seek help? Together with all these symptoms comes another one - SHAME. You think that, OK, I'm in a rut, time to call someone, and then you feel ashamed of yourself how weak you are.