The unexpected dark side of being extraordinarily successful

[WORLD] Depression doesn’t always appear the way we expect. Even those who are outwardly successful and consistently productive can quietly struggle with the disorder. Recent research from the American Psychological Association reveals that nearly 40% of high-achieving professionals report experiencing depressive symptoms while maintaining work performance. This "silent struggle" often leads to delayed diagnosis, as many dismiss their symptoms as normal stress or burnout rather than seeking help.

Common symptoms of depression include persistent hopelessness, fatigue, loss of interest in previously enjoyable activities, and changes in appetite. However, when someone continues to meet their daily responsibilities while battling these internal struggles, it may be referred to as high-functioning depression — a non-clinical term used to describe individuals managing mental health challenges beneath the surface of everyday life.

According to the National Alliance on Mental Illness, high-functioning depression refers to people “grappling with mental health issues while accomplishing their day-to-day tasks and upholding their responsibilities.”

The workplace has become a particular area of concern, with a 2024 Harvard Business Review study showing that employees with high-functioning depression are 30% more likely to experience workplace burnout than their peers. Many companies are now implementing mental health days and emotional well-being programs to address this growing issue.

Dr. Judith Joseph, a board-certified psychiatrist and author of High Functioning, explains that many people experiencing this form of depression tend to stay excessively busy. “They’re overly functioning. When they sit still, they feel empty. When they’re not busy, they feel restless,” she says. Joseph notes that unresolved trauma — from financial difficulties to childhood adversity — can drive some individuals to cope through constant productivity.

Interestingly, cultural factors play a significant role in how high-functioning depression manifests. In collectivist societies where achievement is highly valued, individuals may be even more likely to hide depressive symptoms to avoid burdening others or losing face, according to cross-cultural mental health studies.

While professional support from a doctor or mental health specialist is essential, Joseph also offers a self-help model drawn from her clinical work with diverse age groups. She calls it “the five V’s” — a daily toolkit designed to help people reconnect with joy.

“The five V’s remind you of the five fingers, because joy is within our hands. We just need to know how to grasp it,” Joseph shared. She advises against trying to implement all five tools at once. “High-functioning people tend to overdo things,” she says. Instead, she encourages a gentler approach: “Try one or two each day, with the mindset of, ‘I’m going to aim for one moment of joy today.’”

The Five V’s: Tools to Help Navigate High-Functioning Depression

1. Validation
Recognizing and accepting your feelings is a critical first step — and one that many high-functioning individuals struggle with.
“Validation is acknowledging and accepting how you feel, which is very difficult for people who are high-functioning,” Joseph explains.
This emotional clarity helps reduce confusion and leads to healing. “When we can’t identify our emotions, we get confused. Some of us confuse anxiety for anger and end up acting irritable when we’re actually worried,” she adds.

2. Venting
Expressing your emotions in a healthy way is essential. Joseph recommends venting with intention, which includes seeking feedback or support when needed.
If confiding in a friend rather than a therapist, ask for emotional consent first — for example: “I really need to vent right now. Would that be okay with you?”
This step helps avoid overwhelming others and protects you from feeling rejected.
Other venting methods include journaling, praying, singing, or crying — whatever allows for authentic expression.

3. Values
Joseph notes that high-functioning individuals often chase external validation — through wealth, status, or achievements — rather than what genuinely brings meaning.
She encourages a daily reflection on core values: “What are the things that actually give you meaning and purpose in life?”
Prioritizing these can help shift focus from outward success to inner fulfillment.

4. Vitals
Physical well-being and mental health are deeply connected.
Joseph suggests tuning into both traditional and non-traditional “vitals” — not just nutrition, movement, and sleep, but also relationship quality, digital habits, and work-life balance.
Asking, “How can I support my mind-body connection today?” can be a valuable check-in.

5. Vision
Finally, Joseph emphasizes the importance of forward-thinking and planning joy into your life.
“This is a reminder to practice joy, and plan joy in the future because many of us get so busy we forget to do this,” she says.

Small moments — like enjoying a quiet coffee or resting after completing a task — are worth celebrating. These create space for hope and optimism in daily routines.

Neuroscience research supports Joseph's approach, showing that small, consistent practices of self-awareness and emotional regulation can physically reshape neural pathways over time, making positive coping mechanisms more automatic for those struggling with depression.