We Cannot Continue to Overlook ‘High-Functioning’ Depression

I first saw a psychiatrist for my anxiety and depression as a junior in high school. During her evaluation, she asked about my classes and grades. I told her that I had a 4.0 GPA and had filled my schedule with Pre-AP and AP classes. A puzzled look crossed her face. She asked about my involvement in extracurricular activities. As I rattled off the long list of groups and organizations I was a part of, her frown creased further.

Finally, she set down her pen and looked at me, saying something along the lines of, “You seem to be pretty high-functioning, but your anxiety and depression seem pretty severe. Actually, it’s teens like you who scare me a lot.”

Now I was confused. What was scary about my condition? From the outside, I was functioning like a perfectly “normal” teenager. In fact, I was somewhat of an overachiever. I was working through my mental illnesses and succeeding, so what was the problem?

I left that appointment with a prescription for Lexapro and a question that I would continue to think about for years. The answer didn’t hit me all at once; rather, it came to me every time I heard a suicide story on the news saying, “by all accounts, they were living the perfect life.” It came to me as I crumbled under pressure over and over again, doing the bare minimum I could to still meet my definition of success. It came to me as I began to share my story and my illness with others, and I was met with reactions of “I had no idea” and “I never would have known.”

It’s easy to put depression into a box of symptoms, and though we as a society are constantly told mental illness comes in all shapes and sizes, we are stuck with a mental health stock image in our heads that many people don’t match. When we see depression and anxiety in adolescents, we see teens struggling to get by in their day-to-day lives. We see grades dropping. We see involvement replaced by isolation. People slip through the cracks.