[Sportschosun Reporter Jang Jong-ho] The term 'high-functioning depression' is often used to describe a state in which a person appears to maintain daily life, including work and relationships, while internally struggling with persistent sadness, lethargy, emptiness, and a loss of interest. It is not an official medical diagnosis, but in actual clinical settings it may be diagnosed as major depressive disorder or persistent depressive disorder. Because the person is still getting through work and daily routines, both the individual and those around them may fail to notice the symptoms, mistaking them for simple fatigue or a personality issue. That can delay treatment, so caution is needed.
'High-functioning depression' is not an official diagnosis used in psychiatry. It is an informal expression commonly used to describe people who seem to manage daily life such as commuting, working, and social interactions relatively well, while internally experiencing depression, lethargy, and emptiness. In other words, it is less a separate illness than a term for understanding people whose depressive symptoms are not easily visible on the outside.
In actual clinical practice, doctors do not determine whether someone has depression based only on whether they can work. They look at how long sadness or loss of interest has lasted, and whether there have been changes in sleep, appetite, energy, and concentration. Depending on the assessment, a patient may be diagnosed with major depressive disorder or persistent depressive disorder, and doctors also check whether the symptoms could be caused by another physical illness or medication. Major depressive disorder is generally considered when symptoms such as depressed mood or loss of interest last for at least two weeks, while persistent depressive disorder is considered when relatively chronic depressive symptoms continue for more than two years in adults.
The core symptoms of depression are not limited to simply feeling down. A person may lose interest in or pleasure from activities they once enjoyed, a symptom known as anhedonia. They may also become easily fatigued, or experience reduced concentration and impaired judgment. Other common signs include sleep changes, such as insomnia or sleeping too much, changes in appetite and weight, and unexplained restlessness or lethargy. Some people complain first of irritability, sensitivity, or recurring physical pain rather than sadness.
People experiencing so-called high-functioning depressive symptoms often keep working by relying on a sense of responsibility or familiar routines, despite these difficulties. But even routine tasks may require far more energy than before, and they may push themselves excessively to avoid making mistakes. They may seem unchanged at work, only to find that even conversation or household chores feel overwhelming after they get home. The pattern can repeat, with no real recovery even after spending the entire weekend lying down.
Depressive symptoms should not be dismissed as mild simply because work performance is being maintained. What matters is not just the outward level of functioning, but also how much energy it takes to sustain that daily life.
Burnout and depression are easy to confuse because they share similar symptoms such as fatigue, lethargy, and poor concentration. The World Health Organization (WHO) classifies burnout not as a disease, but as an 'occupational phenomenon' related to chronic workplace stress. Its main features are feelings of depleted energy, cynicism or psychological distance from work, and reduced professional efficacy. The symptoms usually appear mainly in the workplace or in specific work-related situations.
Depression, by contrast, often continues even after leaving work. A vacation or enough rest may not improve the mood, and interest and enjoyment can decline across daily life, including hobbies and family relationships. People may see themselves as worthless or feel excessive guilt, and in severe cases, thoughts of death or self-harm may also occur. Unlike temporary sadness, depressive feelings tend to be persistent and heavy, and they are not easily relieved even when something pleasant happens.
That said, burnout and depression are not always clearly separate and can occur together. It is important to examine whether the symptoms are limited to work, whether they improve with rest, and whether interest in daily life and self-evaluation have changed. Rather than trying to diagnose oneself, it is more accurate to seek an evaluation from a specialist.
Depression is not a condition that can be definitively diagnosed with a single blood test or brain scan. In psychiatry, doctors conduct a comprehensive assessment through interviews, looking at the type and duration of symptoms such as depressed mood, loss of interest, sleep and appetite changes, fatigue, and reduced concentration, as well as their impact on daily life. If necessary, they also check for other possible causes that can produce similar symptoms, such as thyroid disease, anemia, sleep disorders, or medications being taken.
Treatment depends on the severity and duration of symptoms, as well as the patient's overall health. Psychotherapy, including counseling and cognitive behavioral therapy, may be used, and antidepressants or other medications can be added when needed. Managing lifestyle habits such as regular sleep, exercise, and meals can also help recovery. However, if symptoms persist, it is important to seek medical care from a specialist rather than trying to solve the problem through lifestyle changes alone.
Professor Choi Won-seok of the Department of Psychiatry at Korea University Guro Hospital advised, "Depressive symptoms should not be considered mild simply because a person appears to be maintaining daily life on the outside." He added, "If sadness, lethargy, or loss of interest lasts for more than two weeks, or if recovery does not come even after enough rest, it is necessary to seek an evaluation from a psychiatrist rather than trying to endure it alone."
Jang Jong-ho, bellho@sportschosun.com
This article has been translated by GripLabs Mingo AI.
