How Cognitive Behavioral Therapy (CBT) and Exposure Response Prevention (ERP) Can Help Adults with OCD

We all know what depression looks like and feels like. It’s the inability to get out of bed in the morning, an unorganized and messy house, not being able to hold down a job or manage relationships. But depression doesn’t always look the way we expect it to. Sometimes, it looks like getting through the day — going to work, caring for others, and meeting responsibilities — while quietly struggling beneath the surface. Functional depression, often referred to as high-functioning depression, describes depression that isn’t always visible on the outside but can still create significant inner turmoil. Those with functional depression can hold down jobs, manage a household and relationships, and function relatively well on a day-to-day basis, even while feeling emotionally exhausted or disconnected inside. The keeping up of appearances can be extremely draining and difficult for the individual. You can think of functional depression like a duck gliding across a pond. On the surface, it appears as though the duck is gliding gracefully and easily. But below the surface, its feet are flailing just to stay afloat. If it takes someone without depression 5% of their energy to wash the dishes, it may take someone with functional depression many times that amount to do the same task. They will still get the task done, but the emotional toll can be enormous. Those with functional depression can have similar symptoms as someone who suffers from depression, but the difference lies in their ability to continue functioning outwardly. Feeling sad, helpless, or hopeless. Becoming disinterested in things that used to bring them joy. Changes in eating habits, like eating too much or too little. Trouble sleeping or sleeping too much. Difficulty concentrating. Negative thoughts about yourself and others. People with functional depression may feel an enormous amount of these depressive symptoms yet have become skilled at hiding or “masking” their struggles from those around them. They can create an illusion of being “fine,” even when they are not. Functioning does not mean thriving. Others with depression may not appear as high functioning in all areas of their lives. While they may seem to be excelling from your vantage point, depression may be quietly affecting areas you cannot see. Your co-worker, for example, may be excellent at her job but struggle to get out of bed on the weekends or feel overwhelmed managing personal responsibilities. Or your friend’s social media feed may be brimming with happy, smiling photos while hiding a deep sense of emptiness or disconnection. Even if you or a loved one appear to be high functioning, all depression deserves care and support. You don't have to wait until you hit rock bottom to find help. Without treatment, depression can get worse. And even when it doesn’t worsen, everyone deserves a life that doesn’t require enormous effort just to meet basic needs. The trouble is that functional depression can be hard to spot, even for yourself. So, what happens? You continue to try to keep it up. But every task demands more and more and what once felt manageable begins to feel exhausting. And eventually, burn out. If you think you or a loved one are living with functional depression, treatment is available. Life InSight offers compassionate, individualized support to help you better understand what you’re experiencing and move from simply getting by to truly feeling well.

Many adults feel overwhelmed, behind, or disorganized without realizing ADHD may be the cause. Learn common signs, why it’s missed, and how neuropsych evaluation helps. Bergen County, NJ (virtual/in-person).