High-functioning depression: a hidden burden demanding clinical recognition

High-functioning depression (HFD) describes individuals experiencing persistent depressive symptoms, such as low mood and emotional exhaustion, while maintaining outward success. Owing to preserved functionality, the underlying distress is often unnoticed, misattributed or suppressed. HFD challenges existing psychiatric frameworks, delays diagnosis and increases the risk of progression to major depressive disorder and suicidality. Current screening tools may lack sensitivity, and stigma can lead to disengagement from therapy. Expanded diagnostic awareness, improved clinician training and culturally attuned care are essential for recognising and validating internal suffering in this overlooked population.

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Publication Details

Journal
BJPsych Bulletin
Published
2025-12-23
DOI
https://doi.org/10.1192/bjb.2025.10193
Primary Topic
Treatment of Major Depression
Type
article
Field-Weighted Citation Impact
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article

High-functioning depression: a hidden burden demanding clinical recognition

Olanrewaju Joseph Oduola, Okereke Promise Udohchukwu, Egide Ndayambaje, Onyedikachi F Uzor et al.
BJPsych Bulletin
Treatment of Major Depression
article

High-functioning depression: a hidden burden demanding clinical recognition

Olanrewaju Joseph Oduola, Okereke Promise Udohchukwu, Egide Ndayambaje, Onyedikachi F Uzor, Chukwuemeka V. Umeh, Christian C. Obetta, Wisdom O. Okereke
article en

Abstract

High-functioning depression (HFD) describes individuals experiencing persistent depressive symptoms, such as low mood and emotional exhaustion, while maintaining outward success. Owing to preserved functionality, the underlying distress is often unnoticed, misattributed or suppressed. HFD challenges existing psychiatric frameworks, delays diagnosis and increases the risk of progression to major depressive disorder and suicidality. Current screening tools may lack sensitivity, and stigma can lead to disengagement from therapy. Expanded diagnostic awareness, improved clinician training and culturally attuned care are essential for recognising and validating internal suffering in this overlooked population.

BJPsych BulletinVol. 50(2)
University of Nigeria (NG), Oxford Brookes University (GB), University College Hospital (GB), Borders General Hospital (GB), University of Rwanda (RW), Orbits Lightwave (United States) (US), Sheffield Teaching Hospitals NHS Foundation Trust (GB), University Hospital of the West Indies (JM), Innovative Design Engineeering & Analysis (United States) (US), U.S. Global Leadership Coalition (US), University College London (GB)
Openalex Percentile: Top 31%
Treatment of Major Depression
DOIOpen Access PDFOpenAlex
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