WHY IT’S OKAY NOT TO BE OKAY

In South Africa, studies show that over a quarter of the population suffers from depression, whether they know it or not. “Our study shows that 25.7% of South Africans are probably depressed, with more than a quarter of respondents reporting moderate to severe symptoms of depression,” says Dr Ashleigh Craig, a researcher at the Wits Developmental Pathways for Health Research Unit (DPHRU).

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Although society is working towards destigmatising mental health issues, there is still much to be done. Especially when it comes to issues like dysthymia flying under the radar, since the characteristics of this condition – also known as high-functioning depression (HFD) – are milder and thus not as easy to diagnose.

WHY IT’S DIFFERENT
HFD is harder to detect than major depressive disorder (MDD) because individuals living with it either don’t know they have it or exhibit the behaviour of a successful, proactive person who leads a busy life.

The scary thing is that these individuals tend to be always on-the-go and seldom find time to prioritise their overall well-being, carrying on with life by ‘pushing through’ their stress and anxiety.

“This type of depression is a consolidation of chronic major depressive disorder and dysthymic disorder. The symptoms must be present for at least two years for a diagnosis,” says Phumzile Mthembu, a clinical psychologist practising at Netcare Akeso. “It’s almost invisible, and very hard to identify, but very persistent. People with HFD can still go to work or engage in social activities without anyone noticing their distress,” Phumzile adds.

HFD symtoms are mild and don’t appear to be as debilitating as we usually see with major depressive disorders. Those suffering from HFD, however, develop unhealthy coping mechanisms to trick themselves into thinking that “they’ve got everything under control”, says Phumzile.

FACING THE TRUTH
The symptoms of HFD are unique to each person’s personal circumstances. Generally, those who are affected display the following types of behaviour:

– Poor appetite
– Mood swings
– Over-working or ‘workaholism’
– Insomnia or general restlessness
– Excessive use of cigarettes or alcohol
– Social withdrawal

In severe cases, people experiencing HFD may seek out drugs to cope, feel a huge sense of performance anxiety or guilt, and may even battle with suicidal thoughts. They may also feel so paralysed by guilt and shame that they’re too embarrassed or afraid to ask for help.

HOW TO MOVE FORWARD
If you’re living with HFD, you may be afraid to admit that you need help because of the existing stigma around mental illness. Perhaps you come from a culture or family that frowns upon depression or talking about it, or maybe you’re not comfortable with showing vulnerability. The truth is that you should put your mental health above the opinions of others.

Reach out to someone you trust. Know that your feelings are valid and make it clear that you’d like to keep your conversation private. Do not put pressure on yourself to find a quick-fix, instant solution – rather, work towards better understanding your thoughts and feelings so that you can find the right medical assistance.

HOW CAN YOU HELP?
If your loved one is dealing with HFD, these are a few ways to give them the support they need:

– Educate yourself on the condition.
– Try not to overwhelm them with your own personal frustrations and stresses.
– Work on solidifying the lines of communication.
– Let them know their feelings are valid.

Seek professional help from mental-health facilities or support groups like SADAG on 0800 567 567.

by Charndré Emma Kippie