Life long high-function depression and its discontents

Out run it

Cats always look like the world doesn’t meet their standards. Pixabay

Once upon a time, I was giving a speech about my problems with writing, or rather, not writing. I included an insight I had after many years of struggle. I disclosed that I had understood my chronic depression upside down. I thought I was depressed because I was blocked. Wrong. I was depressed because I wasn’t writing.

The audience gasped like I’d dropped my drawers.

I’d openly admitted to being depressed. Not only that, but I was admitting that I’d had a life-long battle with depression. It’s something you might whisper to a best friend, but certainly not something you would announce in public!

Yeah, I’ve been depressed since I was about 16 years old. I was in therapy for more than 10 years. I take two antidepressants and they don’t make me happy. You have to do that all by yourself.

Family history

Even before therapy and medication I could get by. My father was the same way. He was clearly profoundly depressed but he got up and went to work every day. He conducted his life. But he’d come home every evening and would practically collapse into a coma in front of the television.

I was more socially active than he was. I had friends, charities, obligations, craft projects. But a day in which I did not have to speak to anyone was a good day. A day where I could sleep all day was a good day. On really bad days I couldn’t wait to get alone so I could cry myself to sleep.

It’s no way to run a life. In fact my life didn’t really begin until I started taking Prozac. After that, therapy was helpful. After that I could talk in public. After that my bills got paid on time. After that, I could go for weeks on end without the color draining out of the world.

Don’t be afraid of the drugs

Psychiatric drugs are a crap shoot, but worth trying.

Be warned that no drug is perfect. Prozac has side effects but none that are worse than depression. Depression drugs wear out eventually. So after a couple of years Prozac was all side effects and no “effects.” So I moved on to Zoloft which had no effect at all. I cried for six months. Then I went to Paxil which worked great until it stopped working. Then Wellbutrin which is not very strong but is an excellent anti-compulsive. Then Viibryd, which was lovely but was hideously expensive and also eventually stopped working. Then Effexor which works very well at the moment. However, if you forget to take it for a couple of days the withdrawals are the stuff of Satan.

Currently I take Wellbutrin and Effexor which together make a complete Susan. For now.

Drugs don’t work the same on everybody. If your doctor prescribes something there is no guarantee it will work and you have to wait three weeks or so before you can tell. It’s no fun, but it beats the hell out of staring at the ceiling wishing you would catch a virulent and fast-acting cancer so you don’t have to face getting up in the morning.

All drugs do is make you able

After a long time coping with depression au naturel you build up habits of thinking, behaving and being. Once you start taking the antidepressants you are now able to let those coping mechanisms go. But those mechanisms have gotten familiar and second nature.

And that’s why therapy is highly recommended. If you’ve been depressed for a long time, you need some training in how to think, behave and live in the world. You’ve kept yourself alive for this long and you are to be congratulated for that! But to live a good life, it’s okay to get some help. Almost every community has a clinic with a sliding price scale. You’ll get the luck of the draw and your therapist may not be Sigmund Freud or even Freddy Freud, but they know more than you. And it would be well to get what they can give you even if they aren’t very good at it.

Letting people know

Mental illness has a pretty serious stigma, but you need to let people know. Don’t hide it. Some people will, out of love and kindness, say stupid unhelpful things, but that’s okay. Embrace their kindness, if not their actual words. Some people will look at you funny. That’s on them, not you. Some people will want you to be on permanent suicide watch. Reassure them and wait for them to get over that.

Letting them know is for your benefit, not theirs. If your friends know that you sometimes get fogged in by depression, they will know if they haven’t heard from you in a couple of days, they should invite you out of the house or drop by.

One of the slim advantages of high-function depression is that movement helps. Turning on all the lights in the house helps. Going outside to stand in the sunlight helps. A friend helps. They remind you that there’s color out there somewhere. They remind you that it’s you and not the world.


I used to tell people that I have chronic depression but I like to present it a moving target. Yes, absolutely, exercise helps, but often that’s just not an option. Getting up and walking outside may be as much as is possible. By movement, I mean commitments, hobbies (I write, draw, crochet, belong to clubs and discussion groups, etc.). These things keep you looking outward, not inward. It’s good to always be in touch with your feelings. It’s bad to sink beneath the waves. If you know you have to be somewhere in an hour, you’ll get up off the couch and put your clothes on. Human company or small tasks can lift your mood even if you aren’t in the mood to have your mood lifted!

High function

High function depression means you’re pretty good at convincing people that you are fine. Sometimes it means you can lie to yourself about it. Don’t. When my father was young, the only treatment for depression was a warm handshake and a slap on the back.

Science has come a long way. Let it help.


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Susan Cogan wears a lot of different hats and is the author of more than a dozen books and hundreds of articles and blog posts. She is also a CTI-trained life coach, Buddhist, artist, wife, and body servant to three cats.



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Susan Brassfield Cogan

Susan Brassfield Cogan

I write self-help, life coaching, and political opinion. I am a creativity and mindfulness coach