Does Trauma Play a Role in High Functioning Depression?

Exploring the Relationship Between Trauma and HFD

High Functioning Depression (HFD) is a complex mental health phenomenon that is not yet a recognized DSM-5 diagnosis and that often evades detection due to individuals' ability to maintain their daily lives and to maintain high levels of functioning. One of the critical questions surrounding HFD is whether trauma can be a contributing factor in its development.

Trauma's Role in Mental Health

Trauma, both acute and chronic, can significantly impact an individual's mental health. It can manifest in various ways, including post-traumatic stress disorder (PTSD), anxiety, and depression. While trauma is likely not the sole contributing factor of HFD, it can certainly play a role in contributing to its onset and exacerbation.

The Link Between Trauma and HFD

  • Psychological Trauma: Experiencing traumatic events, such as abuse, accidents, or loss, can trigger depressive symptoms in individuals. Even when they maintain their daily responsibilities, the emotional toll can lead to symptoms of what some report to be HFD.

  • Complex PTSD: Some individuals who have experienced chronic or repeated trauma may develop Complex PTSD, which can share symptoms with HFD. This can include emotional numbness, difficulty experiencing pleasure, and persistent feelings of sadness.

  • Coping Mechanisms: Trauma survivors may develop coping mechanisms, such as perfectionism or over achievement, to deal with their emotional pain. While effective on the surface, these coping mechanisms can mask underlying depressive symptoms associated with HFD.These individuals may sublimate and avoid acknowledging distressing symptoms until they hit a breaking point.

Recognizing Trauma-Related HFD

Trauma-related HFD may exhibit similar symptoms to HFD without significant trauma. These can include:

  • Functional Stability: Individuals with trauma-related HFD can maintain their daily routines and responsibilities at high rates of functioning.

  • Subtle Emotional Changes: Feelings of sadness, emptiness, or numbness that don't necessarily disrupt daily life.

  • Cognitive Challenges: Problems with concentration, memory, or decision-making.

Healing and Recovery

Addressing trauma-related HFD requires a trauma-informed approach, which can include:

  • Therapy: Trauma-focused therapy can help individuals process their traumatic experiences and manage associated symptoms. Somatic therapies, EMDR, CPT may all be helpful.

  • Self-Care: Engaging in self-care practices, such as mindfulness and stress reduction, can be beneficial.

  • Support: Building a strong support network and seeking help from mental health professionals are essential steps toward healing.

Conclusion and Further Exploration

Understanding the relationship between trauma and HFD is crucial for those who may be experiencing it. To explore the topic further and gain insights into your own experiences, Dr. Judith offers a modified Trauma inventory looking at adult and childhood traumas and High Functioning Depression Quiz. For those who resonate with these symptoms or suspect they might be experiencing symptoms of HFD, Dr. Judith provides a thoughtful and insightful resource that may be useful for self reflection and awareness. Her High Functioning Depression Quiz and trauma inventory may offer potential ways to explore these feelings further in a confidential and supportive manner. You can take this insightful quiz at Dr. Judith's High Functioning Depression Quiz and the Trauma Inventory for a better understanding of your experiences. Keep in mind that this is in no way a diagnosis and that these tools may be useful when discussing a treatment plan and diagnosis with your licensed provider.

Disclaimer: You may want to consider your individual mental health needs with a licensed medical professional. This page is not medical advice.

Dr. Judith Joseph, a board-certified Psychiatrist and Media Consultant with over 1 million followers on social media, leads the First-of-its-kind  study on High-Functioning Depression. While there is a multitude of research on depression and dysthymia, there is very little on depression in the prodromal phase in people who have symptoms of depression but do not meet criteria for a major depressive episode because they are  functioning at a high capacity and they do not report or acknowledge being in significant distress. These individuals do not necessarily identify with the emotion “depression” until someone points out that they are exhibiting symptoms of depression and or anhedonia. While High Functioning Depression is a term that has risen recently in the past 5 years in the online discourse and mental health circles, it is not yet recognized amongst medical professionals and is not in the diagnostic manual for psychiatry (DMS-5). Many individuals during and after the Covid-19 pandemic began to present to Dr. Judith’s practice using the term, “High Functioning Depression” and there have been reports of HFD worsening without treatment into fatal forms of mental illnesses. This along with Dr. Judith’s online followers asking for more resources on HFD, led to Dr. Judith and her research team submitting the first of its kind High Functioning Depression study to the IRB in 2023. She is currently enrolling individuals into this study to learn more about the risk factors and unique presentations of individuals who identify as having High Functioning Depression.  Dr. Judith holds degrees in biology, chemistry, religion medicine, and business from prestigious institutions such as Duke University and Columbia, and has post-doctoral and research training at Columbia University and NYU. Passionate about inclusive mental health treatments, Dr. Judith heads a dedicated team of 10 women focused on innovative research for various mental health conditions. Her lab pioneers high-functioning conditions research, develops psychometric scales for mood and anxiety, and promotes evidence-based approaches. Her lab has enrolled patients into phase 2-4 clinical research studies aiding in the development of novel treatments for pediatric, adult and geriatric conditions ranging from ADHD to Alzheimer’s dementia. Some of the novel treatments have become FDA approve and now help to treat millions of people worldwide. Her clinical research site, Manhattan Behavioral Medicine has participated in both Pharma and NIH funded research and is one of the few clinical research sites solely owned and solely operated by a black woman Principal Investigator. This is important as it is well known that for many years minority populations and women were largely underrepresented in clinical research. Dr. Judith is dedicated to creating space for diversity and inclusion in this space so that research and evidence-based treatments are representative of all populations. Dr. Judith Joseph is committed to advancing mental health treatment and embracing diversity in her work.

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What Causes High Functioning Depression?