You’re Not Invisible, Your Struggle Is Real

If you're Googling phrases like "I’m always tired but look OK," or "brain fog but functioning," you’re not alone and you’re certainly not imagining things. What you may be experiencing is high-functioning depression: a quieter, more socially acceptable form of depression that hides behind your responsibilities, your schedule, and your ability to "keep it together."

What Is High-Functioning Depression?

High-functioning depression isn’t an official medical diagnosis, but it describes a pattern I see all the time in the clinic and have experienced personally. It often overlaps with what's known as persistent depressive disorder (dysthymia) or atypical depression. But because people are still going to work, taking care of families, and handling life, they often don’t recognize it as depression at all.

You might be able to:

• Get up early and get the kids to school
• Go to work and perform well
• Smile and laugh at social events

But underneath, you feel like:

• You’re running on fumes
• You're emotionally disconnected from everyone, including yourself
• You don’t care about things you used to enjoy
• You're irritable, withdrawn, or flat
• You’re performing rather than participating in your life

It’s like moving through the world with a mask on, and the longer you wear it, the harder it is to remember who you were underneath.

What Are the Symptoms of High-Functioning Depression?

The symptoms are often subtle but persistent. You might not even recognize them until you look back and realize how long they’ve been there. Common symptoms include:

• Chronic fatigue, no matter how much you rest
• Brain fog, forgetfulness, or feeling mentally "slowed down"
• Low self-esteem or persistent feelings of guilt or worthlessness
• Disrupted sleep (either insomnia or sleeping too much)
• Low libido or lack of interest in physical intimacy
• Loss of interest in things that used to bring joy
• Increased irritability or a short fuse
• Withdrawing socially, even if you still show up physically
• Overcompensating with productivity or perfectionism

You might brush these off as "just stress," or think you're just failing to cope. But these signs are often your mind and body waving a flag, asking for support.

Why It Matters, Especially for Women

Women are nearly twice as likely as men to experience depression, but they often don't receive a diagnosis or treatment. Why? Because their symptoms are frequently minimized, misunderstood, or masked by functioning.

In the clinic, I see it all the time: women who show up for everyone else but haven’t felt joy, energy, or calm in months or years. They're praised for being "strong" or "holding it all together" when in reality, they're silently unraveling.

This matters because untreated depression doesn't just affect your mood. It impacts your immune system, your hormones, your relationships, your risk for chronic illness, and your ability to fully live.

And when depression goes undiagnosed because it doesn’t look like depression, that suffering is prolonged.

Real Stories, Real Hope

Even Olympic athletes, business leaders, and high achievers experience this. Recently, swimmer Leisel Jones spoke out about her own high-functioning depression; remaining strong while deeply struggling inside. A simple reminder to "stay until tomorrow" helped her hold on.

You are not the only one fighting this quiet battle. And you don’t have to fight it alone.

You Deserve Better Than "Just Getting Through the Day"

If any of this sounds familiar, know this: you're not broken. You're not weak. And you're not alone.

You deserve care that sees beyond your smile and your productivity. Care that understands that depression can wear many faces, some of them incredibly high-achieving.

That’s why I’m building a full video course for people living with high-functioning depression. It’s based on over a decade of counseling hundreds of patients through it and walking through it myself. It will cover:

• Understanding your symptoms
• How depression affects your brain and body
• What healing can look like (naturally and/or with medications)
• How to advocate for yourself in a system that often overlooks invisible illness

You can sign up to be notified when it launches at drgoodwinmd.com.

You're Valid. This Is Not Your Fault.

If these words and symptoms describe you, it doesn’t mean you’ve failed. It means you’ve been enduring something heavy, often silently. High-functioning depression is valid. It matters. And you matter. Many people search these same questions late at night, desperately hoping to find an explanation for why they feel so drained when they look "fine" to everyone else. Finding language for your experience is the first step toward hope.

Next Steps: You’re Already Moving Forward

The very act of reading this means you’re seeking understanding and that is powerful. Start by acknowledging what you’re feeling. Naming what’s happening brings clarity. Share it with someone safe, whether a friend, counselor, or even on paper in your journal. Watch for patterns: is this lasting months or years? That persistence may point toward a form of depression that is absolutely treatable.

And most importantly, look ahead with hope. Depression whispers that this is forever, but it isn’t. Healing is possible. In the next blog installment, we’ll explore what’s actually happening in your brain when depression takes hold and how understanding that science can guide recovery.

Because here’s the truth: if you’ve ever thought, “Why do I feel drained when I seem fine?” you are not alone, you are not invisible, and you are not without hope.