High Functioning

Many people we encounter day to day do not fulfil the imagined role that people with mental health problems are thought to have. They don’t mope around, they crack on. Some things they say might sound a bit negative and sometimes they may appear a bit down in the dumps but, for the most part, they are just themselves. The friend/family member/colleague that has depression or whatever they have.

Occasionally we see it more clearly, occasionally they have a crisis and get signed off sick and we think it’s come out of nowhere. They were laughing with us just yesterday! Everything was fine one minute and the next they are saying they can’t cope and we wonder what happened to trigger it. They might say that they have been struggling for a while, but if that’s they case, why not let it show?

This is what happens when you are someone who is high functioning with an invisible illness (in my case depression and anxiety).

So many people say ‘but you are ok now!’ or ‘ how did you recover?’ and my answer is no, or I haven’t. I cope. I get by, but the battle is daily and constant. Occasionally it gets too much and the battle overflows into my full consciousness.

I don’t ‘hide’ my illness, I don’t try to pretend I’m ok and I’m not ‘coping’ just because you don’t see the battle within. I just have lived with it for a long time. I am accustomed to this level of despair. I am happy and enjoy my life and at the same time have to work incredibly hard, every day to remember that. It’s just what I do.

Sometimes though, I wish I wasn’t so high functioning. I wish that, when I was feeling really bad it showed. I wish that people could see it and saw it for the illness it is. I wish they would treat it with sympathy and recognise that I might not be able to do as much as normal, that I will be getting more tired, that every interaction will be filled with anxiety. I wish that it was recognised as debilitating so that people saw the effort it is on many days to get out of the house.

I don’t want to be whispered to, or treated like I’m wrapped in cotton wool, but sometimes, I wish that it was an illness that was more widely understood. I just want to say ‘I’m feeling ill today’ and not have to then explain how – that it’s mental, but effects me physically, that even though I laugh and joke and appear happy (and AM happy) I am still battling a terrifyingly intimidating wall of negative thoughts that is collapsing in on me.

I just want to be treated like I would be treated if I had a physical illness, that is widely understood, where people can live with it and get on with their days but still have it easily acknowledged when it’s a bad day.

That’s all I want… But it feels demanding, and largely impossible.

None of this though, is to say that those around me don’t treat me well and with love and care. It’s just that sometimes, when I feel really ill, I want to be able to behave like I feel but because of the illness I have, I can’t. Because it feels selfish, because you can’t see it. So I carry on and rant on my blog about it….

That is all.


  • Being high functioning means that we become accomplished at hiding our condition. We have a strong desire to appear “normal”. This means that on the days our ability to self manage ( cope) leaves us , it’s harder and other people don’t understand.
    On the other hand, when we are coping I think it’s important to remind ourselves how strong we are.We cope with everyday life despite how much more difficult it for us. Everyday ordinary things are a battle for us and if we can get through a day successfully, it’s a tremendous achievement. But it’s tiring and on some days, it’s too exhausting.

    • This is so true….Thanks for validating each of us who may feel guilty of not being “our usual self ” i.e. as others see only the positive in us …not aware of , or able to empathize with the times, which just suddenly appear , when we obviously are not coping with “normal ” life. Your writings and the replies have given me hope that I am not “mad” or useless at times ….nor do I choose to be different …it just has been ME all my life . I can now perhaps look at my life as normal for me …and just get on with each day as it is given me ….no promises ….just I’ll try ..just to accept me ….the way God accepts me …His creation .

  • Dear Katharine, Just reading your book, and am deeply impressed by your honesty and vulnerability. I just wanted to write and say that you are indeed an Esther, sent for this time, and to assure you that your words will be helpful to many. I am old enough to be your grandfather so perhaps I can say with out being patronising that you are an absolute star even on the tough days and Father God thinks you are wonderful. I have lived with anxiety/depression for many years, but by God’s grace the acorn has become a pretty ok oak tree. The best has yet to come! Keep resting in the Father’s unshakable love. John

  • Yes, I can definitely identify with this! At my worst I’d go from working one day to hospital the next and people (other than my psychiatrist who I’d been honest with!) would be surprised/shocked. It’s still a struggle now especially as an introvert, I have to put a bit of a show/mask on just to function in an extrovert designed world. It’s hard to work out whether what I’m doing is healthy or whether I’m covering up when I should be a bit more honest about how I’m feeling. Thanks Katharine 🙂

  • I refer to it as ‘perfectly concealed depression’ (PCD). I’m really good at it until I’m not, if that makes sense. If I’m ‘high functioning’ that would be a wonderful plaudit (I’ll leave that to someone else to judge me…) but I think I get what you are trying to convey.

    And thank you. These slithers of consciousness are so helpful for us to read and reflect on.

  • Hi Katharine. Just heard you on Radio 2 and am now seeking out your book “I thought there would be cake”!
    I can totally relate to what you say as I have battled with chronic insomnia and lack of confidence for 32 years. I have always made the effort to appear “normal” to the outside world so that most people would never know how ill I actually am. My natural chattiness and friendly personality helps me but sometimes even I get irritated by the fact that it can mask how bad I am actually feeling so that even my husband and daughter wouldn’t know how down I am!
    I often say how much easier it would be if I had a bad hip or something tangible that people might empathise with!
    I recently discovered Eckhart Tolle and find his spiritual teachings very comforting. However, the battle within still goes on, though I am practicing the art of surrender which may afford me some peace!
    Best wishes to you on your continued journey x

  • This is exactly how I feel most days yet, as you say, I crack on although sometimes I feel as though I’m cracking up. Christians DO suffer from mental health problems, but sometimes I think other people in the church just think we need more faith or whatever. I do experience God’s joy and peace many a tme, but thank you for saying what I so often struggle to.

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