July 27

Can TMS Treat High Functioning Depression?

Depression is an illness that affects millions around the world. Depression also affects those millions of people very differently. Manifested in varied ways, depression can mean different things for many. But what does the face of depression look like?  

Depression is a mood disorder that negatively affects your thinking and your emotional health. You may lose interest in once loved activities or feel unable to participate in your daily life. Depression symptoms may be mild and only experienced for a short amount of time. For others, symptoms may be severe and your depression experienced for a greater length of time.  

There are different types of depression that can be experienced. But what types of depression occur? What is major depression? What does high functioning depression mean? And why is this difference important?  

Long lasting depression, or Major Depressive Disorder (MDD) may render individuals completely paralyzed by their symptoms. If not long lasting, MDD can produce incredibly severe symptoms, even if it just for a few months. 

Patients become completely limited, if not incapacitated by their symptoms. High functioning depression (also referenced as dysthymia) is not a diagnosis or disorder, but has been popularized recently to better characterize how some people experience depression. What is dysthymia? The term dysthymia is used to describe individuals who suffer from high functioning depression for at least two years. If you are someone experiencing high functioning depression you are experiencing Persistent Depressive Disorder (PDD). 

PDD, or high functioning depression, is a chronic form of depression where the individual suffering seems to be able to function at a normal level, all the while suffering inside.  

Those suffering from high functioning depression may rely on their own coping mechanisms to push through their dark feelings each day, suffering in silence, and without any mental health help. 

Typically, many people who experience depression (mild or severe) may find themselves unmotivated to participate in daily life. There is difficulty in thinking and concentrating, with an increase in purposeless activity. In more severe cases, an individual suffering from depression may find themselves having suicidal thoughts or a fixation on death. If you, or someone you know who is struggling with suicidal ideation, it is important to reach out to a mental health professional, dial 911, and/or go to your nearest hospital.  

If you suffer from depression for longer than a few weeks, you may be suffering from major depression. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is used by mental health professionals to determine and diagnose your depression symptoms. They may consult this manual to determine if your symptoms fit the specific classifications for depression.  

If you experience depression symptoms for longer than two weeks, it is very important to schedule an appointment with a psychiatrist or therapist for an evaluation.  

Symptoms of depression may include: 

  • Difficulty sleeping 
  • Feeling “down” for the majority of your days 
  • Feelings of worthlessness 
  • Feelings of hopelessness 
  • No interest in previously enjoyed activities 
  • Weight loss/weight gain 
  • Suicidal thoughts 

The severity and length of time these symptoms are experienced will determine the type of depression you are experiencing. Major depressive disorder and persistent depressive disorder may be similar but they are not the same. Is your depression getting worse? If you have been experiencing symptoms of depression for longer than two years, but have been managing to cope, you may be suffering from PDD. If your symptoms are much more severe, and you have had an inability to cope (even if it has only been a few months) you may be suffering from MDD. 

Unfortunately for those suffering from major depressive disorder, there is no “high functioning” version. MDD is debilitating and can really impair a person’s quality of life. PDD can also impair quality of life, but to a lesser degree. Regardless of the type of depression someone suffers, it is critical for these individuals to reach out for a psychiatric diagnosis and treatment.  

Ignoring depression symptoms can be damaging and dangerous. An accurate diagnosis and immediate treatment are vital. If your symptoms are not being treated or managed, it can impact your stress and relationships.  

Treatment For Depression 

If you feel like you are suffering from depression, you should reach out to a mental health professional. After a mental health evaluation, they will be able to diagnose your symptoms and create a treatment plan to help alleviate your depression.  

The treatment of your symptoms and mental health conditions will be contingent on the severity of your depression. If your therapist or psychiatrist believes you are suffering from PDD they may offer different options to help reduce and mitigate your depression symptoms.  

Some treatment options for PDD may include talk therapy, medication, and/or transcranial magnetic stimulation. 

Talk Therapy 

A mental health professional, usually a trained and certified therapist, will engage in talk therapy with you to identify the stressors or “triggers” you may experience in your life. You and your therapist may discuss certain difficult moments in your life, how your varied experiences may have affected you, and provide you with healthy coping skills when dealing with your stressors.  

Your therapist can make recommendations for positive alternatives to help encourage a change in your thinking. These strategies can build upon themselves, provide the individual suffering from depression with insight on their behavior, and make them self-aware on how to cope with every day challenges.  


Others suffering from depression may find their symptoms alleviated with medications. A psychiatrist will evaluate your symptoms and work with you to develop an appropriate regimen of medications they will prescribe. Common medications used to treat depression are antidepressants, benzodiazepines, and antipsychotics.  

The most common antidepressants used to treat depression are SSRI’s (selective serotonin reuptake inhibitors). What do antidepressants do? They block serotonin from being reabsorbed into the brain’s neurons, improving your brain’s chemical messaging, enhancing mood boosting sensations.  

Benzodiazepines are used to treat depression because of their relaxing properties. Colloquially referred to as “benzos,” their chemical composition allows relief from the anxiety symptoms caused by the depression.  

Antipsychotics for depression are also a commonly prescribed medication for treatment. They can be combined with antidepressants because of their mood enhancing affect.  

Transcranial Magnetic Stimulation 

A progressive treatment for PDD patients, transcranial magnetic stimulation (TMS) has been a great alternative to traditional methods when dealing with depression. A noninvasive form of brain stimulation, TMS encourages activation of the neurons directly responsible for mood. Magnetic pulses target specific regions of the brain to encourage the cells to activate and release mood enhancing signals. This can gradually alleviate the depression symptoms, providing you with relief.  

Is It Depression If You Feel Like You Can Manage? 

As stated earlier, depression can and does look different for many people. The intensity of your symptoms may vary. Not everyone becomes catatonic. But that does not mean you should minimize the symptoms you are experiencing. Your depressive symptoms and experiences with depression are valid and should be treated as such.  

Recognizing that even if you have been “coping” without any professional mental health intervention does not mean you should continue to do so. Many patients who suffer from high functioning depression should still reach out to professionals who can help monitor and manage their symptoms. Their depression does not become “less than” just because the severity may not be as intense.  

You cannot “will” yourself to recover from mental health illnesses. They require more care than that. You require (and deserve) more care than that.  

If you are struggling with persistent depressive disorder and are confused about where to start looking for help, please call Gemini Health (301) 363 - 1063. We are a team of mental health professionals who can help treat and manage your depression symptoms.  


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