“There is no greater agony than bearing an untold story inside you.”
– Maya Angelou
In a world obsessed with perpetual positivity and #gratitude journaling, we have become quite terrible at distinguishing between feeling down and being depressed. The result? We either overdiagnose, underdiagnose, or outright dismiss what our psyche is trying to tell us. So, before you self-diagnose, gaslight your own emotional experience, or write it off as just another “Monday mood”, let us unpack what depression actually is (and what it is not).
You might be surprised to discover that your low mood is not always your enemy. Depression is both a clinical condition but also a normal human emotion. So, differentiating between the two can sometimes be quite challenging, even for trained professionals like myself.
However, here are some key aspects to consider on depression before you go and self-diagnose, receive a misdiagnosis, or just ignore the idea of it altogether! Because frankly, I do not know which one is worse.
Let’s start with the most obvious…
1) Normal Depression
Feeling low, unmotivated, uninspired, unfocused, emotionally heavy or numb, is a general emotional state that is as normal to the human condition as is breathing. If you have lived long enough on this planet for your frontal lobe to develop, then you have definitely experienced depression. Even though your frontal lobe is not considered the emotional centre of the brain (the amygdala is), you do need it to identify and interpret your emotional states.
Nevertheless, feeling depressed is often a normal reaction to living life. It’s usually triggered by specific life events or circumstances, like losing a job, ending a relationship, or experiencing a setback. This type of depression typically improves as the situation changes or as you adapt to it.
For example, feeling depressed for a period of time after the passing of a loved one or pet is normal. Feeling depressed for a few days after returning home from a phenomenal holiday is normal. Feeling depressed after the loss of a job is normal. Feeling depressed after extended periods of all work and no play is normal. Feeling depressed when you are stuck in an unhappy relationship is also normal. As the famous saying goes:
“Before diagnosing yourself with depression, make sure you are not surrounded by a$$holes.”
Now, there is another general form of “normal depression” which is worth mentioning, and is strongly associated with a person’s personality type.
2) Depressive Personality Type
Some individuals seem to be wired for a more melancholic outlook on life. This isn’t a clinical diagnosis, but rather a personality trait that can predispose someone to experience more frequent or intense periods of low mood. These people often view the world through a darker lens, tending towards pessimism, self-criticism, self-doubt, guilt, a pervasive sense of inadequacy, and a general sense of dissatisfaction.
And no, this is not the same as being “emo” or just having a bad week. It is a deeply ingrained, persistent way of being.
This type of personality is generally shaped by a combination of early temperament (i.e., a genetic personality disposition) and environmental reinforcement — typically overly critical parenting, emotionally unavailable caregivers, or being raised in environments where emotional expression was discouraged or invalidated. Essentially, these individuals learnt that happiness is risky, hope is hurtful and foolish, and therefore, it is safer to expect disappointment than risk experiencing deep emotional pain.
Now, having this personality disposition is not necessarily unhealthy or abnormal. In fact, many great thinkers, artists, and philosophers throughout history have exhibited these traits. It is simply a different way of perceiving and interacting with the world around us.
Also, having this predisposition does not mean that you are destined for clinical depression. Many people with this disposition lead fulfilling, meaningful lives, often channelling their introspective, pessimistic, and cynical nature into creative or analytical pursuits. However, if you are prone to this personality type, then you do need to be more vigilant about your mental health, as you do carry a higher susceptibility to falling prey to clinical depression… which is when normal becomes abnormal.
3) Clinical Depression
When depression, however, shows up repeatedly without any specific cause, then it starts to indicate a cause for concern. Clinical depression is generally a form of depression that is enduring and impacts all aspects of your life, including personal, social, and occupational. You tend to feel low irrespective of what is happening in your life. You cannot “will” yourself out of clinical depression.
This type of depression is generally diagnosed as Major Depressive Disorder (MDD) with intensities ranging from mild, moderate, to severe. Unlike a normal depressive state, clinical depression is not just feeling low and has a host of other symptoms associated with it such as, social withdrawal, significant changes in appetite, sleep difficulties, fatigue, loss of energy, feelings of worthlessness and guilt, and a loss of interest in previously enjoyed activities. So, while normal depression is a natural response to life’s challenges, clinical depression is a medical condition that often requires professional help.
Now, apart from these two “classifications”, there is another form of depression that often goes unnoticed, namely, high functioning depression.
4) High Functioning Depression
I often refer to this type of depression as “hidden depression”, because it generally does not show its face until it has hit a severe stage. High functioning depression (HFD) is generally a form of depression that largely affects individuals who are high achievers and emotional suppressors. From the outside, individuals with HFD seem to function perfectly fine. In fact, the more severe the depression the more performance-driven they become.
People often admire these individuals for their commitment, discipline, excellence, and performance. They just seem to always get things done, always have their sh** together, always on top of things, and always approach tasks with seemingly ease. Yet, on the inside, these individuals tend to feel deeply empty. A hollowness that they cannot quite identify or filter out. It is omnipresent, shadow-like. Even in moments of seeming joy, the emptiness creeps in at some point, like water trickling through a cracked wall. Until the wall can no longer hold, and water comes gushing through.
These individuals have learnt from a young age to suppress their emotional experiences to the point where they suppress all emotions, not just negative ones. Remember, you cannot selectively suppress emotions. Consequently, individuals with HFD struggle to allow themselves to feel intense positive emotions like joy and excitement.
To compensate for this, they focus on relentless pursuits of purpose-driven work. They aim to achieve, excel professionally, make money, get the house and car, go on that fancy holiday. Because these individuals tend to reason to themselves that if feeling sh** or feeling utter bliss are kinda the same thing, then they may as well do the things that they believe will eventually bring them joy. Sadly, it never works out that way. The more they try to excel, the deeper the depression sets in. Also, by keeping the focus on external markers of “great”, it keeps others from spotting the profound “bad” that resides inside.
Eventually, the grasp of HFD shows itself in things like severe burnout, persistent relationship difficulties, rapid decreases in performance, sleep disturbances, extreme fatigue, persistent irritation, periods of catatonia, and unexplained autoimmune diseases.
5) Intellectual Depression
Yup, you read that right, the higher your intellect, the more likely you are to suffer from depression. For ease of reference, let’s call this “intellectual depression”.
Why is this the case?
So, you may be surprised to know that a key reason why those with higher intellectual potential tend to more easily fall prey to depression is that they are able to “grasp” the world and themselves much quicker. They internalise beliefs about themselves much quicker.
As such, when these individuals are raised in an environment where there is a lot of criticism, punishment, belittling, or lack of encouragement, they will internalise these “bad beliefs” about themselves and the world much quicker.
To add to this, when you have a higher intellect, you tend to get bored with people much quicker, due to your ability to process things so efficiently. This often leaves these individuals open to bullying as children, which further strengthens their negative beliefs about themselves and the world they live in. This can often leave these individuals with a persistent lack of motivation, pessimistic outlook, and depressive demeanour, as they do not believe they are able or capable of achieving things in life, nor would they want to, because there is nothing good in the world in any case.
Navigating Out Of Depression
If you feel, by this point, you are getting depressed just reading this, then don’t fear, Dr Es is here! Keep reading, there is a way out…
For clinical depression, treatment is generally a combination of psychopharmacology (medication) and psychotherapy. However, for HFD, there is often deeper self-work that needs to take place, which is best addressed with long-term psychotherapy.
With HFD, there is often a need to reconnect to the body, to develop an awareness around how emotions feel in one’s body. Because those with HFD are such pro emotional suppressors, they generally have great difficulty in reconnecting with their emotional selves. This is where the use of antidepressants gets really tricky, because if the person is already so depressed that they can barely function, then trying to add psychotherapy on top of that without any pharmaceutical assistance is like asking someone to run a marathon with ankle weights–doable, but profoundly tough.
Then on the flipside, if a person uses antidepressants and is at a stage to engage therapeutically, then the antidepressants will further suppress the exact thing you are trying to work with–emotions! This is why I tend to hold off on the use of antidepressants and rather work therapeutically, unless I do sense that they struggle to engage in the therapeutic process. In which case, antidepressants can be a lifesaver!
Nevertheless, there is never an easy fix to either clinical or high-functioning depression. Symptoms like depression often serve as indicators that something has gone wrong. I strongly believe that depression serves the purpose to push us on the couch and not give us the energy to continue barking up the tree we are currently on — because it is the wrong damn tree!
However, I also acknowledge and have great appreciation for the fact that some forms of depression are organic dysfunctions (i.e., a biological brain abnormality), in which case, delving into the depths of the psyche is unlikely to yield any major changes.
In a Nutshell: Key Takeaways
- Not all depression is clinical — some forms are normal, even healthy responses to life.
- Temporary low moods (after loss, stress, or change) are part of being human.
- A melancholic or depressive personality type may feel things more deeply, but that is not the same as having a disorder.
- Clinical depression is persistent, pervasive, and often comes without clear cause.
- High-functioning depression hides behind success, performance, and perfectionism.
- Intellectual individuals may be more prone to depression due to faster internalisation and emotional suppression.
- The goal is not to suppress sadness but to understand what it is signalling.
- Medication and therapy both have their place, but timing and context matter.
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