Addressing The Silent Killer: High Functioning Depression & Suicidality

I’ve worked in the mental health field for about five years, and in those five years I’ve worked in different treatment settings, with different populations, and had my fair share of treating and supporting people who suffer from depression and suicidal thoughts. In most cases, these clients have had debilitating symptoms that have resulted in multiple hospitalizations or treatment center stays over their lifespan. They often have other co-occurring diagnoses, and/or struggle with substance abuse or other maladaptive behaviors such as self-harming.

Their symptoms and behaviors are so unmanageable that they struggle to live a productive or seemingly fulfilling life. They stop going to work or school, they stop hanging out with friends, they appear sad or distressed most of the time, and they lack a general sense of motivation or interest in anything. The people closest to them can usually pick up on the fact that something is wrong or off because their behavior isn’t in alignment with the person they’ve known them to be. The person doesn’t have to come out and say “I’m depressed” or “I’m suicidal”, because they begin to wear their depression and/or suicidality on their sleeve and this allows for their support system to intervene or try and offer help.

But what happens when a person wears their mental illness well? What happens when the depression and suicidality is not so easy to spot and you can’t see the downward spiral? How do we support a person when we have no inclination that they are suffering or that they are merely moments or one tough circumstance away from being motivated to check out on life?

After all of my experience with depressed and suicidal clients, this year was the first time I was personally affected. In this past year, I’ve known three highly functioning people that have committed suicide. I wasn’t extremely close with any of the three, but from what I knew and could see, they all appeared to