Why you shouldn’t distinguish so-called “high functioning mental disorders” from “mental disorders”

I’m seeing a lot of stuff from mental health awareness groups about “High functioning depression,” “High functioning anxiety,” “High functioning ADHD” and you name it. Obviously, just because a person’s work/school performance or social media profile looks alright doesn’t mean they can’t also have a psychiatric diagnosis. But there are far better ways to get this idea across to to the public than by dividing people using made-up labels like “high functioning” that ultimately only worsen confusion and stigma.

There are no separate diagnoses specifying high-functioning vs. low-functioning depression, just like there aren’t separate types of depression for right- vs. left-handed or short vs. tall people. There are just infinitely many different variations of major depressive disorder for the infinitely many people who have it.  There will never be a diagnostic label that captures how your specific combination of symptoms and identity and life all intersect — nor should there be, because that is not what these labels are for.

But adding the words “high-functioning” to a person’s diagnosis is not just unnecessary, it is harmful, because it increases stigma for everyone else. For example, by saying you have “high functioning depression” you’re making sure to specify that you’re not a loser like a stereotypical depressed person, thereby removing any positive effect (on stigma) that publicly proclaiming your diagnosis might have had. It is essentially an attempt to boost your own social appeal by distinguishing yourself from others who are less fortunate. It also functions to buy into and support negative stereotypes. (I wouldn’t refer to myself as having “high functioning depression” any sooner than I’d call myself a “female scientist.”)

I’m afraid that this seems to be part of a trend among young stigma fighters to embrace diagnostic labels while still being unable to accept that mental illness necessarily entails struggling/suffering, and while still holding very negative attitudes towards people with mental illness who don’t meet their standards for being sufficiently successful (attractive, happy-looking, and so on).  But it doesn’t do much good to de-stigmatize diagnostic labels while stigmatizing the real experience of people who live with those diagnoses, many of whom do not have picture-perfect lives.

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For more on this topic, see this recent writing by Sam Dylan Finch and M. Slade.

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