A quiz may help spot the silent sister of depression when you’ve lost your spark

When Functioning Hides Distress

Some people with depression struggle to get out of bed, while others continue meeting obligations and may put even more energy into work. Joseph says this second pattern can go unnoticed, including by the people experiencing it.

She describes high-functioning depression as continuing with daily responsibilities while quietly losing the ability to feel pleasure. The condition is not an official DSM-5 diagnosis, and its absence from the manual may contribute to people overlooking symptoms or postponing treatment until burnout.

Understanding Anhedonia

Joseph said anhedonia may not look like a crisis in the usual sense, but she considers it an existential crisis. She argues that loss of joy deserves attention alongside more visible signs such as mania or psychosis.

What The Study Found

Joseph and colleagues interviewed adults using questionnaires assessing high-functioning depression, trauma and anhedonia. Their peer-reviewed study appeared in the journal Cureus. The results supported the researchers’ hypothesis that people with high-functioning depression had increased levels of anhedonia and trauma. Participants with higher anhedonia scores also had higher high-functioning depression scores; parents and caregivers had the highest scores for both.

A Quiz For Reflection

Joseph developed an anhedonia quiz based on the Snaith-Hamilton Pleasure Scale, published in the British Journal of Psychiatry. Questions cover everyday experiences, including enjoying praise, savoring meals and finding satisfaction in work or accomplishments.

The quiz is not a diagnostic tool. Joseph presents it as a way to consider what may be getting in the way of a fuller, more joyful life; people taking it are asked to share an email to see their results.

Responsibilities And Burnout

She has also seen patients arrive at an emergency room without understanding why, then learn they had been carrying unresolved emotional pain. Joseph says the pattern can occur in professions that discourage vulnerability, including medicine.