Depression Isn’t Just Sadness—It’s Disconnection From Yourself

Depression can show up in many different ways. It’s not always tears and isolation—it can also look like going through the motions, showing up for others, and keeping it together while secretly feeling numb, exhausted, or hopeless inside.

At Sea to Summit Psychiatry, we understand how invisible depression can be. You might be functioning well enough on the outside—holding down a job, caring for your family—but inside, you’re struggling to find meaning or motivation. This is sometimes referred to as high functioning depression, and while it may not look like crisis, it can still be incredibly painful and draining.

What Is High Functioning Depression?

High functioning depression isn’t an official diagnosis, but it's a real experience that many people relate to. It often refers to a form of persistent depressive disorder (also known as dysthymia), where symptoms are milder than major depression but last for years—and are often masked by a busy or “successful” exterior.

Common symptoms include:

  • Low energy or chronic fatigue

  • Difficulty feeling joy or excitement

  • Negative self-talk or quiet self-criticism

  • Withdrawing emotionally even while staying socially active

  • Feeling “stuck” but not knowing why

Because people with high functioning depression are often still getting by in life or even succeeding in areas, their suffering is frequently overlooked—even by themselves. But that doesn’t mean it’s not real, or that it doesn’t deserve care.

Treatment That Goes Deeper Than Symptoms

At Sea to Summit Psychiatry, we believe that depression is more than a chemical imbalance. It’s often a sign that something in your life—your work, relationships, past experiences, or sense of purpose—is out of alignment.

That’s why we take a holistic, insight-oriented approach to depression treatment. Your care plan might include:

  • Personalized medication management

  • Parts work or insight-oriented psychotherapy

  • Lifestyle interventions for sleep, nutrition, and nervous system regulation

  • Support with ketamine or psychedelic-assisted therapies when appropriate

Can TMS Make Depression Worse?

Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation treatment used for major depression, especially when other treatments haven’t helped. It’s generally safe and well-tolerated, and many patients experience significant relief.

However, it’s a fair question to ask: Can TMS make depression worse? In rare cases, some individuals report increased anxiety, irritability, or worsening mood—often due to incorrect targeting, overly aggressive protocols, or underlying bipolar tendencies that weren’t properly identified before treatment. That’s why we always recommend a thorough psychiatric evaluation first.

If you’re considering TMS, we can help you decide whether it’s the right fit—or explore other options that align better with your needs and goals.

You Don’t Have to Pretend You’re Okay

Whether your depression is loud and obvious or quiet and hidden beneath the surface, you deserve care that sees the full picture. If you’re tired of pushing through and ready for a different kind of support, Sea to Summit Psychiatry is here to walk with you—step by step, at your pace.

Book a free consultation to learn how we can help.