The Downfalls of Being ‘High Functioning’

I do not, from the outside at least, appear to have a mental illness.

But that’s the point. You can’t see mental illness, and there is no ‘typical’ look. We don’t all sit on the floor in the dark clutching our heads as the media would lead people to believe. This why people like myself who are considered ‘high functioning’ actually have a really difficult time.

I have a degree and a responsible job and a business and a long term relationship and stable friendships. I appear very much have everything together all of the time. This, unfortunately, means that when I fall, I fall hard. The bottom is very far away. It also means that I find it incredibly difficult to ask for any help or support. Something I learnt in therapy a few years ago is that one of the reasons I try to do everything at once and perform to a high standard is that I feel as though I need to overcompensate. I don’t want people to think of me as fragile or ill or somebody they need to protect, so I do everything I can to prove the opposite. The reality is, however, that there are times where I am fragile and ill and need protecting. And how do you ask for that when you’ve been trying your whole life to portray yourself as anything but?

One of the times I relapsed into my eating disorder a few years ago, I was assessed again by the eating disorder team. I was told in not so many words that I had had treatment there twice and individual therapy was no longer an option (despite me having had it again since as a result of deterioration), but that I could attend a group (which I wasn’t able to do). The psychologist in my assessment asked if the reason I had relapsed is because I liked being in the ‘sick role’ and people knowing I was unwell. Only one person in the world at that time knew I had relapsed and that I was at that assessment because I spent months covering it up, horrified that somebody might realise what was happening and that I had lost control once again. I remained private about it for many years until having a further relapse that meant I could no longer hide it. My weight is now stable again. I don’t like the ‘sick role’. I like the ‘well role’.

I like to show people that having a mental illness doesn’t automatically mean that you cant participate fully in life. I know there are people who are unable to work and struggle to function day to day and I am absolutely not diminishing that. But it is possible for some of us to live normal(ish) lives. Sometimes I think I maybe try too hard to prove this to the detriment of my own wellbeing, which only causes me to feel ashamed when I do inevitably relapse.

The other side to this is that being ‘high functioning’ can lead me to feel fraudulent. This online mental health community is amazing, and there have been many times where I have doubted if I deserve to be a part of it. I see people struggling every day yet I can go months and years now without bipolar disorder impacting upon my functioning. I am now in a good place with my anorexia recovery. This doesn’t mean, however, that my struggles are any less valid, and that goes for all of us who fall under this umbrella.

No matter how together people may seem, please remember that they may be struggling. You have no idea what battles people are facing. Please don’t judge them based on what you see on the surface.

There could be so many things bubbling underneath.


  1. Love this post and totally relate to the pretending to be okay vibes.

    I did it for years. People labelled me as ‘strong’ and a ‘superwoman’, but the truth is no human being can achieve those labels. We all have a breaking point and need looking after sometimes.

    Liked by 1 person

  2. Very thought provoking post this Cara. That comment about the ‘sick role’ – wtf?!? Someone once said to me when I was very ill that at some level I must want to not get better. It really, really hurt. I wanted nothing more, I just didn’t see how it could be possible. While I believe strongly in talking about mental health and using my experiences to hopefully help others, I don’t want to be associated with being depressed but with overcoming it. When I’ve been unwell I’ve just wanted to hide away from the world, and not have anybody see me in that state when I’m not me. Great post.

    Liked by 1 person

  3. Wow, you really nailed the part about feeling fraudulent! I felt this way too with my own mental illnesses, as I appear to be more in the ‘well role’ than the ‘sick role.’ Thank you, Cara, for highlighting that our struggles are still valid. I don’t think we should see mental illness as a competition to be the ‘sickest.’

    Liked by 1 person

  4. I am so sorry they said that to you! (Liking the sick role). Do these people think that mental illness is just “one and done”?
    It’s horrible that even Doctors and other medical professionals think like this. 😦


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