Specialist psychological support for people who appear to be coping, achieving and managing well — while privately carrying a low-grade depression that rarely gets named, let alone addressed.
High-functioning depression is not a formal diagnostic category, but it describes something clinically real: a persistent low mood, flatness or sense of going through the motions that coexists with continued, often high, performance at work and in relationships.
Clinically, this pattern most often maps onto Persistent Depressive Disorder (dysthymia) — a chronic, lower-intensity depressive presentation that can be harder to recognise precisely because it does not stop someone from functioning.
Because the outward picture looks fine, this experience is often missed — by colleagues, by friends, sometimes by the person themselves, who may not recognise what they are carrying as depression at all.
My approach draws on CBT and schema therapy, addressing both the persistent low mood itself and the underlying beliefs — often around achievement, self-worth and the permissibility of struggling — that maintain it.
This is not about waiting for things to become a crisis before they are taken seriously. Persistent, lower-grade depression is genuinely treatable, and addressing it early tends to be more straightforward than waiting until functioning is also affected.
I work particularly with professionals who are used to managing well, for whom acknowledging this experience can itself feel like an admission they are reluctant to make.
"The people who carry this longest are often the ones who function best — which is exactly why it tends to go unaddressed for years."
Dr Sanya Krljes · Consultant Clinical Psychologist
Because functioning continues, high-functioning depression often does not meet the threshold that prompts people to seek help — yet it is genuinely treatable, and the longer it persists, the more it tends to shape identity and self-expectation.
Psychological therapy addresses the underlying pattern directly, rather than waiting for it to escalate into something more acute before being taken seriously.
I am a Consultant Clinical Psychologist with doctorates in cognitive neuroscience (Imperial College London) and clinical psychology (UCL), and over 20 years of clinical experience, including extensive work with professionals managing exactly this gap between presentation and internal experience.
I take this experience seriously on its own terms, without requiring it to have escalated into crisis before it is worth addressing properly.
Qualifications
MSc Neuroscience — King's College London
PhD Cognitive Neuroscience — Imperial College London
DClinPsy — University College London
HCPC Registered · BPS Chartered Psychologist & AFBPsS
A free 30-minute consultation — by phone or video — where you can tell me a little about what has brought you here. No pressure, no obligation.
hello@praxispsychology.uk · London & Online