Did you just call me high-functioning?

by Diana Hoguet

I am often told I am high functioning for someone who lives with a mental illness.  It is meant, I believe, to be a compliment, or at the very least, an observation.  And yet it can trigger me to want to stand on my soapbox and rant about not judging a person’s mental illness — as if they had just accused me of something despicable.   The irony is that I work very hard at functioning as effectively as I can, and if I am struggling I still will do my damnedest to LOOK like I am holding it together. In fact, I’ll admit I pride myself on it, because I know it matters  in how I am perceived by coworkers, friends and family. But then there’s the me inside, the little me, that fears the tyranny of my disease and knows how quickly all my “high” functioning could crumble.

First, let me just say that I am grateful for the gifts I have been given that contribute enormously to my ability to function at all.  These are:  1) Having access to medical care and therapy, 2) Being blessed with adequate means to support myself, 3) Being educated, 4) Having access to a wide variety of therapies and the freedom to choose, and 5) Being otherwise healthy.  If I did not have any one of these assets, let alone all of them, I would have added stressors in life that would affect my functionality and my motivation.  There are many people living with my same diagnosis who may appear to be marginally functioning in our world, but relative to the very limited assets they have, their lives are nothing short of miraculous. It would be ludicrous to put them on any kind of measurable scale of high and low functioning.  We are spiritual beings, with spiritual gifts to offer each other, and I sincerely hope there is no high/low scale for that.

Second, the term high functioning is never interpreted the same way by any two people. It may be useful from a clinical perspective, but beyond that it is a subjective label that could mean a hundred different things.  For example, I have had people assume that I must have a very mild case of bipolar disorder, and then other people who know me well who know how much I’ve wrestled with my disease and they praise me on how hard I work on myself in my therapies and group outreach efforts. Then there are others who only want to know about what meds I take and attribute my high functioning to a good psychiatrist and good luck with my meds. Well, the truth is that my bipolar disease can be deadly and can flip on a dime.   Yes, I do work hard in therapies, but if I did not have the insurance and extra pocket money to do that, would I maybe have found some other therapeutic activity that I can do for free,  like long-distance walking?  And yes, I am lucky to have a good psychiatrist and a reliable med regime, but I have taken more than 60 different meds for my mood disorder over the last 30 years, with enormous ups and downs.  It’s never been easy, and my regime today could need tweaking tomorrow. It is all a process.

Labels like high functioning don’t humble themselves to the exquisitely dynamic experience that we call mental illness.  There are too many variables at play affecting how a person will present. Labeling undermines the hard work we all do at coming to a place of self acceptance as we are.  It’s important that we ask ourselves why we so often value functionality foremost as a sign of mental health.  My experience is that functionality can ebb and flow. When I push myself to be functional all the time because I mistake that as the most important mark of recovery, I might be missing  out on some of my own greater gifts, like compassion and tolerance — gifts I believe I have  BECAUSE I live with a mental illness.

Diana Hoguet

Board member, Interfaith Network on Mental Illness


The opinions expressed in this blog are those of the submitter. They do not necessarily reflect the opinions of the board of directors or members of the Interfaith Network on Mental Illness.