Still showing up. Still getting through the day. But something underneath doesn’t feel right — a heaviness that won’t lift, a flatness where things used to feel meaningful. This isn’t a crisis you can point to, but it isn’t okay either. What you might be experiencing has a clinical name: Persistent Depressive Disorder, often called high-functioning depression. It’s a DSM-5 diagnosis that can look completely invisible from the outside, which is exactly why it goes unaddressed for years.

In this video, Rey NP, a dual-certified nurse practitioner, breaks down five signs of high-functioning depression that are almost always missed — from sleep that doesn’t actually restore you to a mind that won’t stop replaying conversations. He then walks through a four-step, evidence-based framework you can start applying this week: behavioral activation, exercise as a neurological intervention (not a fitness goal), sleep optimization, and nutritional psychiatry — including the research behind each one.

If this sounds familiar, this video is a place to start — and a reminder that feeling this way isn’t something to just push through alone.