Such "herculean efforts" would constitute distress. If you're successfully busting ass every day to compensate for depressive symptoms, you might have a depressive disorder.

As for your point w.r.t. circumstances: yes, this seems to be by design. Someome who might be diagnosed with schizophrenia in the US could easily be considered just quirky or even revered as a sort of spiritual guru in other cultures where symptoms have fewer/no negative impacts (and thus do not present so "horribly").