October 25, 2022

What Is High-Functioning Anxiety?

by | Oct 25, 2022 | Anxiety

People who others would describe as high achieving, successful, or confident can come across as “having it all together” or effortlessly managing the demands on their daily lives. In reality, many of these people suffer from what is referred to as high-functioning anxiety. 

How to identify high-functioning anxiety

High-functioning anxiety is not a formal mental health diagnosis but rather a way of referring to a type of anxiety. It has many of the same symptoms of Generalized Anxiety Disorder but may be more challenging to recognize because it typically does not involve a major disruption in a person’s ability to manage daily tasks. 

Put simply, high-functioning anxiety is no different from “normal” anxiety in terms of severity or difficulty. People who would be considered to have high-functioning anxiety have developed coping mechanisms, whether healthy or not, that make it so that their anxiety doesn’t affect their outward presentation of productivity or happiness.

When a person experiences daily panic attacks, difficulty engaging in social interactions, or is unable to complete certain tasks, it can be more obvious that they are struggling with anxiety. For people with high functioning, there is typically little to no interruption in their outward activities, but internally they are filled with the same distressing symptoms. 

Understanding this form of anxiety is crucial to help people recognize that anxiety does not always look like they might expect, and even if you are holding it together externally, your internal experience matters and deserves to be treated. 

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For reference, the symptoms of Generalized Anxiety Disorder include the following:

  • Excessive worry 
  • Feeling restless, wound-up, or on-edge
  • Fatigue not solely related to sleep
  • Concentration difficulties
  • Irritability
  • Physical symptoms such as stomach pains, headaches, nausea, etc.
  • Sleep interruptions- often difficulty falling asleep or restless sleep

Additional signs that might indicate you are dealing with high-functioning anxiety may be: 

  • Overpacking schedules and responsibilities
  • Inability to accept failure or less than perfection
  • Overthinking and overanalyzing
  • Fixating on mistakes
  • Difficulty drawing boundaries and overstretching limits
  • Chronically comparing yourself to others
  • Difficulty relaxing even when there is no immediate deadline or urgency

High-functioning anxiety doesn’t look like one thing in particular, but in most cases, there is an emphasis on maintaining appearances and struggling to show vulnerability. 

But isn’t that normal for high-achieving people?

A level of stress is expected in high-achieving people, but there is a distinct difference between stress and anxiety. 

Stress is solely a marker of how the brain and body react in times of pressure or threat. Focusing better under a deadline or presenting especially well in a big meeting are all examples of how the body can adapt to stress. 

Anxiety, on the other hand, relates more to the cognitive effects of stress some people experience; especially worry. Stress resolves quickly and rarely leaves any ongoing damage. Anxiety is persistent, sometimes even chronic, and can cause a host of long-term issues for our mental and physical health. 

Stress can be a normal experience for most people, and especially for people who have fast-paced jobs or engage in activities with a high level of responsibility. But when stress turns into ongoing anxiety, it needs to be addressed. 

Who experiences high-functioning anxiety?

Everyone can experience high-functioning anxiety, but there are certain risk factors that may increase the likelihood of developing it. 

  • Pressure or high expectations from outside sources
  • Previous high achievement 
  • Low self-esteem outside of accomplishments
  • People who carry excess responsibility (immigrant families, eldest children or those who have been labelled as “the good/smart/mature child”)
  • High responsibility jobs 
  • Limited resources or “back-up” plans
  • Attempting to compensate for learning differences (ADHD, dyslexia, etc.)

Let’s look at some examples: 

A CEO will undoubtedly feel a level of stress in their daily work activities. That stress will help them assess the situations accurately, make good decisions, and manage a fast-paced work environment. But just because the CEO looks calm and collected on the outside, doesn’t mean they aren’t riddled with anxiety behind the scenes. They may struggle to relax when spending time with loved ones, struggle to get adequate sleep because they’re up running through items on their to-do list, or they may refuse to take leisure time that would benefit their mental health. 

High-functioning anxiety doesn’t just apply to executives and professionals. Let’s look at an example of a high school student who plays two varsity sports, is on the student council, works a part-time job, and maintains a 4.0 grade point average. On the outside, this student is excelling and doesn’t look like they need support. Surely if something was wrong, they would start slipping in one of these areas, right? 

High-functioning anxiety doesn’t necessarily apply to just “high-functioning” people. A 20-something may have a good but entry-level job, a small group of friends, and a partner. They may not be CEO-level successful or valedictorian, but that does not mean they cannot suffer from high-functioning anxiety. Remember, high-functioning in this respect refers to whether the person can continue functioning at their normal level. The 20-something might look like they are doing well in all areas, but they also may be overscheduling and having trouble saying no to work and activities, fearing the future, and ruminating on past mistakes. 

Does it mean these people just know how to handle it better?

On the surface, it can look like people who high functioning anxiety simply know how to better manage their anxiety, allowing them to not experience the life disruptions anxiety can cause. When we look further, however, people with high-functioning anxiety are usually doing one of two things: coping with unhealthy coping strategies or not coping and heading straight for burnout. 

Unhealthy Coping Mechanisms 

Many people with high-functioning anxiety “get by” only because they are relying on unhealthy coping mechanisms. For some, these include efforts to stay awake or focus for longer or attempts to numb the stress. While they may work in the short term, these unhealthy coping mechanisms will inevitably either stop working or bring their own negative consequences.

Common unhealthy coping mechanisms seen in people with high-functioning anxiety include:

  • Substance use to numb or forget
  • Being a “workaholic”- spending all free time working
  • Caffeine or stimulant use to increase productivity 
  • Excessive spending or gambling
  • Perfectionism in work and other areas
  • Withdrawing from relationships

Long-term effects

Many people with anxiety do not seek help until their symptoms have increased to a level that impacts some part of their life. For some people that point is daily panic attacks, being unable to attend work or school, or trouble in their relationships. For people with high-functioning anxiety, that line of when help is necessary becomes much harder to pin down. 

Because they will likely wait longer to seek help, the negative effects of chronic stress and anxiety will only compound before they are effectively treated.  

It is widely known that stress has long-term effects on the brain and body. Memory can be affected, the immune system can be suppressed, cardiovascular health can be undermined, and gastrointestinal and endocrine systems can be affected, among other concerns. 

Continued use of maladaptive coping skills can also lead to problems with addiction, relationship distress, and financial distress. 

Why does it happen?

Like with many mental health conditions and symptoms, we aren’t sure exactly what causes high-functioning anxiety, but there are some common hypotheses:

Individualistic vs. community-based societies

When we used to live in smaller, more close-knit communities, there was a sense that we would be taken care of by our community members if something happened to us or reduced our ability to care for ourselves. 

In current times, this “safety net” doesn’t feel like reality to many people and that fear of “what if” can be terrifying. In order to combat that, many people strive to be able to take care of all their needs by themselves, no matter what. 

That translates to making more money, securing more opportunities, and foreseeing all possible negative outcomes; all behaviors that quickly lead to anxiety. 

The rise of comparison

Humans have always compared themselves. But there’s a difference between comparing yourself to the 100 people in your village, or even the 1,000 people in your town, and comparing yourself to the entire world.

The increased connectivity we have with social media and the internet can be wonderful in so many ways, but the increase in comparison can be a downfall. 

If the high-school student is able to see exactly what other students their age are doing to get into high-level colleges, the fear that they’re not doing enough can lead them to push beyond their limits. What might have felt “just fine” many years ago, now doesn’t seem enough compared to others. 

Capitalism and success-driven societies

The undercurrent to all these theories is a society that values success. The “American Dream” paved the way to prioritize hard work and success. While not inherently a bad thing, it can create an unhealthy fixation on doing more and better no matter the cost. 

As a society, we celebrate the “big wins”; a new job, getting accepted to a prestigious school, buying a home, etc. Rarely will you see people receiving praise for resting, taking care of themselves, and connecting to their passions, even if that is what’s best for them.         

Feeling pressure to keep up with the rest of society can quickly lead to high-functioning anxiety.                                                    

What do we do to treat high-functioning anxiety?

Acknowledge it’s happening

For many people with high-functioning anxiety, acknowledging that what they are experiencing isn’t ok and isn’t healthy is the toughest part. When you’re used to being on top of everything in your life, admitting that something isn’t going well can feel daunting and uncomfortably vulnerable. 

There is power, however, in owning it. Most people find that high-functioning anxiety continues to escalate as they gain more responsibility and their lives become more complex, so the sooner you can identify and address the anxiety, the better. 

At a minimum, this means acknowledging it to yourself. Ideally, it means talking about it with your support system and with a mental health professional so you can take action to feel better. 

Draw healthy boundaries around responsibilities

Saying “no” to tasks and projects can feel deeply uncomfortable when you’re used to always taking on more, but it’s critical to identify how much you can take on without feeling overburdened. 

Practice phrases like:

  • “I don’t have the bandwidth for that right now, but feel free to check back in next week”. 
  • “I need to prioritize some time for _______, I’ll get that back to you by Tuesday.”
  • “I need some assistance to get this done by the deadline you asked for.”
  • “Sorry, I’m not available for that.”

You are deserving of rest and leisure time, as well as time to work on healing from chronic stress and/or burnout. Having a few phrases in your back pocket can help you in the moment when your natural inclination would be to say yes and take on more. 

Practice stress management

This one is fairly obvious, but that doesn’t mean it’s any less important. Practicing stress management on a regular basis is vital to managing high-functioning anxiety. 

The exact method of stress management looks different for everyone, but some common practices are:

  • Exercise
  • Mindfulness meditation
  • Self-care strategies 
  • Dedicated time for passions/interests
  • Music
  • Creative pursuits
  • Consciously increasing humor in your life
  • Gratitude practices

Identifying markers that clue you into worsening symptoms

Because a hallmark of high-functioning anxiety is ignoring or not being aware of it until it becomes highly distressing, it’s important to learn what anxiety looks like for you and how to notice when it’s increasing. 

Some people like to have specific tangible markers like noticing how long it’s been since they exercised or reached out to a friend, and some people like to set aside time to focus on assessing their current mental state. 

However you do it, it’s just important to do it. Knowing that your anxiety is starting to increase early on will help you jump into action with coping skills so that hopefully, you can manage it much easier. 

Start Your Mental Health Education:

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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