What is High-Functioning Anxiety? How to Tell if You Have it
Published By Justin Baksh, LMHC, MCAP
December 8, 2023
High-functioning anxiety may not be officially recognized as its own medical condition, but it is still a significant issue for many people. While we don’t have exact numbers for how many people have high-functioning anxiety, we do know that anxiety disorders are really common. Studies show that between 19 and 33 percent of people in the United States are affected by anxiety.
High-functioning anxiety is unique, though, because people who have it often seem very successful and “in control” on the outside, even though they are struggling with anxiety on the inside. This makes it really important for us to talk about and understand high-functioning anxiety, so we can better recognize and support those who might be dealing with it.
How Many People Have Anxiety?
There are several types of anxiety, including generalized anxiety disorder, social disorder, panic disorder, or a specific phobia, such as fear of heights, among others. As a whole, however, anxiety disorders are the most prominent mental health condition in the United States.
- Anxiety is the most common mental disorder in the U.S.
- The U.S. Census Bureau Household Pulse Survey reported in 2023 that nearly one-third of adults (32.3%) experienced symptoms of anxiety and depression.
- Anxiety is more prevalent among women (23.4%) compared to men (14.3%).
- Anxiety is most common in high-income countries versus low-income countries.
- Anxiety occurs in the United States at more than double the rate than it does worldwide (7.3 percent).
- Most of those who have anxiety (56 percent) rate it as moderate or severe.
These statistics help us understand just how widespread anxiety disorders are, and high functioning anxiety is a part of this larger picture.
What is High Functioning Anxiety?
“High-functioning anxiety is anxiety that a person can mask and keep from affecting their ability to complete tasks in daily life.
What it is not, though, is unimportant or non-disruptive. A high-functioning anxiety sufferer may be able to avoid a breakdown at work, but may have that breakdown as soon as they get to a private place. They may plan their life carefully, avoiding things that might trigger too much anxiety. They may miss out on things because they are afraid of an incident.
High-functioning anxiety is not the same as properly managed anxiety. It is not the same as minimal anxiety. It is just anxiety that is hidden, not anxiety without any effect.“
-Long-time anxiety sufferer, What Does Anxiety Feel Like?, Quora
High-functioning anxiety is closely related to generalized anxiety disorder (GAD). With GAD, people feel excessive worry or anxiety about everyday things. High-functioning anxiety can be thought of as a specific kind of GAD. While people with high functioning anxiety experience similar feelings of anxiety, they’re often able to keep up with their day-to-day life in a way that might not be possible for someone with more typical forms of anxiety.
The key difference between high-functioning anxiety and other anxiety disorders is how it looks from the outside. With most anxiety disorders, the struggle is more visible – people might avoid certain situations, or it is clear they are having a hard time. But with high functioning anxiety, it’s a bit like being a swan on a lake – on the surface, everything looks smooth and calm, but underneath, there’s a lot of frantic paddling going on. People with high-functioning anxiety often appear to be highly successful and on top of things, but inside, they’re dealing with constant worry and stress.
Internally, someone with high-functioning anxiety might be experiencing a lot of turmoil. They often deal with ongoing stress, self-doubt, and worry. These feelings can be about anything and everything – their job, relationships, daily tasks, or even about how they’re perceived by others. Despite these challenges, they don’t let these worries stop them from doing everything they need to do. In fact, sometimes it’s these very anxieties that drive them to push harder and achieve more.
From the outside, it might not be obvious that someone with high-functioning anxiety is struggling. They often come across as incredibly organized, detail-oriented, and proactive. They might be the person who’s always volunteering for new projects at work, or the friend who always seems to have everything together. But this outward success can be a double-edged sword. The pressure to maintain this image of success can feed into their anxiety, creating a cycle that’s hard to break. It’s like they’re wearing a mask of success, hiding the real challenges they’re facing on the inside.
Signs of High Functioning Anxiety
High-functioning anxiety comes through as a mixed bag of emotional and physical symptoms accompanied by behavioral signs. If you suspect that you or someone you love suffers from high- functioning anxiety, check out these signs to see if you might be right.
Emotionally, people with high-functioning anxiety often experience a constant sense of nervousness and worry. They might have fears about making mistakes or not being good enough. These fears can lead to feelings of being on edge or a looming sense of dread about what might go wrong.
Physically, the symptoms can be quite varied. Some common ones include excessive sweating, a racing heart, headaches, and even digestive issues like stomachaches. People might also experience muscle tension, which can lead to feeling physically drained or exhausted. Sleep disturbances are common, too – either struggling to fall asleep or waking up frequently due to anxiety.
Behaviorally, those with high-functioning anxiety often exhibit traits that, on the surface, are seen as positive. They are usually high achievers, driven by their internal anxieties to excel at everything they do. They are often highly organized and proactive, always planning and preparing to avoid any possible issues. This level of organization can sometimes border on perfectionism, which can add to their stress.
Their proactivity is another hallmark trait. They are often the first to volunteer for tasks or take on new challenges. While this can seem like a strength, it is often a way for them to feel in control, which is a critical aspect of managing their anxiety.
How High-Functioning Anxiety is Different than Generalized Anxiety Disorder
Beyond the hidden aspect of high-functioning anxiety versus GAD, there is a key difference among those who suffer from each in their response to anxiety-provoking situations.
In GAD, the anxiety often leads to avoidance – avoiding situations, people, or tasks that trigger anxiety. With high-functioning anxiety, the response is often the opposite.
People with high-functioning anxiety, however, are likely to confront these situations head-on, using their high levels of achievement and organization as tools to manage their anxiety.
This approach can make it seem like they are handling their anxiety well, but it is often more about managing appearances than truly coping with the underlying issues. They might take on more work or responsibilities as a way to prove to themselves (and others) that they can handle it, even if it means increasing their stress levels.
What Causes High-Functioning Anxiety?
There is not a single cause of anxiety. It can arise from a myriad of factors, working alone or together.
High-functioning anxiety, like many other mental health conditions, can be genetic. If you have family members who have struggled with anxiety disorders or other mental health issues, you might be more likely to experience high-functioning anxiety yourself. This doesn’t mean it is guaranteed to happen – genetics are just one piece of the puzzle. But it does play a role in your overall risk.
Your environment and the society you live in can often play a part in high functioning anxiety. Stressful life events, such as major changes, relationship problems, or financial troubles, can trigger or worsen this type of anxiety. Workplace stress is a common trigger, especially in environments that place high demands on performance and productivity.
The broader societal context can also play a role. For example, constant connectivity and the pressure to be available 24/7, as well as the influence of social media, where everyone seems to be showcasing a perfect life, can contribute to the development of high-functioning anxiety. These societal factors can create unrealistic standards and expectations that people feel pressured to meet.
Gender-Specific Risks and Societal Pressures
Gender plays a significant role in the risk of developing high-functioning anxiety. Women, in particular, are more likely to experience anxiety disorders, including high-functioning anxiety. This increased risk can be linked to a variety of factors, including societal pressures related to gender roles, expectations, and even the way women are socialized to handle stress and emotions.
Women often face unique stressors, such as balancing career and family responsibilities, dealing with gender-based discrimination, or managing societal expectations around appearance and behavior. These pressures can contribute to the development of high- functioning anxiety, as women may feel the need to excel in all areas of life while also managing their underlying anxiety.
High-Functioning Anxiety’s Impact on Daily Life and Relationships
High-functioning anxiety is not a benign condition. It can leave a trail of wreckage in the lives of those who suffer from it.
Challenges in Personal and Professional Lives
In the workplace, people with high-functioning anxiety may excel and are often seen as highly competent and dependable. However, this comes at a cost. The constant internal pressure to perform can lead to excessive stress and anxiety, making it hard to relax or feel satisfied with their achievements. It can start to affect physical health as well.
In their personal lives, the challenges are just as significant. Strained relationships with family and friends can result from the need for perfection and control. People with high-functioning anxiety might find it hard to unwind or engage in leisure activities, as they are often preoccupied with worries or planning for future tasks.
The Tendency to Over-Function and the Risk of Burnout
A common characteristic of high-functioning anxiety is the tendency to over-function – to take on too much, to constantly be in ‘doing’ mode. This can be driven by an inner narrative that one must always be productive or that their worth is tied to their achievements. Even though it can sometimes lead to short-term success, it is not sustainable in the long run. The constant pressure and unattainable standards will eventually lead to burnout, characterized by exhaustion, cynicism, and a feeling of reduced professional ability.
Burnout not only affects mental and physical health but can also lead to a decrease in productivity and satisfaction, the very things people with high-functioning anxiety are often striving to achieve.
Effects on Personal Relationships and Self-Care
The impact of high-functioning anxiety on personal relationships might be hard to notice at first, but it can be quite strong. People with high-functioning anxiety might struggle to be fully present in their relationships, as their minds are often elsewhere, consumed by worries or planning. They might also have high expectations of themselves and others, which can lead to conflicts or misunderstandings.
Self-care is often neglected by those with high-functioning anxiety. They might neglect their own needs, such as adequate sleep, proper nutrition, or relaxation, as they prioritize work or other obligations. This neglect can worsen anxiety symptoms and impact overall wellbeing.
Pros and Cons of High-Functioning Anxiety
While high functioning anxiety comes with its challenges, it is also associated with several positive traits.
Positive Traits Associated with High-Functioning Anxiety
People with high-functioning anxiety are often incredibly organized and detail-oriented. This can make them exceptionally good at planning, meeting deadlines, and managing projects. Their drive and determination often lead to high levels of achievement in various aspects of life, from career success to personal goals.
Another positive trait is their ability to anticipate and prepare for challenges. In both professional and personal settings, this forward-thinking approach can be a significant asset. Additionally, many individuals with high-functioning anxiety are empathetic and sensitive to the needs of others, making them thoughtful friends, partners, and colleagues.
Negative Impacts of High-Functioning Anxiety
However, these positive traits can come with a downside. Perfectionism is one of the common negative traits of high-functioning anxiety. This is not just about wanting things to be done well; it is a relentless drive for flawlessness that can create significant stress and dissatisfaction. Perfectionism often leads to setting unreasonably high standards, for oneself and, sometimes, for others, which can be a source of frustration and disappointment.
Difficulty with assertiveness is another challenge. People with high-functioning anxiety might struggle to express their needs or set boundaries, often because they fear conflict or want to avoid disappointing others. This can lead to neglecting their own needs, because they have taken on too much responsibility.
A major con is the internal struggle that comes with high-functioning anxiety. The constant anxiety, worry, and stress takes a toll on health, both mentally and physically. It can lead to anxiety attacks, chronic fatigue, and other stress-related health problems.
Treatment and Management of High-Functioning Anxiety
Several treatment modalities have been proven to combat anxiety, including the high-functioning kind,
Cognitive-Behavioral Therapy (CBT) and Other Therapeutic Approaches
One of the most effective treatments for high-functioning anxiety is cognitive-behavioral therapy (CBT). CBT helps individuals identify and alter thought patterns that drive their anxiety. Through CBT, people with high-functioning anxiety can uncover and challenge irrational fears and beliefs, develop healthier coping mechanisms, and reduce the anxiety that often drives their need for perfection and control.
Other therapeutic approaches can also be beneficial. For instance, mindfulness-based therapies help in staying present and reducing worry about the future. Psychotherapy can offer a deeper understanding of the root causes of anxiety and provide strategies for emotional regulation. Group therapy can also be helpful, offering support and understanding from others who are facing similar challenges.
Medication as Part of a Comprehensive Treatment Plan
In some cases, medication can be a necessary part of treating high-functioning anxiety. Medications such as antidepressants or antianxiety drugs can help manage the symptoms of anxiety, making it easier to engage in therapy and make lifestyle changes. It is important to note that medication is often most effective when used as part of a broader treatment plan.
Coping Strategies and Lifestyle Changes
There are several coping strategies and lifestyle changes that can be implemented to help manage high-functioning anxiety.
Coping Strategies for High-Functioning Anxiety
- Stress Management Techniques: Deep breathing, meditation, or yoga can help reduce stress. They are also great tools to help you calm down in anxious moments.
- Time Management: Learning to prioritize tasks and set realistic goals can help reduce the pressure that often fuels anxiety.
- Setting Boundaries: This involves learning to say ‘no’ to additional responsibilities and ensuring there is time for rest and self-care.
- Healthy Lifestyle Choices: Exercising and being more active, eating a healthy diet, and getting enough sleep are very important for mental health. Exercise, in particular, is a powerful way to manage anxiety.
- Building a Support Network: The support of friends, family, or a therapy group can provide emotional stability and a sense of understanding.
- Mindfulness and Relaxation Techniques: Activities such as mindfulness meditation or progressive muscle relaxation can help keep you grounded and reduce the intensity of anxiety symptoms.
When and How to Seek Professional Help
Sometimes it is hard to know when to seek professional help. However, it is an important step in managing high-functioning anxiety. If you are constantly feeling overwhelmed by anxiety, despite managing daily responsibilities, or if anxiety starts to significantly impact your work, relationships, or overall wellbeing, it is time to consider professional support.
Seeking help can begin with a conversation with your primary care physician. They can provide an ear for your worries and guide you toward a mental health expert, such as a therapist or psychiatrist who specializes in treating anxiety disorders. You can also reach out directly to therapists who focus on anxiety or cognitive-behavioral therapy.
Accepting that you may need help is an important step in dealing with high-functioning anxiety. It involves recognizing that your anxiety is not just a normal part of your personality or a necessary component of your success, but a condition that deserves attention and care.
One of the biggest hurdles in seeking help can be overcoming the stigma associated with mental health issues. Many people with high-functioning anxiety worry about being perceived as weak, especially if they are used to being seen as highly capable and in control. It is important to remember that having anxiety does not take away from your strengths or capabilities. Taking control of your health by seeking help reflects strength, not failure.
Overcoming stigma is vital. Mental health issues are common, and, just like physical illnesses, they are treatable. Seeking help is a positive, responsible action. There is an increasing recognition of the importance of mental health, and reaching out for support is seen as a proactive step towards a healthier, more balanced life.
You Are Not Alone
Remember, you are not alone in your journey with high-functioning anxiety. It is a path many walk, and there is a wealth of support and effective treatments available. Taking the brave step to seek help can be the start of a more fulfilling, balanced life. While the journey may have its challenges, it leads to a place of better understanding, management, and, ultimately, peace.
Embrace the courage to reach out and start transforming your anxiety into a stepping stone for personal growth and wellbeing. Take that step today. Reach out, seek support, and start your journey to a life where anxiety is a challenge you know how to manage, not a barrier to your happiness and success.
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