August 16, 2021

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Caitlin Harper

What Is High-Functioning Anxiety?

People who struggle with high-functioning anxiety might present as very put-together externally. They might do well at their jobs, at sports, at relationships, and in other areas of their lives, but inside, they’re fighting an internal battle and churn of anxiety. While high-functioning anxiety is not its own separate diagnosis, if you have anxiety, it can be helpful to build self-awareness about what triggers your anxiety, how it manifests, and how you can cope, even when you might appear to everyone else like you have everything figured out.

Successful. In control. Confident. Busy. Driven. At first glance, why would anyone assume someone with these traits had anxiety? But if they pulled back the curtain, they would see that the success and drive are fueled by a fear of failure. The confidence is a projection to mask a tendency to dwell on every single detail of your day. The busyness is a result of the fact that you never feel like you’ve done enough and yet you can never rest or relax. And the control is an effort to avoid discomfort and eliminate any possibility of making a mistake.

Even though these traits might not be what we think of when we hear the word “anxiety,” they can be—for people who have high-functioning anxiety.

People who struggle with high-functioning anxiety might present as very put-together externally. They might do well at their jobs, at sports, at relationships, and in other areas of their lives, but inside, they’re fighting an internal battle and churn of anxiety.

Anxiety is a normal part of life, but when someone has an anxiety disorder, it involves more than temporary worry or fear. For a person with an anxiety disorder—which includes generalized anxiety disorder, panic disorder, and various phobia-related disorders—the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.

While high-functioning anxiety is not its own separate diagnosis, if you have anxiety, it can be helpful to build self-awareness about what triggers your anxiety, how it manifests, and how you can cope, even when you might appear to everyone else like you have everything figured out.

What are the signs and symptoms of high-functioning anxiety?

Because high-functioning anxiety is actually anxiety, the signs and symptoms are going to be similar:

  • Feeling restless
  • Feeling tired
  • Difficulty concentrating or losing your train of thought
  • Irritability
  • Muscle pain, tightness, or soreness
  • Difficulty sleeping—including falling asleep, staying asleep, and/or being rested

You might also:

  • Have nervous habits, like tapping, checking behaviors, or nail or skin picking
  • Hold tension in areas of the body like the jaw or back
  • Have a feeling of extreme overwhelm

Because of the nature of high-functioning anxiety, the signs and symptoms might express in additional ways that are more in-line with our sense of being high-functioning.

How does high-functioning anxiety show up in our actions?

“Many people with high-functioning anxiety fear disappointing others,” Caity Thompson, a therapist and MyWellbeing community member said in a recent MyWellbeings Small Talk. “Their schedules will be way overloaded. They take on way more things than they can so that they’re constantly doing things. At the same time, they struggle with fears of failure, so they feel like they’re never doing enough, causing them to continue to overload their schedules.”

People with high-functioning anxiety also frequently overthink things. They might try to constantly plan out every question they might be asked in a meeting so they’ll be as prepared as possible. They also might review conversations that they’ve had with people, looking for mistakes and errors, just to guarantee that they won’t make those mistakes again.

This overthinking might impact their sleep. They might struggle to fall asleep and might wake up in the middle of the night with racing thoughts that they just can’t stop.

“The big thing to remember about anxiety is that it’s very fear-driven,” Caity said. “Part of the reason that people with high-functioning anxiety excel so much is that they might be afraid of failure. But while anxiety can propel us to do a lot of things, at a certain point, there’s diminishing returns, such as when it’s getting in the way of us sleeping or when we’re never able to relax. It’s impossible to just keep going all the time.”

“I love to use the metaphor of an axe,” she said. “If I chop wood for eight hours, I’m going to get a lot less wood than if I chopped wood for two hours, then took the time to sharpen the blade, then continued. We need to be able to sharpen the blade and turn the mind off sometimes.”

People with high-functioning anxiety might also build very controlled lifestyles so that they avoid things that make them uncomfortable. This avoidance of things that make them uncomfortable can also lead to procrastination or decision paralysis. It’s difficult for people with high-functioning anxiety to make decisions when they have an extreme fear of making mistakes or errors, they’re very uncomfortable with uncertainty, and will do anything they can to avoid that discomfort and uncertainty.

“An important thing to remember about not making a decision is that avoiding making a decision is actually making a decision,” Caity said.

How can I cope with high-functioning anxiety?

People with high-functioning anxiety often avoid seeking treatment or getting help for a number of reasons. Because they are so successful in other parts of their lives, they might believe that they should be able to handle their anxiety on their own or that they don’t “deserve” help at all.

They might also be afraid that if they treat the “negative” parts of their anxiety, they might lose the “positive” parts as well, such as their drive, work ethic, or attention to detail. Often, they think everyone feels the way they do, especially when they are surrounded by other successful people or that they should hide their “failure” to cope with stress, since they don’t see other successful people exposing their feelings of anxiety either. They might also think that they won’t be taken seriously, since they have hidden their feelings of anxiety so well and don’t present as a typically anxious person to the outside world.

With all of these barriers to seeking help, what can someone with high-functioning anxiety do?

The best first step is recognizing that you have anxiety

Just because you have it all together, doesn’t mean you don’t have anxiety. If you’ve already been diagnosed with anxiety, work with your healthcare provider to figure out the best treatment for you. If you haven’t been diagnosed, get assessed by a mental health professional. Even if you don’t meet the full criteria for an anxiety diagnosis, you can still work with a therapist or get other forms of treatment to help with your symptoms.

Even before you seek treatment, there are methods you can use to cope. Start to notice your triggers and how your anxiety or anxious feelings manifest in you. Do you hold tension in your body or have habits like grinding your teeth or picking at your skin? When do these seem to come up the most or what situations appear to set them off?

You can also practice mindfulness

When your mind is constantly racing, slowing it down for even a few minutes can have a big impact. While it might not seem like pausing for just a few minutes could possibly help, if you make it a practice it will change the way your brain reacts to those stressful situations. And if you build that muscle and are able to use it before triggers set you off, you’ll have a powerful coping mechanism that you’ll be able to rely on to practice preventative self-care.

Identify the things you both can and can’t control

Make a list or journal about what is making your mind race or what is keeping you up at night. Be honest with yourself about whether you can or can’t control the things you are stressing about. Realizing that you can’t control everything can be scary, but coming to that realization will also allow you to put your energy toward the things that you can control and start to release the things that you can’t control from your mind (and hopefully the tension in your body will follow).

Seek support from others

You don’t need to suffer alone! You can find a friend, family member, or coach to talk to about what is going on or get support from a therapist. There are a number of ways to treat anxiety, and a combination of different ways can be most effective. You can try therapy like Cognitive Behavioral Therapy (CBT), support groups where you can connect with other people who have the same or similar experiences to you, or medications like selective serotonin reuptake inhibitors (SSRIs).

Even though your anxiety might be high-functioning, it can still have a huge impact on your life. Just because there are positives to your anxiety doesn’t mean you have to suffer through the negatives. There are ways to keep your sense of drive and celebrate your success while coping with the negative impacts of your symptoms and living a full (and restful) life.

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About the author

Caitlin is MyWellbeing's Content Lead, a writer, speaker, communication coach, and the founder of Commcoterie, a communication consultancy. She teaches teams how to use professional coaching communication techniques in their everyday conversations, helps leaders engage their teams with effective and inclusive communication, and partners with service providers to activate their programs and offerings with their own clients through inspiring communication strategies. Find out more, including how to work with her, at www.commcoterie.com.

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