May 23, 2023

By: Cathy P.

In a world that admires success, confidence, and productivity, it’s easy to assume that someone who appears to have it all together is free from any internal darkness or struggles. However, beneath the surface, many people battle a silent but traumatizing condition: high-functioning anxiety. Those living with high-functioning anxiety face a unique set of challenges, since their internal battles unfold behind smiles and achievements, carefully concealed from those closest to them. High-functioning anxiety has both positive and negative characteristics. While some of the positive qualities may appear as strengths (such as being able to handle daily tasks well), it’s not to discount the inner struggle the person may be experiencing. It can be for those very reasons that someone doesn’t seek help or endures anxiety in silence (1). It’s important to shed light on a condition that people often suffer with in silence.

According to the National Alliance on Mental Illness, more than 40 million adults in the US have an anxiety disorder. (5) High-functioning anxiety is not officially recognized as a distinct mental health disorder, but rather a term used to describe individuals who outwardly appear successful and in control, yet experience intense internal despair. There is a distinct difference between generalized anxiety and high-functioning anxiety. With generalized anxiety, an individual might try to remove themselves from an anxiety-provoking situation. They take the “flight” path of the “flight or flight” response. However, the individual with high-functioning anxiety tends to take the “fight” path, and push themselves to work harder in order to combat the anxiety (4). These people may excel in their professional lives, maintain relationships, and engage in various social activities, while silently battling crippling anxiety.

While high-functioning anxiety manifests differently in each person, there are common symptoms that are often experienced (2).

1. People pleaser: fear of driving people away, fear of letting others down

2. Talking a lot, nervous manic chatter

3. Nervous habits (playing with your hair, knuckle cracking, lip biting)

4. Need to do repetitive things (counting stairs, rocking back and forth)

5. Lost time (arriving too early for appointments)

6. Need for reassurance (asking for directions multiple times or checking on others frequently)

7. Procrastination followed by long periods of manic non-stop work

8. Insomnia (difficulty falling asleep or waking early and being unable to fall back to sleep)

The causes of high-functioning anxiety may stem from a combination of genetic, environmental, and psychological factors. Some specific causes may include (1):

- Family history of anxiety disorders

- Exposure to negative or stressful life events

- Certain physical health condition like thyroid issues

- Shyness or nervousness traits from childhood

- Achieving high levels of success in a short amount of time

Recognizing and seeking treatment for high-functioning anxiety is crucial for overall well-being. Some of the most effective courses of treatment include psychotherapy, medications, and stress and relaxation techniques (5). Cognitive-behavioral therapy (CBT) can help people understand and manage anxiety symptoms. Lifestyle changes like regular exercise, mindfulness, and relaxation techniques can prove effective. Prioritizing self-care, setting realistic expectations, and maintaining healthy boundaries are essential in maintaining mental well-being. Connecting with supportive friends, family, or support groups can provide a sense of belonging and understanding. Sharing experiences and seeking support can be empowering and therapeutic. If you think you may need treatment, speak to your doctor about which treatment method might be best for you (1).

High-functioning anxiety is an often overlooked and misunderstood condition. People who seem to have it all together may silently struggle with overwhelming internal agony. By understanding the symptoms, causes, and available treatment options, we can foster empathy, support, and encourage those battling to seek help. Don’t just get by with your anxiety, get help. Even if you’re excelling at work or at home, you are doing so at the expense of your overall health and well-being. Being overworked and overwhelmed isn’t a badge of honor. (4) Living with high-functioning anxiety demands strength and resilience. Prioritize self-care, seek professional guidance, and surround yourself with a supportive network. Remember, your mental health matters!