High Functioning Anxiety

High Functioning Anxiety: Signs, Characteristics, and Cure

High Functioning Anxiety

Many people deal with anxiety throughout their lives. Yes, some stress or anxiety may be beneficial in that it reminds us to be mindful of important things such as meeting deadlines for work or school or studying for exams.

But, when anxiety becomes too intense, then it is a problem, especially when it interferes with your daily life and your ability to thrive. For those with high functioning anxiety, it may not be as noticeable as other forms of anxiety.

You may appear calm and still go about your daily life in what appears to be a normal manner. However, your anxiety may seep out in a more subtle way.

Even though high functioning anxiety is not officially recognized as a clinical disorder, it can trigger chronic, and sometimes debilitating anxiety disorders.

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Often, those who suffer from high functioning anxiety may not be completely aware that they have this condition.

When this occurs, the stress and anxiety they experience deepens and they have difficulty recovering from it.

However, this type of anxiety is treatable and those who seek professional help and are focused on recovery can experience a significant improvement in their symptoms.

If you suspect that you or a loved one suffer from this condition, here is what you should know about high functioning anxiety.

1. What Is High Functioning Anxiety?

High functioning anxiety is not recognized as a mental health disorder yet.

Therefore, it is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Typically, high functioning anxiety has been used to describe people who have anxiety symptoms that, on the surface, do not impact their functioning.

Often, anxiety disorders make it challenging to complete tasks and achieve goals. Typically, people with anxiety may exhibit symptoms like worrisome thoughts that can lead to physical reactions.

Such reactions may include:

  • Racing heartbeat
  • Headaches
  • Restlessness
  • Agitation

People with high functioning anxiety may experience some physical symptoms of anxiety. But they’re able to function and achieve the goals they set in their lives.

They do not experience disruptions or impairments in their life functions. Because of this, they may not realize there is something wrong. A good example is a fear of poverty being the driver behind working exceptionally hard to become successful in their careers.

High Functioning Anxiety Causes

Causes of High Functioning Anxiety

An individual with high functioning anxiety may appear fine on the outside. Meanwhile, their heart is racing, they have gastrointestinal distress, and they experience intense feelings of doom.

But they are able to power through these feelings to overcome their anxiety while in public. But once they are alone, these same strong people may break down. 

Having to control strong emotions and constantly appear strong all the time is exhausting. It can require time alone or times of poor functioning to recover. As a result, other medical and mental health issues may develop.

Dangers of High Functioning Anxiety 

High functioning anxiety is often unnoticed because of its less obvious nature, leading to extreme challenges.

The dangers of not recognizing high functioning anxiety include:

  • Heart Issues

There is a causal link between anxiety, heart disease, and related health issues.

Studies acknowledge that people with anxiety have a higher risk for heart attacks [1*] and other related health problems. Untreated anxiety for significant issues may make you vulnerable to heart disease.

  • Gastrointestinal Issues

Problems such as upset stomach and nausea are common in people with anxiety. Gastrointestinal distress can become worse if the anxiety goes untreated. Unnoticed and prolonged high functioning anxiety could cause problems related to the gut.

  • Respiratory Issues

Difficulty breathing is another common physical symptom associated with anxiety. This inability to breathe properly puts stress on other body functions that require adequate oxygen to work properly.

Researchers have found evidence that anxiety may lead to respiratory issues [2*] .

  • Drug Dependence

People with untreated high-functioning anxiety are also more likely to develop substance dependence.

It is common for people who suffer from untreated mental illnesses to self-medicate with alcohol and narcotics. Therefore, anxiety disorders commonly occur with substance use issues.

  • Chances of Remaining Undiagnosed

People with high functioning anxiety often struggle with the fact that other people don’t understand their condition, including their friends and family.

While a person with high functioning anxiety might appear to be the epitome of success, others don’t see that beneath a seemingly perfect exterior, they’re fighting a constant churn of anxiety.

  • It Can Make You Feel Ungrateful

High functioning anxiety can appear as negative self-talk or dissatisfaction from one’s own performance. Vocalization may happen inside your head that tells you you’re not good enough.

This could make it difficult to know what to do with a compliment. You may become skeptical, and that reluctance builds self-doubt.

However, when it comes to negative feedback, you believe everything you hear and absorb it like a sponge without hesitation.

This is because anxiety has a way of turning your opinions about yourself inside out and upside down. 

Causes of High Functioning Anxiety

Medical professionals still haven’t determined the causes of high functioning anxiety because of a lack of research in this area. Regardless, there could be many ways anxiety disorders present in people. 

Although experts do not fully understand or agree about the causes of anxiety disorders, it is believed that they likely occur due to a combination of factors, such as: 

  • Genetics

Those with a family history of anxiety disorders or other mental health conditions are more likely than others to develop anxiety.

  • Personality

The risk of having an anxiety disorder is increased when there are personality traits of shyness or nervousness in new situations.

  • Exposure to Stress

Experiencing stress or trauma can trigger anxiety.

  • Other Health Issues

Underlying physical health concerns, such as thyroid disorder or heart problems, can trigger or worsen anxiety symptoms. Having another mental health disorder is also a risk factor for an anxiety disorder.

  • Drug or Alcohol Use

Misuse or sudden withdrawal of drugs and alcohol can trigger anxiety-related symptoms. 

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2. Recognizing the Signs of High Functioning Anxiety

Unlike some other mental disorders, the symptoms of high functioning anxiety are not easy to spot. A person with high-functioning anxiety might appear as the epitome of success to their peers.

They are always on top of things with being prepared, organized, and presentable.

However, what people don’t see behind the facade is that a person suffering from high functioning anxiety is driven by crippling fears of self-doubt and failure. 

Here are 12 common scenarios that people with high functioning anxiety may experience: 

1. You Cancel Plans too Often

You look forward to events and get-togethers with friends. However, you often decide not to go at the very last minute when the day finally arrives despite looking forward to it for so long.

The thought of going to any event fills you with worry and dread. Therefore, you talk yourself out of going.

2. You Are Uncomfortable Meeting New People

You don’t have to be shy or introverted to be uncomfortable with meeting new people. It is possible that mingling and being social just aren’t your thing in settings with people you don’t know.

Sticking to your close-knit group of friends is more comfortable for you. Introducing yourself or being introduced to new people makes you feel self-conscious.

You may worry about making a good first impression. And this worry is so intense that you do not enjoy meeting anyone new.

3. You Don’t Like Waiting for Responses

Do you feel anxious from the moment you send someone a text or leave a voice message until you receive a response?

You may start counting the seconds you wait. And the longer you wait, the more anxious you become.

You overthink why you haven’t received a response yet and conclude that you must have done something to upset the other person.

4. You Sleep Very Little

Medical experts tell us that we need eight hours of sleep to be healthy, but not all of us do.

Can you remember the last time you got eight hours of sleep in one night?

It could be possible to attribute your early morning awakening to anxiousness. Anxiety can keep you from having a restful night of sleep and keep you up at night as thoughts race through your mind.

Being shortchanged on both ends is why sleep deprivation is a common complaint amongst those who suffer from high functioning anxiety.

High Functioning Anxiety Signs

Symptoms of High Functioning Anxiety

5. You Fixate on the Tiniest Details

Are there things that keep you up at night, or have you fixated on the most minor of details?

For example, why did a friend simply reply okay to the long text you sent them, or maybe you remembered you forgot to say thank you to someone who offered you help.

Logically you know this isn’t going to majorly impact your life. Your friend may have been busy when you texted and the waiter you forgot to thank likely won’t remember you.

Still, this type of fixation is common for people with high functioning anxiety, including obsessing over the most trivial things, especially social interactions.

They tend to analyze everything and spend hours and hours wondering what it could all mean and why?

6. You Can Get Hung Up on Old Conversations

People with high functioning anxiety may find themselves playing back old scenarios in their heads.

They think about different actions they could have taken or not taken, such as things like maybe I shouldn’t have texted him/her or maybe I should have given that witty reply.

High functioning anxiety makes you overthink every single social interaction you’ve ever had, big or small. No matter how long ago the interaction occurred, it’s fairly uncommon for people to let go of the past.

7. You’re Unforgiving to Yourself

Do you beat yourself up when you make a mistake?

High functioning anxiety can sometimes resemble perfectionism. It can turn us against ourselves whenever we mess up.

The anxiety makes that mistake bigger in your head than it really was. Therefore, it is difficult to get over it. 

8. You Compare Yourself to Others

To some extent, it’s normal to compare yourself to others. But if you have high functioning anxiety, you might take that to an extreme.

You might have concerns about:

  • How you measure up against your peers
  • Worrying that you’re not living up to your potential
  • You feel like it is never enough no matter how much you accomplish

9. You Are a Constant People Pleaser

Is your well-being suffering because you work so hard to make others happy?

Do you believe you won’t be good enough until you make everyone in your life happy? You may have convinced yourself that the only way you will be accepted is if you go above and beyond what is expected of you all the time.

10. You Need to Keep Yourself Busy

Do you find it difficult to just enjoy sitting doing nothing? Or do you try to occupy yourself with just about anything when you are free?

If you are not active, you feel restless and tense. You might find yourself doing tasks to busy yourself while not being necessarily productive.

Tasks like reorganizing your organized cupboard or cleaning your perfectly working computer fan with a toothbrush are possible scenarios of such behavior.

You don’t mind doing anything as long as it gives you a break from your anxious thoughts.

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11. You Get Very Anxious Whenever You Think About the Future

Looking forward to the future is typically a source of hope for most. But for others, it can bring pessimism.

This could be a sign of high functioning anxiety when thinking about the future fills you with fear and dread.

These fears can be paralyzing as you worry about the unknown and what’s not in your control. It can keep you from living your life to the fullest because you always expect the worst to happen.

12. You Always Focus on the Worst-Case Scenarios

Focusing on worst-case scenarios (aka catastrophizing) happens to many people at some point in their lives.

It might be a result of previous trauma that you can’t shake. Or it could be linked to mental health issues including anxiety or chronic depression.

Catastrophic thinking actually makes things worse, because our unconscious mind doesn’t distinguish emotionally between what we imagine and what really happens.

3. High Functioning Anxiety Test

Here’s a short quiz to measure whether you are vulnerable to high functioning anxiety.

However, remember that mental health conditions should only be diagnosed by mental health professionals.

This test is not meant to be a diagnostic tool, it is meant to be an assessment tool. Assessment can be a valuable first step toward getting treatment.

Score Key

Every Yes has a value of 1 and every No has a score of 0. A score of six or more will indicate the likelihood of high functioning anxiety.

  Yes No
Do you worry a lot about everything going on in your life?    
Do you have trouble controlling your worry?    
Are you a people pleaser?    
Do you get irritable and/or easily annoyed when anxious?    
Do you worry about your future more than required?    
Do you like being always busy at work?    
Do your compare your accomplishments with others?    
Do you overemphasize even the tiniest details?    
Do you worry about how well you do things?    
Do your muscles get tense when you are worried or anxious?    
Do you find it hard to sleep at night because you’re worried about things that you need to do tomorrow?    

4. Characteristics of High Functioning Anxiety

There are both positives and negatives to having high functioning anxiety. A person with this condition may appear as outgoing, initiative-taking, organized, passionate, loyal, and overachiever.

Being detail-oriented further enhances their job performance and can build trust among their colleagues and peers.

However, high functioning anxiety can present challenges like insecurity, racing thoughts, nervousness, and behaviors like overthinking, insomnia, and people-pleasing.

Here is a breakdown of positive and negative characteristics that those with high functioning anxiety might exhibit.

The negative traits of high functioning anxiety such as mental fatigue can be treated- Click below to get professional help.

Positive Characteristics

  • Passionate, giving 100% in tasks
  • Proactive planner
  • High achieving
  • Tidy and orderly
  • Detail-oriented
  • Diligent
  • Helpful

Negative Characteristics

  • People-pleasing for fear of driving people away
  • Nervous habits, such as:
    • Playing with your hair
    • Cracking knuckles
    • Biting lip
  • Overthinking
  • Limited social life, often turning down invitations
  • Rumination often tends to dwell on the negative aspects of things
  • Fearful of the future
  • Keeps overly busy/full schedule and cannot say no to others
  • Potential for alcohol or substance abuse
  • Racing mind
  • Mental and physical fatigue

Other Functional Characteristics of High Functioning Anxiety

High functioning anxiety impacts sufferers’ lives with the following functional characteristics.

  • It’s Not Easy to See

It is common for someone with high functioning anxiety to appear very driven and successful.

Your anxiety makes you appear efficient when you always deliver your work on time. You are always immaculately dressed, never late to work or meetings, and seem to have an endless amount of energy.

But what people don’t see is the crippling anxiousness that creates your drive for success. Nobody thinks anything is wrong because you always perform at such a high level.

Therefore, additional stress is on you because then you can never appear unprepared.

  • It Causes Intense Stress

With high functioning anxiety, you can feel stressed even when there’s no reason to be. For instance, consider what happens if your boss gives you a deadline.

Your brain may immediately go into overdrive, as you begin to worry about managing your time and what could go wrong and prevent you from completing the task on time.

And if you did an excellent job, your boss may then assign you additional tasks. And again, the stress cycle begins and instead of feeling a sense of accomplishment, you spiral into a continuous web of stress.

  • You Can’t Say No

As mentioned earlier, someone with high functioning anxiety may fear being asked to do something because they can’t seem to say no. You might tend to have impossibly high standards, which cause you to take on more than you can handle.

Because of this, you could struggle to say no to work projects, social plans, or helping a friend, even when you are already stretched thin. The problem lies in you choosing the strain of exhaustion over the dread of letting someone down.

High Functioning Anxiety Negative Symptoms

Negative Characteristics of People With High Functioning Anxiety

  • You Have Difficulty Asking for Help

When performing at a high level, you might not see that anything is wrong.

Meanwhile, your external success masks your internal stress.

You might not even realize you need help or if you do, you may be hesitant to ask for help. Just chatting with a friend or asking for help could significantly alleviate the tension you build up inside. 

  • It Takes Control of Your Life

High functioning anxiety can control many aspects of your life without you realizing it. It may cause you to create strict routines from which you can’t deviate.

These compulsive habits can mislead you to believe that you are in control of your life.

However, things like missing a single workout or using the wrong color highlighter can throw you into a full-blown meltdown. In actuality, your habits hold you and those around you captive.

Finding ways to gently break these habits can help break the grip that this anxiety has on you.

5. High Functioning Anxiety and Depression

Anxiety and depression often pair up as one of the most frequent comorbid mental health disorders. It is typical for people with high functioning anxiety to experience both depression and anxiety at the same time.

However, it is hard to spot, even for those with both to recognize they are anxious and depressed.

This is because the stereotypical image of depression or anxiety doesn’t match up with what people living with high-functioning anxiety and depression present themselves.

The constant anxiety acts as an energizer for sufferers of high functioning anxiety and depression and drives the person towards achieving their goals.

But, when alone, the symptoms of depression emerge as feelings of self-doubt and self-criticism, fatigue, helplessness or guilt, moodiness, and a desire to avoid interaction with others intensify.

High Functioning Depression Vs. High Functioning Anxiety

Depression and anxiety are not the same conditions. Depression is a feeling of sadness and is indicated when someone persistently feels down or disappointed. Alternately, anxiety is marked by nervousness, feelings of gloom, and overwhelming irritability. 

Depression is primarily divided into two categories:

  • Major depressive disorder (MDD)
  • Persistent depressive disorder (dysthymia)

Although the signs and symptoms of both are similar, there is a difference in the intensity and duration of each.

The prime symptoms of both major depressive disorder and dysthymia include:

The symptoms of dysthymia are usually considered milder than those of major depressive disorder and do not typically cause disruption of life function.

Therefore, many mental health professionals consider high-functioning depression to be a form of dysthymia.

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Recognizing the Signs of High Functioning Anxiety and Depression 

Often the signs of high-functioning anxiety and depression are not noticeable.

For instance, a person may be doing their job well or having a relationship. However, they do experience disruptions in life activities that may not be so obvious to themselves or others.

Some of these hidden disruptions can be seen in behaviors such as declining social invitations with the excuse that they are busy or stressed with work, sleeping less or more, and an overreliance on coping mechanisms like excessive exercise, overeating, or overindulging in alcohol or illicit substances.

The signs of high-functioning anxiety and depression may include:

  • Pervasive self-criticism
  • Excessive worry or guilt over past or future decisions
  • An inability to slow down or to feel absolute joy

Just like other forms of anxiety and depression, these symptoms of high functioning anxiety and depression will get worse with time if not treated. 

Possible Complications of High-Functioning Anxiety and Depression

Most patients with high functioning anxiety and depression do not seek treatment. Unfortunately, when left untreated or unnoticed these conditions can diminish a sufferer’s life to the point where they are surviving rather than thriving.

The worst complication of chronic high-functioning anxiety and depression is that it can lead to a variety of other medical and mental health issues when left untreated.

Additionally, research has shown a correlation between mental health disorders and chronic illness.

Changes in body system/function caused by mental illness over a prolonged period of time include fluctuations in:

  • Heart rate and circulation
  • Increased inflammation in the body
  • Metabolic changes
  • Irregularities with stress hormones

When left untreated, high functioning anxiety and depression can also lead to other serious mental health issues like panic attacks and major depressive disorder.

6. Misconceptions About High Functioning Anxiety 

At this point, you’ve gained insights into what high functioning anxiety is.

But it is also essential for you to understand what it isn’t. It is common for people to confuse high functioning anxiety with other forms of stress.

Due to its less obvious nature or symptoms, high functioning anxiety is often misunderstood or underestimated.

Most people assume that those afflicted are just stressed out at work, need a vacation, or have some other condition that is causing their discomfort. In reality, they are suffering from high-functioning anxiety.

High Functioning Anxiety Positive Traits

Positive Traits of People With High Functioning Anxiety

Here are some facts you need to know to clear any misconceptions you may have about high functioning anxiety.

  • It’s Not Generalized Anxiety Disorder (GAD)

Generalized anxiety disorder (GAD) is an anxiety disorder that is marked by excessive, exaggerated anxiety and worry about everyday life events for no apparent cause.

For example, people with symptoms of generalized anxiety disorder tend always to expect the worst. They also can’t stop worrying about health, money, family, work, or school. 

High-functioning anxiety is not a generalized anxiety disorder. And the lack of an official diagnosis does not imply that it doesn’t fall under the umbrella of anxiety. Although it is a mild form of anxiety, high functioning anxiety has a specific concern or object to be anxious about, unlike GAD.

  • It’s Not Obsessive-Compulsive Personality or OCD

OCD is characterized by obsessive, intrusive thoughts, as well as compulsive behaviors that are used to help manage those thoughts. Having an obsessive-compulsive personality or obsessive-compulsive disorder tends to lead to:

    • Excessive orderliness
    • Perfectionism
    • Great attention to detail

People with high functioning anxiety are often considered perfectionists. No matter how unrealistic their expectations are, they demand consistent excellence from themselves. As a result, they are seldom satisfied with their performance. And they don’t feel deserving of the praise they receive. But that does not mean high-functioning anxiety and OCD are the same.

The primary difference between OCD and high functioning anxiety is compulsive behaviors.

An OCD patient satisfies their anxiety by performing repeated compulsive tasks. Meanwhile, a person with high functioning anxiety does not perform any compulsive acts.

  • It’s Not Social Anxiety

Social anxiety disorder, also known as social phobia, is a mental health condition. It is an intense, persistent fear of being watched and judged by others. This fear can affect your work, school, and other day-to-day activities. It can even make it difficult to make and keep friends.

People with high-functioning anxiety can be friendly, accommodating, and quick to offer praise to their co-workers. But at times, they will seem overly serious, unable to relax and be themselves.

This happens because people with this condition are constantly worried that they will be rejected or judged for their work performance, personalities, or social abilities (or lack thereof).

That could cause others to believe that the person with high functioning anxiety either has a superiority complex or social anxiety

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7. Treating High Functioning Anxiety 

With high functioning anxiety, your successes are never enough to calm your fears. While you struggle with your anxiety internally, you are still doing pretty well externally. You probably have very high expectations and standards for yourself.

But it all comes at the expense of putting your needs last and focusing on:

  • What is most important at work
  • Saying yes to others
  • Aiming higher with your goals
  • Achieving even more

Inherently, these aren’t terrible things to focus on. In fact, most of these are good things, but the problem comes when your behaviors are driven by fear and insecurity, rather than feeling whole from within.

Here are some tips and coping strategies that you can practice in beginning to address your high functioning anxiety.

Remember How Unique and Amazing You Are!

You may have so many incredible strengths that you don’t even realize. Whenever you compare yourself to someone else or fear that you are not good enough, you are way too hard on yourself.

Stop beating yourself up and instead, practice making a list of your strengths and identifying all the amazing qualities you have.

If that seems hard, that’s ok. It can be hard to identify your strengths when you don’t have practice doing that.

Some good examples of your strengths may include:

  • Thoughtful
  • Organized
  • Loyal
  • Committed
  • Detail-oriented
  • Intelligent

Write all your strengths down and put them somewhere where they can serve as a reminder when you are feeling unsure.

Practice Self-Compassion and Speak to Yourself as You Would to a Friend

You may have learned to be hard on yourself at some point in your life as a way of motivating yourself and avoiding failure. But being hard on yourself does not make you do or feel better. It makes you feel worse.

Change the way you talk to yourself. An easy way to practice this is to talk to yourself the way you would speak to your friend. Think of a struggle you’re currently going through.

Consider how you’re currently speaking to yourself about this struggle. Now think about what you would say to a friend who might go through the same struggle.

Coming from a place of compassion and extending that to yourself can be transformative in coping with high functioning anxiety.

High Functioning Anxiety Treatment

How to Manage High Functioning Anxiety

Give Your Body the Rest It Needs

It’s so easy to push through the signs that your body gives you telling you that it’s time for a break.

These signs can look like this:

  • Tiredness
  • Headaches
  • Muscle tension
  • Hunger
  • Difficult emotions like:
    • Anxiety
    • Irritability
    • Frustration

These signs do not mean that you are not good enough and you should keep going. It’s not a reflection that something is wrong with you or who you are as a person. It just means you are human.

Start listening to the signals your body is giving you, whether they are physical or emotional. Practice tuning into yourself and what your body is telling you.

Release Tension Through Physical Relaxation

Anxiety is very physical.

Among other symptoms, you might experience:

  • Difficulty breathing
  • Jaw tension
  • Muscle tightness
  • Twitches
  • Increased heart rate
  • Headaches

Practice taking deep breaths and intentionally releasing the tension that you may sometimes be unaware of building up in your body.

The following relaxation techniques can help you attain physical relaxation:

1. Progressive Muscle Relaxation

It helps you focus on the difference between muscle tension and relaxation. You then become more aware of physical sensations. One way to practice muscle relaxation is to start by tensing and relaxing the muscles in your toes.

Then progressively work your way up to your neck and head. You can also start with your head and neck and work down to your toes. Begin by tensing your muscles for about five seconds and then relax for 30 seconds and repeat.

2. Deep Breathing

Most people take short, shallow breaths into their chest. This can make you feel anxious. Instead, try practicing deep breathing regularly.

    • Sit comfortably
    • Inhale through your nose
    • Fill your belly with air
    • Hold it for a few seconds
    • Now exhale through your mouth

Professional Help

If you think that you cannot control your high functioning anxiety on your own, it may be time to consider getting professional help. The following treatment options could help.

1. Psychotherapy 

Also called talk therapy, it can be very useful for people with high functioning anxiety. This type of therapy challenges unhelpful thoughts and beliefs that can lead to stress and self-destructive behaviors. 

2. Medication 

When used in combination with other therapies, anti-anxiety medication and antidepressants can be very helpful in controlling anxiety symptoms.

Only a health professional can prescribe you the best medication for your condition. Consult with a health professional before using any medications for your anxiety symptoms

3. Create a Support Network 

A support network could involve getting support from a close loved one, friend, relative, or co-worker. Having someone close that understands you, can help with the everyday feelings associated with high functioning anxiety.

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Bottom Line

High functioning anxiety is something that is challenging to understand.

If you believe you have it, don’t try to ignore it. Instead, talk about it or get professional help because ignoring it could only make it more detrimental to your mental and physical health.

Recognizing your condition and seeking support for it will prevent your anxiety from getting worse.


+2 sources
  1. Anxiety disorders and cardiovascular disease. (2016)
    Source link
  2. Panic anxiety, dyspnea, and respiratory disease. Theoretical and clinical considerations. (1996)
    Source link

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Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of experts strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.