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What Lurks Beneath: High Functioning Anxiety

Most people experience some type of mental health issue or concern at some point in their lives. Many of those people are able to rebound & go on functioning, and it’s a temporary issue that they soldier through. However, for some people, mental health issues are chronic. They are something that needs to be contended with daily…and it can feel like an uphill battle, taking a toll on your energy and spirit. What’s worse is that sometimes the most “functional-looking” people on the outside are suffering miserably on the inside. This is the case for many people who are considered by most definitions as high functioning who struggle with intense anxiety on the inside.

If this resonates with you, let’s face it: some days are better than others, but for the most part you know you’ll make it through even if it’s exhausting. At the same time, it’s important to acknowledge to yourself how frustrating it can be that what you deal with seems invisible to other people. If you can’t relate to experience of anxiety, or you find your anxiety as being very debilitating, this blog is not meant to exclude you by any means. Your struggles are just as important and valid. This blog, however, focuses on the often invisible suffering of the person with high functioning anxiety—the very person who, on the outside, often doesn’t appear anxious at all.

What Does High Functioning Anxiety Mean? 

High functioning” simply refers to a person’s ability to meet their basic needs and “function” in society (most days). It may be the anxiety that feels like it’s on the verge of turning into a panic attack, but rarely does. It may feel like you’re so close to not making it into work, but you almost always manage to anywayThough “high functioning anxiety” is not a clinical diagnosis, it can be helpful to describe people’s experiences of struggling with anxiety but being able to carry out their responsibilities in most areas of their lives.

These individuals have probably experienced feeling invalidated when people point to how well they seem to be doing in life (e.g., with jobs, relationships, etc), and therefore they somehow can’t be that anxious. Having successes in other areas of their life does not signal that a person experiences no anxiety. In fact, it may actually be quite the opposite for those with high functioning anxiety. The anxiety they feel may be intensified the more they accomplish. So as you are congratulating them on some accomplishment they may secretly be petrified that you will see through their smile and identify some failing or weakness inside of them.

What Does High Functioning Anxiety Look Like?  

This can be tricky, because every individual is different and every experience can be unique. Below you will find several characteristics of high functioning anxiety, but please feel free to add your own experiences to this list.

What are the symptoms of high functioning anxiety?   
  • Feeling uncomfortable if not busy
  • Feeling worthless if not striving or succeeding
  • Irrational/unhelpful/hurtful self-talk
  • Intrusive thoughts
  • Repetitive behaviors/checking
  • Being very detail oriented
  • Liking to be in control of things/projects
  • Fear of failure
  • Exhaustion/loss of joy
  • Easily overwhelmed/frustrated
  • Losing time due to over-planning and arriving early
  • Fear of abandonment
  • People pleasing/have trouble setting boundaries
  • Over-explaining
  • Striving for perfection
  • Contending with imposter syndrome
  • Heart pounding & stomach clenching sensations in the body
  • Finding it difficult to breathe when you are caught off guard or stressed
  • Difficulty in sleeping or enjoying restful “down” time 

One of the reasons why high functioning anxiety gets overlooked and disregarded so often is because a lot of these characteristics can be viewed as purely good things, but like most things there is a cutoff point where it becomes too much. Being detail orientated on the outside seems like a really helpful thing, and it can be, but on the inside to an individual with high functioning anxiety it may actually entail agonizing over little details or rereading documents many more times than needed because you are afraid to make a mistake. Maybe even afraid to your core. The often laughed off comment about being “a little perfectionistic” or “that’s just my OCD” with organizing and task completion may be so out of control on the inside that it far throws off the benefits of these traits. In fact, it can lead to other’s interpretations that you are ideal for them to give more work and responsibilities to, which can intensity a feeling of drowning.

Where does high functioning anxiety Come From? 

Anxiety has many common root causes, and oftentimes it is at least partly due to early childhood or adolescent experiences or socialization. Anxiety can absolutely develop later in life for a variety of reasons, but a lot of times it has ties back to early developmental stages. This may be related to feeling as though you need to be perfect in order to be accepted or at least not to make waves. Maybe making any mistakes didn’t feel like an option because you didn’t want attention. So, you didn’t want to appear in need of any help. Sometimes trauma can lead to anxiety. This may manifest as overexplaining or people pleasing, which can stem from a childhood survival tactic of having to read the emotional temperatures of other family members. There may be some core beliefs you have about yourself and others that you aren’t even aware of that keep you stuck in a loop of anxiety. One example might be: If I’m not constantly busy, people will see me as worthless with nothing to contribute or just think I am lazy.

Coping Strategies for anxiety

It’s a journey to tame anxiety: what might work one day may not even touch your anxiety the next day. It’s finicky. Sometimes a situation won’t make you anxious and then a similar one feels unbearable a week later. So many things contribute to anxiety and its alleviation. Here are some things to consider as potential coping strategies.

  • Adequate sleep (do NOT underestimate this one)
  • Drinking enough water
  • Eating regular healthy meals throughout the day
  • Deep breathing
  • Thoughtstopping practices
  • Grounding activities
    • Meditation
    • Yoga
    • Mindful coloring
    • Tapping
    • Anything that brings you to the present
  • Exercising regularly 
  • Examining the core beliefs you have about yourself and others
    • Are they rational?
    • Where did they come from?
    • Are they helpful to you anymore?
  • Talking your thoughts/ fears through with other people
  • Practicing asking for help, saying NO or delegating. Start with small tasks and build up from there
  • Practice emotional time outs; times where you force yourself to DO NOTHING for 5-10 minutes at a time (that means no playing with your phone too!) 

Ongoing Help  

If you have high functioning anxiety, you are likely an independent ambitious individual. By nature, you are hardwired not to ask for help. However, it can be beneficial to get an outside perspective on what might be keeping you stuck in the loop of anxiety. You’ve likely been able to manage your anxiety well enough to succeed, but it’s likely that you can further reduce your discomfort with the help of a therapistSometimes it’s not enough to just be succeeding in various areas of life, you deserve to enjoy that success and that life as well. If you feel open and ready to start the process of challenging and reducing that internal anxiety, make an appointment with Angelus todayIts time to take the anxiety you experience and stop it from stopping you from enjoying life fully.

Blog Credit: Natalie Drozda, MA, LPC is a PH.D student in Counseling Education and Supervision at Duquesne University & therapist at Angelus Therapeutic Services