Unmasking "High-Functioning" Anxiety

The fast-paced nature of today keeps many of us moving around-the-clock. From school endeavors to career deadlines, romantic relationships, to the demands of parenthood, we’re often pulled in countless directions. But for some it's a different kind of "busy"....

CONSTANTLY busy. Perfectionistic. Juggling a hundred different projects and responsibilities. Constantly scanning the future and laying the plans and groundwork for what you want or don’t want to happen. Feeling motivated and pulled forward by the hot energy coursing inside of you. Being described as super Type A. Having a mind that races and obsesses over your to-do list if you accidentally wake up at 4 in the morning. Covering up your daily anxiety with overthinking, overdoing, over-performing, over-preparing, over-everything…
— Annie Wright, LMFT

Each task is often accompanied with its own goal or expectation of achievement. However, many do not account for the anxiety that is attached with such high demands. For some, the overlooked anxiety becomes a persistent part of day-to-day life. Those fitting this description are often considered to have high-functioning anxiety. Visually, this is the person who experiences symptoms of anxiety; excessive worrying, racing thoughts, difficulty sleeping, yet they (or you) still find ways seemingly successfully navigate through life (or at least certain parts of life).

While some anxiety or good stress (eustress) can be motivating, too much can begin to affect one’s quality of life. Recognizing such symptoms and implementing healthy coping skills can be key. Know, there is a difference between thriving and surviving.


What is High-Functioning Anxiety?

Unlike generalized anxiety disorders, there is no clinical diagnosis for high-functioning anxiety.  Affecting roughly 40 million adults, anxiety disorders are the most common mental health issue in the United States. And “high-functioning anxiety” may be particularly common for ambitious, young, professional Millennials, Xennials, Gen-X’ers living in the Baltimore-Washington Metro Area or in other major urban areas.

So what does someone experiencing high-functioning anxiety look like? VERY similar to someone suffering from GAD. A person suffering from “anxiety-like” symptoms has the capability of managing day-to-day tasks. These individuals are the friends or loved ones who appear to always “have it together” in any event. They are the individuals that are never asked, “Are you okay?" because everyone knows they are go-getters. 

Beyond the poker face portrayed on the exterior, these individuals are feeling anything but poised and fine on the inside.

A study conducted by the National Institute of Mental Health referred to high functioning-anxiety as, “silent anxiety attacks, hidden by smiles”. Participants of the study shared similar negative characteristics such as overthinking, need for reassurance, and external validation. In addition to a sometimes limited (free-flowing) social life, and overly busy work/school schedules; most likely due to fear of saying NO or due to elements of FOMO

Positive characteristics were also identified among participants. These are the successes that onlookers often observe, unknowing that the individual is suffering. Many participants exhibited outgoing, high achieving, detail-oriented, and proactive personalities.

Do you identify with any of these characteristics?


15 Signs of High-Functioning Anxiety - from Psychology Today

1. You’re always prepared.

Your mind frequently jumps to the worst-case scenario in any given situation. As a result, you may find yourself over-preparing. For example, you might pack underwear and makeup in both your checked luggage and your carry-on, just in case the airline loses your suitcase. People see you as being the reliable one — your preparations often do come in handy — but few people (if any) realize that your “ready for anything” mentality stems from anxiety.

2. You may be freaking out on the inside, but you’re stoic on the outside.

Interestingly, many people with high-functioning anxiety don’t reveal just how nervous they are, which is another reason why it’s often a secret anxiety. You may have learned to compartmentalize your emotions.

3. You see the world in a fundamentally different way.

Your anxiety isn’t just "in your head.” Researchers from the Weizmann Institute of Science in Israel found that people who are anxious see the world differently than people who aren’t. In the study, anxious people were less able to distinguish between a safe stimulus and one that was earlier associated with a threat. In other words, anxious people overgeneralize emotional experiences — even if they aren’t threatening.

4. You constantly feel the need to be doing something.

This can be a real problem if you’re an introvert who needs plenty of downtime to recharge. This doesn’t necessarily mean you’re attending lots of social events; instead, you may feel a compulsion to always be getting things done or staying on top of things. Staying busy distracts you from your anxiety and gives you a sense of control.

5. You’re outwardly successful.

Achievement-oriented, organized, detail-oriented, and proactive in planning ahead for all possibilities, you may be the picture of success. The problem is, it’s never enough. You always feel like you should be doing more.

6. You’re afraid of disappointing others.

You might be a people-pleaser. You’re so afraid of letting others down that you work hard to make everyone around you happy — even if it means sacrificing your own needs.

7. You chatter nervously.

Even though you’re an introvert who prefers calm and quiet, you chatter on and on — out of nervousness. For this reason, you're sometimes mistaken for an extrovert.

8. You’ve built your life around avoidance.

You’ve shrunk your world to prevent overwhelm. You stick to routines and familiar experiences that give you a sense of comfort and control; you avoid intense emotional experiences, like travel, social events, conflict, or anything else that might trigger your anxiety.

9. You’re prone to rumination and overthinking.

You do a lot of negative self-talk. You often replay past mistakes in your mind, dwell on scary “what if” scenarios, and struggle to enjoy the moment because you’re expecting the worst. Sometimes your mind races and you can’t stop it.

10. You’re a perfectionist.

You try to calm your worries by getting your work or your appearance just right. This can bring positive results, but it comes at a cost. You may have an “all-or-nothing” mentality (“If I’m not the best student, then I’m the worst”). You may have unrealistic expectations of yourself, and a catastrophic fear of falling short of them. 

11. You have aches, repetitive habits, or tics.

According to psychotherapist Annie Wright, your anxiety might manifest physically in your body as frequent muscle tension or aches. Similarly, you might unconsciously pick at the skin around your nails, tap your foot, scratch your scalp, or do other repetitive things that get your nervous energy out — even if you appear composed in other ways.

12. You’re tired all the time.

Your mind is always going, so you have trouble falling asleep or staying asleep. Even when you sleep well, you feel tired during the day because dealing with a constant underlying level of anxiety is exhausting.

13. You startle easily.

That’s because your nervous system is in overdrive. A slammed door, an ambulance siren, or other unexpected sounds really rattle you.

14. You get irritated and stressed easily.

You’re living with constant low-level stress, so even minor problems or annoyances have the power to frazzle you.

15. You can’t “just stop it.”

Anxiety isn’t something you can tell yourself to just stop doing. In fact, the researchers from the Weizmann Institute of Science found that people who are anxious have somewhat different brains than people who aren’t. They noted that people can’t control their anxious reactions, due to a fundamental brain difference. (However, you can learn to cope with your anxiety and greatly lessen it . See the resources below to help you get started.) 



How can High-Functioning Anxiety be managed?

Stigmas that surround mental health often causes people to suffer in silence. Increasingly more people suffer from the symptoms of high-functioning anxiety and may not realize the inner distress it causes them. This means you are not alone. Seeking help through a therapist, life coach, or other healthy support systems can be beneficial.

Although high functioning-anxiety is becoming a well-known concept, it lacks much-supported research. However, limited findings have shown positive benefits of managing a healthy “optimal level of anxiety.” To achieve this entails keeping anxiety at a mid-point; not too high nor too low.

A common fear among individuals with high functioning-anxiety is that a decrease in symptoms will decrease one’s drive and “over-achieving” qualities.

Self-awareness is important. Being cognizant of negative characteristics or impossible deadlines can help minimize physical symptoms; heart racing, tension headaches, panic, internal organ stress etc. Self-implemented interventions such as self-compassion, a guided meditation / mindfulness practice, deep breathing and/or progressive muscle relaxation can be great for managing tension.

Other helpful tips are: 

Psychotherapy / Talk therapy — therapy is still roundly considered a primary support for helping to treat anxiety disorders, including “high-functioning anxiety.” Talk therapy helps address the roots of the issues that led to the anxiety disorder in the first place such as unresolved trauma, unprocessed grief, low self-esteem, etc. Therapy will certainly help you develop some immediate coping mechanisms to deal with your anxiety, but most therapists will also place an emphasis on helping you to understand and help heal the roots of your anxiety, leading to more integral and sustainable long-term change.

Simple changes to your routine: such as keeping a regular bedtime, limiting caffeine intake, maintaining a healthy balanced diet, seeking supports, finding time for regular exercise, and more practicing  intentional self-care.


Did you see yourself in this article?

What’s one tip or insight that’s helped you in living with “high-functioning anxiety”? 

I’d love to read your responses in the comments below. 

Until then, Be well.  


We are what we think. All that we are arises with our thoughts. With our thoughts, we make our world.
— Buddha


Brittany Spencer is a Graduate Student Intern at Space Between Counseling Services. As she prepares to graduate from McDaniel College mental health counseling master’s program in July 2018, Brittany plans to seek licensure as a LGPC. 

Brittany has recently taken to the Charm City community and participated in psychoeducation outreaches focused on bridging stigmas in counseling, LGBT-related concerns, and Afrocentric Worldviews. Brittany’s integrative therapeutic approach has allowed her to interact with the young and older adult population to increase self-awareness, educate about community-based resources, and strengthen coping skills. Within a safe and compassionate environment Brittany strives to increase the autonomy of her clients.

While not working to evolve her counseling skills, Brittany enjoys outdoor activities. As summer approaches, she enjoys 5k races, bonfires, and community festivals.  She loves attending WNBA basketball games, bicycling, and watching America Ninja Warrior.