The term “anxiety” is one that is used often in our society but is, just as often, misunderstood.  There are varying anxiety disorders and varying levels of severity within them, but it remains to be something that is rather understated and overlooked by healthcare professionals. While the stereotypical anxious person exudes symptoms of nervousness and general overwhelm, the most common anxiety sufferer is actually someone who shows hardly any symptoms at all. High-functioning anxiety is a generalized term that is used to classify those who suffer from anxiety but remain capable of leading a functional lifestyle. Although the diagnosis for this term has yet to be pinned down, the amount of people assumed to be experiencing it are vast. 

Anxiety is a mental health condition that such a huge percentage of the world’s population suffers from, and those with high functioning anxiety sometimes don’t even realize that they are suffering from it. In this article, we are going to be discussing anxiety disorders – the cause, symptoms, types, treatment and specifically what high-functioning anxiety looks like.  

What is high-functioning anxiety? 

According to psychologists, the term high-functioning anxiety has been used to describe people who have symptoms of anxiety that, on the surface, do not impact their functioning. In fact, those with high-functioning anxiety may actually appear to function more proficiently than those without – although that isn’t usually the case. While their anxiety may not inhibit them from functioning in every-day life and all that it entails, those suffering from high-functioning anxiety operate at a strong, and often hidden, deficit.  

Surprisingly, high-functioning anxiety is not identified as an official mental health diagnosis in the medical world. As with most-all anxiety disorders, it is a misunderstood and understated condition that no one has truly been able to put their finger on. High-functioning anxiety has evolved into a sort of catch-all category for anyone suffering with some sort of generalized anxiety disorder, who is also still functioning generally well in their normal tasks and activities. The amount of people who suffer from anxiety to some degree is staggering, and of those who claimed to experience anxiety, most of them considered themselves high-functioning.  

More interesting yet, people with high-functioning anxiety are not only known to operate productively in life, they can actually be known to function at a higher capacity than those without anxiety. How is that possible, you might ask? Those who have been categorized as having high-functioning anxiety actually use their “negative” symptoms as tools to propel them further and be even more productive and successful in areas of their life. 

Symptoms of High-functioning anxiety

 In order to fully understand what high-functioning anxiety really looks like, it’s important to have a clear picture of the tell-tale signs and symptoms. Based on the large percentage of people experiencing anxiety, there is a likely probability that someone you know and love suffer from it themselves, and you just may not know it. 

 Here are the most common characteristics of high-functioning anxiety to look for in yourself and those around you:

• Perfectionism

• Excessive need for control at all times

• Extreme organization or “type A” tendencies

• Fidgeting habits (nail-biting, pulling hair, bouncing legs, “busy” hands)

• Fear of disappointing others

• Harshly critical of self or fear of failure

• Nervous energy

• Inability to delegate work to others

Often in situations of any anxiety disorder, the condition can go completely undiscovered. Either the person themselves has lived with this degree of anxiety their whole lives and is unaware that it’s “abnormal”, or they actually have acknowledged their anxiety and have managed to keep it maintained below the surface. Knowing these common symptoms makes it easier to recognize high-functioning anxiety within or around you. 

The Positives

 While many symptoms of high-functioning anxiety are outwardly negative, a multitude of them, like some listed above, actually present as positive attributes. Being early or on time, highly organized, hard-working and extremely motivated and detail-oriented are all things that can lead to a highly successful person in both work and personal life. But it’s important to keep in mind that just because these qualities may serve the person well, there is still a very real and tireless battle they are facing internally. 

Someone with high-functioning anxiety may present their symptoms in a way that people find admirable, cute, or quirky. You may see someone that presents these characteristics and consider them “just a part of their personality”. While that could be true for some, most of these qualities are caused and driven by underlying anxiety.

It’s important to acknowledge that “positives” in high-functioning anxiety, as usually, they are worked hard for. For someone that is facing chronic anxiety of any kind, there is hard work constantly happening internally just to accomplish normal tasks and responsibilities.

Some positive characteristics of someone with high-functioning anxiety include:

• Extremely organized/orderly

• Punctual (consistently arriving early)

• Reliable and consistent

• Plans everything in advance

• Goal oriented

• Hard-working and detail focused

• May appear calm and collected

• Selfless (always concerned about other’s feelings)

• Productive (constantly going and accomplishing)

• Active  

  If you are assessing a person based on their accomplishments, their ability to thrive and succeed in work and relationships – those with high-functioning anxiety are likely to appear quite successful. People suffering from anxiety tend to suffer far more beneath the surface than they appear, and while by some definition they might be thriving, they are working in overdrive to function that way. 

The Negatives

Just as there are many positive characteristics in high-functioning anxiety, there are equally, if not more, negative. The negative traits in someone with high-functioning anxiety are often quiet or completely invisible to those around them, so it’s hard to fathom or understand just how much someone is struggling to be as “high-functioning” as they are. While symptoms of anxiety can be harnessed and used in someone’s benefit with great effort, there are symptoms that simply inhibit one in their daily life; characteristics that make life significantly more challenging. 

Some of the most significant negative characteristics involved in high-functioning anxiety include: 

• Constant over-thinking or over-analyzing

• Habitually arriving early to things (losing time)

• Need for constant reassurance and affirmation

• Finds worth in performance or achievement

• Constant feeling of fear or worry

• Feeling overwhelmed by small and insignificant tasks

• Dreading the future and uncertainty

• Inability to be flexible or adjust to change

• Nervous habits 

• Limited social abilities

• Self-isolation from social nervousness

• Constant exhaustion and fatigue

• Being a people please (often neglecting themselves in order to please others)

• Racing mind and thoughts

• Inability to fall and/or stay asleep

  Clearly, there are an overwhelming number of negative characteristics involved in high-functioning anxiety disorders, that make life significantly more challenging for the person suffering. If you or someone you love meets the criteria listed above in either the positive or negative spectrum, seeking a mental health evaluation would be in your best interest. There are ways to ease the symptoms and challenges involved with anxiety disorders and the first step is reaching out and sharing what you’re experiencing. We offer Psychological Testing for those looking for more information about their mental health and overall wellness.

Types of Anxiety

 When speaking of high-functioning anxiety, it may be unclear what “type” of anxiety that is referring to. While it may present in a less obvious way, high-functioning anxiety is most closely related to the symptoms of generalized anxiety disorder (GAD). GAD is a highly common form of anxiety, but there are many other. It’s important to be aware of all types of anxiety and know how they can present in you or your loved ones. 

The primary forms of anxiety are:

Generalized Anxiety Disorder (GAD) 

A form of anxiety that typically leads a person to feel anxious over a variety of situations. Someone suffering from GAD will experience anxiety on a daily basis about tasks, responsibilities or situations that are not specifically stressful for others.  

Panic Disorder

When a person is experiencing frequent, recurring panic attacks. This form of mental illness presents acute, sudden and severe onset of fear, paranoia and panic. This includes mental and emotional symptoms, as well as physical. Including, but not limited to: cold/hot sweats, visual disturbances, elevated heart rate, chest pain and difficulty breathing. 

Post-Traumatic Stress Disorder (PTSD)

PTSD is a disorder that is brought on by a traumatic experience or loss in your life. After experiencing trauma, your mind and body are both impacted negatively and need to heal and process that experience. PTSD occurs when you aren’t healing or processing that trauma in a healthy way. This may look like frequent “triggers” when you encounter something that feels associated with the traumatic experience. Those triggers will often provoke a response similar to that of the initial trauma, and the person feeling as if they are reliving the traumatic experience repeatedly.  

Social Anxiety Disorder

A disorder associated with the stress of social situations. If a person is suffering from social anxiety, they are typically overwhelmed or excessively worried or fearful of being in the presence of others – especially unfamiliar people and larger groups. If your feelings of stress surrounding social situations is inhibiting you from attending outings or keeping you isolated to your own home – you are most likely suffering from social anxiety disorder.

 Obsessive-Compulsive Disorder (OCD)

OCD is a condition that causes a person to compulsively and involuntarily act out an urge or habit repeatedly. The compulsions don’t typically serve a purpose that is related to real-life needs and depending on the severity can inhibit a person’s ability to function normally in life and work. For example, someone with OCD will feel compelled to complete a hygienic act, like brushing their teeth or washing their hands, obsessively because they are convinced that it is necessary in order to avoid illness. These urges are not typically based in a real need, but rather a habit or ritual that “needs” to be done in order to satisfy the OCD tendency.

 Separation Anxiety Disorder

Separation anxiety occurs when a person fears being removed or separated from a person or place. They might experience both physical and emotional distress when being disconnected from that person and experience those symptoms in anticipation for a future situation of separation. A person suffering from separation anxiety may also live in constant fear of losing their family member or loved one to death or loss of some kind. This disorder is most-commonly seen in young children but can also occur in adults in certain situations.

 Phobias

This specific type of anxiety is among the most common and also the most likely to affect someone’s daily functionality. A phobia is an irrational fear of something in your life; whether it’s an animal, situation, place or activity. The phobia causes severe distress and can keep the person from being able to live life normally. The most common phobias experienced among people are snakes, rodents, insects, heights, flying, closed or open spaces. 

High-functioning Anxiety & Substance Abuse

Unfortunately, people who are facing high-functioning anxiety are more likely to suffer with substance abuse issues. Typically, this correlation is due to an inability to cope with the struggles of anxiety. People with high-functioning anxiety tend to seek out substances as a way to ease the challenges and temporarily relieve the immense stress they are experiencing in their daily life. This unhealthy relationship with drugs or alcohol can end up in a substance dependency or addiction, which is then determined a dual diagnosis upon treatment.  

In these cases, it is in a person’s best interest to seek the help of a mental health provider or psychiatric care provider who can offer several treatment options for those suffering from substance abuse, as well as high-functioning anxiety.

How to Treat High-Functioning Anxiety

While there are many different types of anxiety and levels of severity, there are also many methods to successfully treat and manage those conditions. The best course of treatment is determined by the type of anxiety you are experiencing and to which degree. If you are experiencing any of the symptoms mentioned above, there are steps you can take to getting the help best suited to you and your mental condition. 

Cognitive Behavioral Therapy 

Cognitive Behavioral Therapy (CBT) is a therapy method that focus on targeting and controlling your thought patterns and feelings, in order to change the way you behave. CBT is known to be incredibly successful in the treatment of many mental illnesses, specifically depression and anxiety disorders. Essentially, CBT is centered around the belief that the way we interpret and process life experiences and hardships directly affects our behavior and how we feel.  

In CBT, you are forced to face current problems and stresses in your life and restructure how you think, feel and process them. With the collaboration of you and your therapist, you will work to retrain your brain to solving problems that arise and better control your mind and emotions. The treatment course of CBT with a therapist is typically a finite amount of treatment sessions, and ideally once you finish that series of treatment you will be able to practice the new methods in your day to day life and successfully cope with your challenges and anxiety on your own. 

Psychotherapy

Psychotherapy, more commonly referred to as “talk therapy”, involves the support of a therapist – who will collaborate with you to help you not only cope with the challenges of anxiety, but combat the troubling symptoms. Psychotherapy is typically extremely effective in treating high-functioning anxiety. There are an abundance of practices and methods used within talk therapy that specifically challenge the anxious thoughts and behaviors associated with anxiety disorders.

Medication Treatment

In many cases of high-functioning anxiety, the help of psychotherapy and CBT is completely effective in treating and healing the person with the condition. However, there are many situations where the best course of treatment is medication treatment. If you are under the care of a therapist or general practitioner, they will often refer you to a psychiatric care provider who will be able to treat you with the proper course of medication treatment.

There are several types of mental health medications used to treat anxiety disorders. Some of the most commonly used are: 

• Selective Serotonin Reuptake Inhibitors (SSRIs)

• Benzodiazepines

• Tricyclics

• Beta blockers

• Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

Mindfulness Practices

There are many instances that practices of mindfulness and meditation can be an extremely beneficial course of treatment for high-functioning anxiety. When you are facing an anxiety disorder, your thoughts are typically racing elsewhere and working on over-drive to focus on the problems and worries of tomorrow. Mindfulness techniques are designed to help you focus on the here and now, to be fully present in your body and mind and eliminate or quiet the stress and irrational thoughts that consume your mind when you’re experiencing anxiety of any kind. The art of mindfulness practiced in your daily life can aide in anxiety management, stress management and the overall management of your health and well-being.

Some mindfulness techniques include deep breathing, body observation, five senses exercise and self-compassion exercises. Mindfulness and meditation practices are known to be extremely effective in treating and managing mental health conditions, specifically anxiety disorders. 

Bring Awareness

High-functioning anxiety is often referred to as an invisible illness, which means that it is deeply felt, but not seen. It is an incredibly common condition, but much like other mental health disorders, it is extremely stigmatized and often goes unmentioned. The people who are experiencing such hardship, are likely struggling on internally and working tirelessly to lead a healthy and productive life. But they shouldn’t have to. It is important to shed light on anxiety disorders, so that those suffering from it are able to get the help they need. If we are able to talk openly about these disorders, then the risk of those suffering to do so in silence, without help is lessened.

If you or someone you love is experiencing an anxiety disorder – now is the time to reach out for help. There are incredible resources readily available to you, and we are one of them. At Insight Northwest Counseling, we are here to offer therapy and psychiatric services to you in the state of Oregon – both in person and online. Contact us here to book a consult or appointment today.