You’ve likely heard of anxiety disorders, which are thought to affect nearly a third of people at some point in their lives, according to the National Institute of Mental Health. But recently, the idea of high-functioning anxiety has been becoming more popular, meant to refer to someone who might experience symptoms of high anxiety but whose symptoms don’t necessarily interfere with their daily life to a disruptive degree.
While high-functioning anxiety is not a diagnosable condition like generalized anxiety disorder, the term seems to strike a chord with many people, giving a name to symptoms that can be hard to cope with, but don’t necessarily feel as though they rise to the threshold of a diagnosable disorder. But what is high-functioning anxiety, exactly, and how should it be dealt with? Here, experts explain everything you need to know about the term.
Experts Featured in This Article
Nina Westbrook, MA, LMFT, and founder of Bene, which offers mental health resources and and e-workshops.
Monique Castro, LMFT, founder and CEO of Indigenous Circle of Wellness
What Is High-Functioning Anxiety?
High-functioning anxiety is “a phrase that’s going to describe somebody who is functioning at a high level with anxiety, to the point where it doesn’t impede their abilities to carry out daily tasks, interact with their families, and complete tasks at work,” Nina Westbrook, MA, LMFT, told PS. Although numerous people live with high-functioning anxiety, it is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) because it doesn’t impair how someone functions.
According to Westbrook, “High-functioning anxiety has a tendency to propel you forward,” and it can give you a boost of energy rather than be debilitating, such as generalized anxiety. Instead of being frozen by fear or unable to carry out tasks, “their fear almost is a source of energy as it might create lots of adrenaline the same way stress does in our bodies,” Westbrook said, which then provides the energy needed to complete tasks and get through the day.
People who experience high-functioning anxiety may also be experiencing normal anxiety symptoms (like racing thoughts or overthinking), “but it’s usually not visible,” says Monique Castro, LMFT, founder and CEO of Indigenous Circle of Wellness, who is Diné and Xicana. Or, because you’re doing so “well” externally, it can go dismissed although you may be struggling internally.
Signs of High-Functioning Anxiety
Because people with high-functioning anxiety aren’t usually impaired by it when it comes to achievements or success, “most people won’t know this person has anxiety,” Westbrook said. “They might just come off as someone who’s a Type A personality.” And although someone with high-functioning anxiety is able to get through their day-to-day tasks, internally, they more than likely feel depleted and exhausted, Westbrook explained. They may be trying to uphold a perfect perception, “and because outside perception is so important to them, they do everything that they can to uphold the outside image.” This can be ongoing and they end up never taking a break and resting, she said.
Because there are no clear guidelines or diagnosis for high-functioning anxiety, the symptoms may vary from person to person. According to Westbrook and Castro some signs of high-functioning anxiety may include:
- overtalking
- overthinking
- insomnia
- irritability
- racing thoughts
- emotional and physical fatigue
- constant worry
- drugs and/or alcohol use
- fearfulness that lingers
- the inability to create boundaries and say no
- the inability to be present and enjoy experiences
- physical symptoms such as nausea, heart palpitations, migraines, stomach issues, and high blood pressure
Additionally, it is possible for high-functioning anxiety and anxiety disorders to be present with co-occurring disorders and complications, such as depression, eating disorders, and substance abuse, according to Castro. “This may or may not happen, but it’s important for folks to understand that it’s possible,” she said.
How to Manage With High-Functioning Anxiety
High-functioning anxiety may not be an official diagnosis in the DSM-5, but it’s still possible to manage it. First, Westbrook said that you have to be able to recognize and identify it within yourself in order to know there’s something that needs to be addressed. Second, Westbrook advised against waiting until you’ve reached a breaking point to seek help. Instead, she strongly urges reaching out to a mental health professional if you begin to notice a shift in your behavior (like becoming less social) and you’re feeling physical or mental fatigue to the point where you cannot carry out your normal tasks and lifestyle.
If you’re constantly feeling exhausted and tired, like you’re being pulled in a lot of directions, and you can’t recover, Westbrook said tools like adult coloring books, journaling, and exercise can help. In her opinion, exercise can be the best way someone with any type of anxiety can cope and feel better, especially those who are not open about anxiety and aren’t sure if they want to work with a therapist. “Daily exercise routines can help to relieve stress and anxiety, both physical and emotional,” Westbrook says. Writing, spending time with family, meditating, and being consistent with a self-care routine are also other ways to manage your anxiety.
“I think a lot of things that you can do on your own are going to be things that someone who’s dealing with high-functioning anxiety might lean toward to help, because they’re used to presenting themselves in a certain way. They’re used to dealing with everything themselves, not really reaching out for help or support from others,” Westbrook says.
In Castro’s opinion, “the best way to support anxiety, in general, and definitely with high-functioning anxiety is to always remain in some type of balance.” She believes in a holistic approach and explained that our emotional well-being, mental well-being, spiritual well-being, and physical well-being all need to be in balance to avoid various challenges.
Castro also recommends therapy, as it can help you set boundaries with both yourself and others, and it can teach you how to implement and understand the wellness practices that will be the best for your sustainability. Working with a life coach and having community support from friends and family can also be helpful, encourage us, and hold us accountable when trying to find and maintain balance, she says.
High-functioning anxiety doesn’t manifest in one particular way nor is there one perfect way to manage it. But it’s also worth noting that some people may identify with the high-functioning anxiety label because of internalized stigma around issues like generalized anxiety disorder; it could be hard for them to accept that they may have a mental health condition that could require support. But thinking of it as “high-functioning” anxiety seems less severe or disruptive.
To that we say: there’s no shame around needing mental health guidance and support. If you suspect you’re dealing with symptoms of anxiety, high functioning or not, we recommend sharing what you’re feeling with people you trust and, if possible, working with a licensed professional.
If you are feeling anxious or depressed and need help finding help or resources, the Anxiety and Depression Association of America and the National Alliance on Mental Illness (1-800-950-6264) have resources available.
Tamara Pridgett was an associate editor with PS Fitness. She’s a NASM-certified personal trainer and Precision Nutrition level 1 coach, and was a Division 1 All-American sprinter.
