Anxiety is a natural part of life. A regulated amount of anxiety is good for us, as it pushes us to be the best versions of ourselves that we can be. However, there does come a point where anxiety grows out of control and for some, it transitions into what we call “high functioning anxiety”. Those who have developed high functioning anxiety tend to set near impossible standards for themselves as a way of preventing a negative consequence. Although the fear varies from person to person, it often centers around things like rejection, disappointing others, or feelings of inadequacy. It should come as no surprise that this level of anxiety would significantly impact a person’s life, but to understand how, we first need to understand what high functioning anxiety really is.
What is High Functioning Anxiety?
It’s important to know that high-functioning anxiety is not an official medical diagnosis recognized by the Diagnostic and Statistical Manual of Mental Disorder (DSM), but rather an increasingly common term used to describe those who experience high levels of anxiety but are still seemingly able to succeed reasonably well in different aspects of their lives.
Although high functioning anxiety is not an official medical diagnosis, it is generally recognized as a subset of generalized anxiety disorder or GAD. Someone with GAD can be characterized as someone who experiences chronic anxiety, extreme worry, and excessive tension, even when there’s little to no threat. According to Elizabeth Cohen, Ph.D., and New York City-based clinical psychologist, high functioning anxiety is a “blend of different anxiety-related conditions.” This type of anxiety showcases people-pleasing, which most often comes with social anxiety, the physical responses and ‘waiting for the other shoe to drop’ component of GAD, and signs of obsessive-compulsive disorder (OCD).
Others may perceive a person with high functioning anxiety to be organized, proactive, passionate, and even high-achieving. This is because their anxiety is often hidden or masked behind “high performance.” Because those with high functioning anxiety can make everything appear as though it is okay, they are less likely to check in with their mental health regularly. Letting high functioning anxiety go untreated can worsen anxiety, depression, and even suicidal thoughts or tendencies. That being said, it’s essential to know what signs and symptoms to look out for.
What Are the Signs and Symptoms of High Functioning Anxiety?
Unfortunately, there is no “one size fits all” set of signs or symptoms when it comes to high functioning anxiety. Even for a trained expert, it can take several sessions before identifying the level of an individual’s anxiety; it can take even more to determine whether or not that anxiety is “high functioning.” This is because high-functioning anxiety and GAD have similar symptoms, but those symptoms will often look different depending on the patient and the specific variables of their life. That being said, experts have been able to narrow down some of the general symptoms of high functioning anxiety, which can be broken down into two separate categories: emotional and physical.
Emotional Symptoms of High-Functioning Anxiety:
- Racing thoughts
- Fear of being a bad friend, spouse, or employee
- Fear of letting others down
- Consistent overthinking
- An inability to say “no.”
- Fear of the future
- Rumination or a tendency to dwell on the past
- Stress, anxiousness, and worry
- Trouble concentrating
- A propensity to self-compare to others
- Mental fatigue
- People Pleaser Attitudes and behaviors
- The need to do repetitive actions like rocking back and forth or checking
Physical Symptoms of High-Functioning Anxiety:
- Muscular pain (i.e. a tense, knotted back; aching jaw from clenching)
- Bloody or bruised lips from biting or picking
- Chipped or bloody nail beds from biting
- Chronic fatigue, or feelings of depletion
- Nausea in anticipation of events
- Difficulty waking up or waking up in a panic
- Chronic migraines and headaches
How Does High Functioning Anxiety Impact My Life?
A person with high-functioning anxiety is often regarded as an overachiever. They are driven to please others out of fear of disappointing them. Because of this, what others see can be drastically different from what their actual experience is. For example, overthinking may be interpreted as detail orientation, a fear of failure as hard work, and poor boundaries as loyalty. This perception is short-sighted because it fails to consider the struggle required to achieve that level of “success.” Deep down, those with high functioning anxiety know that it severely impacts and even limits their life, but won’t let others know about the pain they are experiencing.
The challenges that a person with high-functioning anxiety faces are often silent. While they may be able to complete tasks related to work or housekeeping, they often stray away from things that are outside of their comfort zone. Their actions are mainly dictated by anxiety, so they are more likely to choose calming activities over those that cause their minds or hearts to race.
According to the National Institute of Mental Health, the symptoms related to this level of anxiety will eventually interfere with daily activities such as job performance, school work, and relationships in a significant way. Consistently presenting a false persona to others can be extremely tiring, both mentally and physically. Compartmentalized feelings may be bottled up over and over again. Because of these habits, people with high-functioning anxiety can often feel isolated and lonely.
How Can I Start to Heal My High Functioning Anxiety?
Thankfully, high functioning anxiety, along with many other anxiety disorders, can be managed. That being said, it is something that is a daily process and something that is going to take time. Each time you find yourself falling into a particular behavior, you need to take corrective action. Typically high functioning anxiety is developed over the course of many years and reinforced by the world around you. Because of this, you will have a lot of conditioning to unpack. Here are three things you can do to start treating high functioning anxiety.
Therapy, specifically cognitive behavioral therapy or CBT, has been proven to help those with high functioning and GAD identify and change destructive thought patterns. Utilizing CBT can help you focus the thoughts that need shifting and change the unhelpful behaviors of perfectionism.
Taking A Break, Or Committing to Doing Less
This is going against the very nature of your being, but you’ll need to commit to doing less overall. At the very least, you need to take an extended break from anything that doesn’t pay your bills or bring you joy. It’s important to know that not every moment of your day needs to be optimized. This break may come as a shock to those around you or to those who may be used to you being available to them 24/7. Be sure to clearly and kindly set your new boundaries, and stick to them.
Practice Outside of Therapy
Therapy doesn’t end after the session is over; it’s a long and consistent process. Be sure to tune into both brain and body. Go out of your way to create new routines that are healthy and that you enjoy. Taking charge of your life by taking control of your time will provide you with the strength you need to continue your healing journey.
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