Blog #2: What is High-Functioning Anxiety? Symptoms, Causes, and Treatment

What is High-Functioning Anxiety? Symptoms, Causes, and Treatment

Frequently, people come to me and ask if I can help them make their anxiety GO AWAY because they want to ELIMINATE their anxiety all together. Although I can empathize with these individuals because anxiety can be difficult to live with and manage, but the reality is that anxiety is one of our basic emotions that has been with us forever.

Since the beginning of the human species, anxiety has been a built-in emotion that assisted us in surviving the harsh conditions that we faced (i.e. extreme weather, being attacked by animals, hunting for food, moving from place to place, etc). It stands to reason, that our ancestors that had anxiety probably outlived and survived those that did not have anxiety.

Now, fast forward to the current day and our current living arrangements in modern cities and societies has evolved so much, but our basic anxiety systems are still the same as the past. Overall, it is very normal to feel anxious at times, especially in stressful situations. However, some people experience excessive and ongoing anxiety that can be challenging to manage and control, which can interfere with daily activities.

When you begin to examine anxiety further, you will discover that there are various types or subsets; including high-functioning anxiety. High-functioning anxiety is not identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM) at this time, but it typically falls under the diagnosis of generalized anxiety disorder (GAD). You can always inquire more with your doctor or a mental health specialist that is able to provide a diagnosis.

Overall, high-functioning anxiety typically refers to people who show anxiety symptoms while maintaining a high level of functioning in different aspect of their lives. These individuals are often very successful in their careers, participate in volunteer/community activities and have strong personal relationships. However, they often struggle internally with feelings of stress, self-doubt, self-criticism, and a fear of not measuring up. On the outside, observers would often describe someone with high-functioning anxiety to be successful, excelling, and in control. Yet behind this mask, many people with high-functioning anxiety still have regular thoughts of worry, fear, and feeling on edge (Mayo Clinic, 2023).

Here are some common physical symptoms of high-functioning anxiety:

• Excessive sweating

• Feeling off-balance or lightheaded

• Headaches or migraines

• Intestinal discomforts (i.e. diarrhea or ulcers)

• Muscle tension

• Racing heart rate

• Rubbery or jelly legs

• Sleep disturbances

• Tingling or numbness in toes or fingers

Here are some common internal (invisible) symptoms of high-functioning anxiety:

• Persistent overthinking or racing thoughts

• Fear of disappointing others

• Constant self-doubt and imposter syndrome

• Difficulty relaxing or “turning off” the mind

• Feeling on-edge or restless

• Anticipating worst-case scenarios

• Emotional exhaustion or burnout

Here are some common external (visible) symptoms of high-functioning anxiety:

• Highly organized and detail-oriented

• Over-achievement or perfectionism

• Taking on too many responsibilities

• Procrastination followed by “panic productivity”

• Always appearing calm or in control

• People-pleasing tendencies

• Difficulty saying no

I just wanted to check-in with you, as I know these lists of symptoms can be overwhelming at first, especially if you identify with many of them. I want you to take a deep breath and realize that this information is to help you uncover some insight and understanding in yourself that you may have not known before. This new knowledge may assist you in being able to manage these symptoms on your own and nothing else is required. However, if you are struggling with high-functioning anxiety, here are some ideas to help you navigate some potential next steps if they are relevant for you.

First, psychotherapy has been shown to be very effective in treating and managing high-functioning anxiety. The main psychotherapy recommended to managing this type of anxiety is Cognitive-Behavioral Therapy (CBT) and there are other related approaches related to CBT that can also be useful as well. Basically, CBT helps people identify and reframe their anxious thought patterns and helps build healthier coping behaviors overall. In addition, there is Acceptance and Commitment Therapy (ACT), which is a form of CBT, that teaches acceptance of anxiety rather than fighting it and it focuses on value-based actions in your life. Also, there is Mindfulness-Based Therapy, which is a form of CBT, that strengthens awareness of thoughts and emotions, as well as tries to reduce overthinking and stress reactivity.

Second, in more moderate to severe cases of high-functioning anxiety, speaking to your doctor and/or psychiatrist about some relevant medications could be an option to use alongside with psychotherapy for best results.

Finally, there are some lifestyle strategies that can be useful in starting to manage the high-functioning anxiety symptoms, including: regular exercise (reduces stress hormones), mindfulness or breathing practices, reducing caffeine and alcohol, setting realistic boundaries, prioritizing sleep, and time management that reduces overwhelming feelings.

In conclusion, today’s modern times can be very overwhelming and we can feel the pressure to have it all; the thriving career, the best romantic relationship, a thriving family and potentially children, volunteer work, traveling the world, having a lot of money, buying all the expensive brands and products, etc. We are often taught to “suck it up” or to be resilience or be appreciative over what we have and be grateful for the privileges we have. However, it can feel like a “house of cards” that will crumble when a gust of wind blows or someone pushes us a little. It’s alright to feel this way, you are normal and human. You don’t have to face this alone. We are here to talk and help if you need. Wishing you all the best and have a wonderful day.