High-functioning anxiety is a catch-all term that refers to people who live with anxiety but identify as functioning reasonably well. It is not a recognized mental health diagnosis.
If you have high-functioning anxiety, you appear to be successful, together, and calm—the typical Type A personality who excels at work and life. However, the way you feel inside may be very different.,
Signs of High-Functioning Anxiety
High-functioning anxiety typically propels the person forward rather than leaving them frozen in fear. As a result, they often appear very successful in work and life—which might be objectively true if that success is measured only in achievements.
What others might not know (and what you would never share) is thatbeneath the surface of a seemingly perfect exterior, you're fighting a constant churn of anxiety.
Here are a few other signs.
You might be the picture of success, arriving to work earlier than everyone else, impeccably dressed, with your hair neatly styled. Coworkers might say you are driven in your work: You've never missed a deadline or fallen short in a given task.
It may have been nervous energy, fear of failure, and being afraid of disappointing others that drove you to success.
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Though you desperately need a day off work to get yourself together, you're often too afraid to call in sick. Nobody would ever believe something was wrong, because you always portrayed yourself as being fine.
If these characteristics sound familiar, here's a look at what you might experience or what others might observe of you if you have high-functioning anxiety.
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In Personal Life
People with high-functioning anxiety tend to always be willing to help others—partly because they're afraid of driving people away, being a bad friend/spouse/employee, or letting others down. Their social schedules tend to be busy and full.
The potential benefits of high-functioning anxiety can be seen in the outcomes and successes that you and other people observe.
Signs You're an Overachiever
Characteristics of people with high-functioning anxiety that are often thought of as positive include:
- Outgoing personality (happy, tells jokes, smiles, laughs)
- Punctual (arriveearly for appointments)
- Proactive (planahead for all possibilities)
- Organized (makelists or keep calendars)
- Orderlyand tidy
- Appears outwardly calm and collected
- Loyal in relationships
In the case of high-functioning anxiety, a struggle often lies beneath that veil of success. The anxiety you feel about your success inevitably must come out.
Characteristics of high-functioning anxiety can be perceived by others as being "cute" or just part of your personality. In reality, these attributes are driven by underlying anxiety.
Other characteristics of high-functioning anxiety are internal and might never be noticed by others—even though they cause you a great deal of stress.
People don't know always know that these actions are caused by anxiety and may view them as part of you who are.
Perfectionism and Anxiety Disorders
Despite being regarded as "high-functioning," you may experience the following struggles in your day to day life.
- "People pleaser" (afraid of driving people away, fear of being a bad friend, spouse, and employee, fear of letting others down)
- Talking a lot, nervous "chatter"
- Nervous habits (playing with your hair, cracking knuckles, biting your lip)
- Need to do repetitive things (counting stairs or rocking back and forth)
- Lost time (arriving too early for appointments)
- Need for reassurance (asking for directions multiple times or checking on others frequently)
- Procrastination followed by long periods of crunch-time work
- Avoiding eye contact
- Rumination and a tendency to dwell on the negative ("What if?" thoughts and dwelling on past mistakes)
- Inability to say "No," always having an overloaded schedule, being constantly busy
- Insomnia (difficulty falling asleep or waking early and being unable to fall back asleep)
- Racing mind
- Others think that you are "difficult to read" (stoic, unemotional, cold)
- Limited social life (turning down invitations)
- Inability to "enjoy the moment" (being unable to relax and be in the present or expecting the worst in any situation)
- Feeling intimidated by the future
- The tendency to compare yourself to others (falling short of expectations)
- Mental and physical fatigue
- Loyal (to a fault) in relationships
- Potential for alcohol or substance abuse as an unhealthy coping method
A high-functioning person is often regarded as an overachiever. However, this perception is short-sighted because it fails to account for the struggle (and, perhaps, anxiety) required to achieve that level of success.
If you asked most people who know you, they probably would not have a clue that you struggle with anxiety every day.
Deep down, you know that your anxiety limits your life—even if you don't let on.
Perhaps you are able to achieve essential tasks (such as those relating to work and housekeeping), but feel your life is limited in other ways (for example, you never do anything outside your comfort zone.
Your actions are probably dictated by your anxiety. You likely choose activities that calm your racing thoughts rather than pursuing activities because you would enjoy them, or because they would expand your horizons.
If you have high-functioning anxiety, you've likely become adept at presenting a false persona to the world and never show your true feelings to anyone.
Instead, you keep it all bottled up inside and compartmentalize your feelings with a plan to deal with them later (but later never comes).
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Types of Anxiety
The National Institutes of Mental Health lists five major types of anxiety:
- Generalized anxiety disorder (GAD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social anxiety disorder (SAD)
Causes of High-Functioning Anxiety
Anxiety has as many causes as people who have it. A few examples include:
- Stress at work or home
- Physical and mental health issues
- Abuse or neglect
- Death of a loved one
- Relationship problems
- Caregiver burnout
In some cases, you might not even know the source of your anxious feelings. An experienced therapist can help you figure that out.
Getting Help for High-Functioning Anxiety
Help is available for people who are dealing with any form of anxiety, including high- functioning forms. However, certain characteristics of high-functioning anxiety might prevent you from seeking help.
Some possible reasons you might not have sought help for high-functioning anxiety include:
- You consider it a double-edged sword and don't want to lose the positive influence of anxiety on your achievements.
- You are worried that your work will suffer if you are not constantly driven to work hard out of fear.
- You might think that because you seem to be achieving (strictly from an objective standpoint) it means you do not "need help" for your anxiety—or perhaps that you don't deserve help.
- You might think that everyone struggles the way that you do and may think of it as normal. On the other hand, you might believe that you are just "bad" at dealing with life stress.
- You've never told anyone about your internal struggles and your silence has reinforced the feeling that you can't ask for help.
- You might believe that no one would support you in asking for or seeking help because they have not seen you struggle.
If you or a loved one are struggling with an anxiety disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Many people have a specific image or idea of what it means to have an anxiety diagnosis. For example, you might envision a person who is housebound, cannot work, or who struggles to maintain relationships of any kind.
We don't often think of the inner turmoil of anxiety as an internal struggle as being reason enough to seek help.
Anxiety can be very much a life of denial. You might even convince yourself that there is nothing wrong—you're just a workaholic, germaphobe, list-maker, etc.
It would be more helpful for us to refer to "high-functioning anxiety" as simply anxiety.
While it can look and feel different from other types of anxiety, it's still present (even though it's well-hidden) and can seriously disrupt a person's life.
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Famous People With High-Functioning Anxiety
When trying to raise awareness of a social issue like mental illness, it can be helpful to identify well-known or famous people as examples.
Stars such as Barbra Streisand and Donny Osmond, and athletes like Zack Greinke and Ricky Williams, have all been forthcoming about their experiences with high-functioning anxiety.
Scott Stossel, the national editor of The Atlantic, has written extensivelyabout his experiences with anxiety in the context of his achievements.
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Normal Anxiety vs. High-Functioning Anxiety
There is little research on the topic of high-functioning anxiety, but we do know that there is an optimal level of anxiety (not too low or too high) that fuels performance (the Yerkes-Dodson Law).
Based on this concept, your ability to function at a higher level might be increased if you had a mild to moderate level of anxiety (as opposed to severe anxiety).
IQ may also play a role in how well people with anxiety function in work and life. A 2005 study found that financial managers with high levels of anxiety made the best money managers—as long as they also had a high IQ.
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Prevalence of High-Functioning Anxiety
According to the National Institute of Mental Health (NIMH), around 19% of adults in the United States have an anxiety disorder. Some people might consider themselves to be in the "high-functioning" category, but it's difficult to know exactly how many.
Treatment Options for High-Functioning Anxiety
If you've never been diagnosed with a mental illness such as anxiety but you identify with the symptoms or characteristics, talk to your doctor. A medical professional you trust can provide support and give you a referral to be assessed by a mental health professional.
How Therapy Can Treat Anxiety
If you are diagnosed with an anxiety disordersuch as generalized anxiety disorder (GAD) or social anxiety disorder, know that there are effective treatment options.
Anxiety disorders can be treated with cognitive-behavioral therapy (CBT), medications such as selective serotonin reuptake inhibitors (SSRIs), and even techniques like mindfulness training.
Many people with anxiety find that using a combination of treatments best helps them manage their symptoms.
If your anxiety symptoms do not meet the full diagnostic criteria for anxiety disorder, treatment with psychotherapy with or without medication may still be helpful.
Medication and Lifestyle Strategies for Anxiety
Coping With High-Functioning Anxiety
Whether you've already sought professional help or are still in the process, here are some tips you can try on your own to reduce your anxiety.
- Commit to spending 10 minutes a day working on your mental health.
- Before you do any cognitive work (changing your thoughts), look at lifestyle changes such as limiting caffeine, eating a healthy diet, and getting regular exercise.
- Sleep hygiene is important too, such as sticking to a regular bedtime, and not staying in bed if your mind is racing. Instead, get up and do something else until you feel tired
- Look at some of your thought patterns. For example, anxiety involves a lot of negative predictions ("What if I don't make this deadline" or "I know I will make a fool of myself during this presentation!").
- When you notice a negative thought, try countering it with something more realistic or helpful, such as "I always make my deadlines, and even if I miss this one it won't be the end of the world."
- Find coping strategies for nervous habits such as biting your lip or chewing your nails. Practicing deep breathing or progressive muscle relaxation can help control tension.
- Learn how to use a competing response to address your nervous habits. This technique has you perform an action that is incompatible with the nervous habit—such as chewing gum to keep you from biting your lip.
Ask yourself why you hold on to your anxiety. Are you afraid that if you are no longer driven by anxiety, that you will stop being an overachiever?
These are real concerns that you will need to address as you work on reducing the effect your anxiety has on your life. This will involve refuting the belief that you can't accomplish things without your anxiety.
It may take some adjustment, but you will find a new groove that gives you a healthy balance between your mental well-being and getting things done.
Reducing the Stigma
Thinking of anxiety in both its positive and negative terms can help you get past its lingering stigma. We all need some level of anxiety to get things done.
Often, stereotypes and their resulting stigma take root when people don't understand what's happening or why, and this applies to anxiety disorders. Sharing your challenges with friends, family, and coworkers can help head off judgment and fear.
Furthermore, sharing your coping strategies can help others recognize and deal with their own anxiety.
Press Play for Advice on Managing Anxiety
Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast shares a strategy to help you cope with anxiety. Click below to listen now.
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A Word From Verywell
High-functioning anxiety can be a double-edged sword. You might be afraid to let go of something that feels like it's part of your personality, but know that you don't need to be secretly anxious to achieve and succeed.
Hold on to your positive traits through the habits that you've developed and try to let go of the tension and internal struggle your anxiety causes.
Not only does success not need to be the result of struggle, but opening yourself up to your true feelings and sharing them with others can make your experience of life and the world around you more authentic.