High-functioning anxiety: When success is fueled by chronic stress

What Is High-Functioning Anxiety vs Low-Functioning Anxiety?

People with high-functioning and low-functioning anxiety share the same symptoms—it’s also imperative to remember that neither are true disorders; they’re signs of underlying anxiety. “Low-functioning” and “high-functioning” refers to how well they are able to mask their anxiety in their daily lives, both physically and mentally. 

As the name suggests, when compared to people with low-functioning individuals, high-functioners are less likely to let anxiety interfere with things such as completing tasks, fulfilling responsibilities, and maintaining relationships with other people.

People with high-functioning anxiety may be successful in many areas of their life—they’re able to balance their finances, relationships, and career growth well. They might even use their anxiety as fuel. But all the while, they’re fighting off anxious thoughts that cause significant stress and emotional turmoil. 

What Are the Signs of High-Functioning Anxiety?

The signs of high-functioning anxiety will manifest differently, depending on the person as well as their circumstances. In interpersonal relationships and interactions, someone with high-functioning anxiety might: 

• Be a people-pleaser
• Talk a lot for fear of silence
• Become withdrawn and overly introverted 
• Need constant reassurance of their talents, intelligence, appearance, and more
• Avoid eye contact
• Have a hard time saying no when something is asked of them—creating an overloaded schedule (and another source of anxiety)
• Have a limited social life
• Be unable to enjoy the moment during important celebrations or events
• Fear losing their loved ones for unforeseen reasons
• Seem tense or on-edge

In their daily life, people with high-functioning anxiety may spend long periods of time: 

• Battling racing thoughts
• Struggling with feeling detached or disconnected from people, places, and social situations
• Hyperfocusing or hyperfixating on projects to avoid making mistakes 
• Overthinking, worrying about the future, the present, or even past events
• Being overly concerned about other people’s perceptions of them 
• Overpreparing for mundane events such as appointments, parties, work meetings, and more
• Procrastinating followed by engaging in long periods of crunch-time work

Someone who is high-functioning may also experience irritating or unpleasant physical symptoms. These can appear in the form of: 

• Fidgeting, repetitive motions like tapping their feet or hands
• Nervous sweating
• Physical tells, such as twirling hair, biting nails, lips, or darting eyes 
• Agitation and short temper 
• Insomnia
• Substance use

Because people with high-functioning anxiety may be recognized for their hard work and dedication on many fronts, they may find it tempting to ignore what they’re feeling—and may focus more on their next achievement than on recognizing what could be causing their anxiety.

What Is High-Functioning Anxiety Caused By?

The root causes of high-functioning anxiety often vary, and the actual anxiety disorder causing their symptoms will as well. Some of the most common causes of anxiety are:

• Work stress 
• Chronic physical or mental health conditions
• The side effects of a prescription medication that isn’t working 
• Forms of abuse
• Bullying—both academically and professionally 
• The death of a loved one
• Relationship issues
• The loss of a friendship
• A divorce or breakup 
• Financial stress 
• Parental burnout

Additionally, some of the more common disorders generating someone’s anxiety are: 

• Generalized anxiety disorder
• Separation anxiety
• Selective mutism 
• Agoraphobia 
• Substance-induced anxiety disorder
• Panic disorder
• Social anxiety disorder
• Anxiety disorder due to a medical condition
• Specific phobias
• OCD or unspecified obsessions without compulsive behavior

The life stressors experienced by people with high-functioning anxiety can often be the relationships, obligations, and sources of fulfillment that define their lives—things they care deeply about. And though they want to offer support and give their energy in many ways, it’s important that someone with high-functioning anxiety gets the support they need, as well.

How to Support Someone with High-Functioning Anxiety

Even in cases where someone has high-functioning anxiety and is able to mask their symptoms, that doesn’t mean the daily struggle is easy. It can also be tough to know how to offer support to someone who seems anxious. You can be there for your high-functioning anxiety friend or family member by: 

• Showing patience: It’s not someone’s fault if they have a form of anxiety that they’re struggling with. If you lose your temper and become exasperated (especially if you’re a parent) over their tendency to worry, it’s not going to help them “snap out of it.” Instead, they’ll likely become more anxious, and will now worry more about disappointing you. Their self-esteem could take a major blow, and this will be another obstacle preventing them from overcoming their anxiety.
• Providing validation: Sometimes, the issues that someone with anxiety is worrying about are legitimate—and would cause anyone to become anxious. Other times, their concerns may be imaginary. But regardless, what they feel is real; and invalidating their emotions isn’t okay, even if you’re attempting to be comforting.
• Expressing concern: Voicing that you care is important, but should also be done in a manner that steers your partner, friend, family member, or coworker toward the resources that can help them. You can communicate that therapy could be of assistance—but you shouldn’t diagnose them with anxiety or make them feel pressured to take any course of action. 

You also shouldn’t use the suggestion of therapy in a condescending manner. And if you lose your patience, this could stigmatize mental health services for them, making it less likely that they’ll seek help. 

If they decide to seek out mental health services, continue to show your support. You can do this by:

• Asking them how you can continue to help (and determine whether what they’re asking crosses any boundaries for you) 
• Offering to attend a therapy session to learn how to better support them.
• Remembering to practice self-care so that you don’t become overwhelmed physically and emotionally

And if they don’t at first find a therapist that they enjoy working with, encourage them to match with a new therapist that is a good fit.

How Is High-Functioning Anxiety Treated?

Managing high-functioning anxiety requires adjusting a large range of factors, from changing one’s diet (such as excluding caffeine) to incorporating mindfulness or other forms of physical exercise into a new routine. However, the real cornerstones of long-term anxiety management are therapy and psychiatric care. 

When it comes to therapeutic methods, cognitive behavioral therapy (CBT) is perhaps the most popular and one of the most successful. CBT can teach clients how to lower their anxiety in the moment, helping them face anxiety-inducing situations or thoughts with a fresh, empowered perspective. 

Psychiatric medication is sometimes prescribed as well, particularly for those who have difficulty preventing their anxiety symptoms from affecting their daily functioning. In many cases, a prescription works even better when coupled with CBT. 

Some of the most common psychiatric medications given to help treat anxiety include: 

• Zoloft
• Prozac
• Lexapro
• Celexa
• Paxil

If you or someone you know seems to be masking the symptoms of high-functioning anxiety, it’s a good idea to sit down with a mental health professional. Though it’s tempting to hide the stress, worries, and fears behind a stoic wall, acknowledging them, and then taking proven steps to regulate those anxious thoughts can offer lasting relief.