Experiencing anxiety every now and then is normal, and it's common to feel anxious before a speaking engagement, a job interview, or when you have to discuss something serious with someone you care about. But for those with an anxiety disorder, the anxiety experienced doesn't dissipate and can become worse over time, interfering with daily activities, such as completing assignments for school and work or socializing with friends and family. Some types of anxiety, such as generalized anxiety, may inhibit people from completing daily tasks and functioning in social settings, but high-functioning anxiety affects people in the opposite way.
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 POPSUGAR. "It's pretty much the symptoms of what anxiety disorder is but what is internal," Monique Castro, LMFT, founder and CEO of Indigenous Circle of Wellness, who is Diné and Xicana, told POPSUGAR. 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.
Castro agreed and further explained, "Some folks might feel fatigued or even energized, some overly energized," in addition to excessive worry and fear. The main difference between many anxiety disorders and high-functioning anxiety is that the latter is often unseen, both Castro and Westbrook said. "They're experiencing the anxiety symptoms but it's usually not visible," Castro said. Or, because you're doing so "well" externally, it can go dismissed although you may be struggling internally.
Signs and Symptoms of High-Functioning Anxiety
Because people with high-functioning anxiety aren't impaired by it, "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. Some symptoms people with high-functioning may experience are: 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, and the inability to be present and enjoy experiences, Westbrook and Castro said. Physical symptoms can include nausea, heart palpitations, migraines, stomach issues, and high blood pressure, Castro added.
Additionally, it is possible for high-functioning anxiety and anxiety disorders to be present with cooccuring 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 professional help if that's the direction you're interested in taking. Instead, she strongly urges seeking help if you begin to notice a shift in your behavior and you're becoming less social and OK in social environments, and any physical or mental fatigue you're feeling is 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 things like adult coloring books, journaling, and exercise can help. In her opinion, exercise is one of the best ways 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, because "daily exercise routines can help to relieve stress and anxiety, both physical and emotional." 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 said.
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 recommended 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 said.
High-functioning anxiety doesn't manifest in one particular way nor is there one perfect way to manage it. If you are in need of more guidance and support when it comes to your mental health, 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.