10 Minutes

Edited & clinically reviewed by THE BALANCE Team
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Generally, it is assumed that individuals with anxiety disorder are always stressed, nervous, restless, and worried even about minor inconveniences in life such that it significantly hampers their productivity. 

However, if you were to know that there exists a category of anxiety where individuals appear confident and always put together on the surface with excellent academic and work records yet they are struggling with anxiety on the inside, would you believe it? Or does this situation sound familiar- almost relatable? Well, this is the scenario of individuals dealing with high functioning anxiety. 

According to statistics, every 1 out of 4 individuals in the UK is dealing with a mental health problem such as anxiety or depression highlighting the prevalence of these disorders among the general population. 

Feeling anxious is a natural response of the body to any fearful stimuli, but what makes it a disorder is an exaggerated response to minor stimuli. Individuals with anxiety may have a pounding heart and racing thoughts and the fear of what is going to happen next always occupies their minds. Individuals with general anxiety disorder simply freeze in response to fearful stimuli rendering themselves unable to function optimally. 

However, high functioning anxiety is defined as a condition in which individuals despite dealing with symptoms of general anxiety disorder, such as constant worry, fear, and overthinking, are able to pull through the tasks of day-to-day life rather effectively. 

When individuals with high functioning anxiety come across a situation they dread, instead of backing off or shutting themselves down, they keep themselves composed, maintaining a confident persona while they are anxious to the core. 

People dealing with high functioning anxiety are a true representation of success. They always arrive earlier at work and are the last ones to leave. In addition, they always go the extra mile to bring out perfection in their work. Constant thoughts of worries always linger in their mind, keeping them restless. 

However, these individuals are experts at masking their inner turmoil by putting their confident selves on display- laughing and chatting amiably with friends and family and achieving excellence at work and academics. If simply put, these individuals are driven by their anxiety which pushes them to exert harder and harder. 

High functioning anxiety often stems from genetic or biological causes. It can even be a result of stressful life events or a shy or nervous personality since childhood. Moreover, high functioning anxiety can also be due to medical conditions such as thyroid issues. 

If you find yourself in a similar cycle of exertion and constant worry while successfully managing your everyday life you might be thinking ‘Do I have high functioning anxiety?’. Well, you can find this yourself by learning about how high functioning anxiety appears for the individual both on the front and from within. 

Following are the traits of an individual with high functioning anxiety:

  • They are high achievers

Individuals with high anxiety disorder are often referred to as an ‘overachiever’ or ‘high achiever’ considering the fact that they strive too hard to achieve their goals and meet deadlines. Despite all the success, they are always dissatisfied with their progress. 

  • They are constantly occupied with worry, anxiety, and fear 

They are always in a spiral of thoughts about ‘what ifs’ and no matter how hard they try to turn off their racing thoughts they are unable to do it, making them feel helpless. 

  • A desire to stay busy all the time

They always want to keep themselves busy and occupied as this keeps their thoughts at bay. Working too hard keeps them busy and thus helps them to avoid the clouds of worrisome thoughts that always loom over their head. 

  • Fear of judgement and failure

One of the reasons for going above and beyond to do a given task is because these individuals can not face failure, rather they fear it. They fear judgement and rejection. They fear that they might be regarded as ‘not good enough for the team’ and in order to avoid such circumstances they become too hard on themselves. 

  • Inability to relax 

The nervous energy of these individuals keeps them restless and pushes them to work harder. 

  • Overthinking and over analysing situations

Even when everything is going smoothly, individuals with high functioning anxiety, complicate the situation by overthinking and stressing themselves a great deal. They are constantly thinking about what is to happen next.

  • Increased heart rate 

A pounding heart is a signal of the anxious state of our body. In high functional anxiety, individuals have an increased heart rate whenever they are dealing with a tense situation.

  • Disturbed sleep

These individuals also find it hard to put themselves to sleep as they often fight insomnia due to their constant racing thoughts. In addition, they often feel groggy the next morning because they never feel adequately rested. 

  • Striving for perfectionism

Individuals dealing with high anxiety set great expectations for themselves which are at times hard to achieve. They set the bar very high and when complimented, they don’t feel like deserving the praise because they are always dissatisfied with their performance.  

  • Inability to open up about their emotions

They often keep their emotions bottled up and are not open to anyone about how they feel. They feel insecure and guilty about their anxiety and most importantly, they fear judgement and rejection. 

  • Eager to please people 

These individuals are people pleasers. They seek affirmation and approval from people who matter to them and can even go on neglecting their own needs. They even have a hard time saying no to people. 

  • Moody and irritable

They can become irritable and moody given the constant effort they put in and remain dissatisfied with themselves. Often these individuals are depressed because they have no outlet to share their feelings making them cranky and moody. 

  • Need for occasional isolation

They feel like nobody can understand them. These individuals are longing for isolating themselves and taking a break from the constant pressures of life. 

Social anxiety is a type of anxiety disorder where individuals avoid social gatherings as they become anxious when they have to interact with people and make conversation. Their anxiety stems from the deep-seated fear of saying something wrong and embarrassing themselves in front of everyone. 

Individuals with high functioning social anxiety face similar discomfort and get overwhelmed when interacting in a social setting but they keep these feelings well masked. On the surface, these individuals chat confidently and do not make it apparent that they are anxious or nervous. 

High functioning social anxiety can be considered as a milder form of social anxiety where individuals have learned the art and tactics to face their fear and engage in a conversation. 

As mentioned earlier, mental health disorders are rampant in the UK. It is estimated that there were roughly 8 million individuals with anxiety disorder in 2013 in England. In addition, it is reported that women are two times more likely to have a diagnosis of anxiety disorder in the UK as compared to men. 

Despite the fact that disorders such as high functioning anxiety and other anxiety disorders are highly treatable, only 36.9 percent of people seek treatment which is a disturbingly low figure. 

Sadly, high functioning anxiety is an invisible anxiety disorder and currently, there are no proper guidelines to make a diagnosis of this disorder. However, professionals in the UK can diagnose this condition but the problem is that individuals with high functioning anxiety are unable to recognize that they are living with an anxiety disorder. 

Depression and high functioning anxiety are potentially linked. It is estimated that 60 percent of individuals with anxiety also have symptoms of depression. 

Furthermore, if high functioning anxiety or other forms of anxiety are not treated it can progress to depression since only a few people afflicted with anxiety seek treatment. 

Individuals with high functioning anxiety often delay seeking help because on the front they are doing great in life as compared to individuals with other forms of anxiety who have their life restricted and impaired. Also, people with high functioning anxiety perceive their anxiety-driven unbeatable persona as a positive trait even if it exhausts them by the end of the day, hence they don’t consider it a reason to ask for help.

Moreover, individuals with high functioning anxiety keep their emotions and thoughts bottled up assuming that no one will understand what they are going through. Since they never open up to anyone they are quite prone to spiral into a state of low mood that progresses to depression. 

Consequently, it is when these individuals hit rock bottom and are unable to push through everyday life, as they enter into a state of depression that they go for treatment. 

The real question is, ‘Is it possible to treat high functioning anxiety?’. Well, the good news is that all forms of anxiety including high functioning anxiety are very much treatable if efforts are made in the right direction. 

Psychotherapy and medication are the cornerstones for the treatment of high functioning anxiety but certain lifestyle changes need to be adapted for improved recovery. 

Here is a guide about how on can deal with high functioning anxiety.

  • Know your symptoms 

The real struggle for individuals with high functioning anxiety is that they don’t feel like they need treatment for their condition because everything is pretty normal on the surface. It is when they admit that they are going beyond the normal threshold of exertion and that they are not thriving but simply pushing through life that they seek help.

You should learn that your symptoms are attributed to high functioning anxiety so that you can accept your shortcomings and work on ways to improve them.

  • Understand the root cause of your fear

Anxiety is a response to deep-seated fear. So once you ask yourself what is the cause of fear and why do you fear a certain situation, you will realise that most of the reason is being judged or worse, fearing abandonment. Once you accept the fact that you can not please everyone and that someone’s opinion of you does not define you, you will start overcoming your fear. 

  • Embrace a healthy lifestyle

It is easy to lose yourself in the vicious cycle of high functioning anxiety where you feel physically and mentally trapped. Hence it is necessary that you stay physically active and meditate and exercise daily. Do activities that keep you connected with yourself. 

  • Find your support group

For an individual with high functioning anxiety it is very difficult to open up but even if you find a single person that you can trust with your thoughts and emotions then do let them know how you feel. 

Find someone who will not judge you and with whom you can share anything without the fear of rejection. This will help you immensely in overcoming the challenges you face and it will make it easier for you to seek professional help.

  • Talk Therapy

It is a very effective way to manage high functioning anxiety. Through this therapy, you speak to a counsellor and they help you address your concerns. This helps you to understand your condition and helps you to manage it with different strategies. 

  • Cognitive Behavioural Therapy (CBT)

It is one of the most efficient therapies available for the treatment of high functioning anxiety. It aims at altering the thought process of individuals by helping them understand their behaviour. It further helps individuals with integrating healthier coping habits in face of a stressor. 

  • Acceptance and Commitment Therapy 

This technique focuses on helping individuals live in the present moment and make the most of it without worrying about the future. This saves the individuals with high functioning anxiety as they are constantly trapped in the worry of what is to happen next. 

  • Eye movement desensitisation and reprocessing (EMDR)

It is helpful psychotherapy that involves a 60 to 90-minute session and helps in treating PTSD, anxiety, and different mental health disorders. It is a technique used to reduce disturbing thoughts and therefore it helps a great deal in high functioning anxiety by suppressing unwanted thoughts.

  • Dialectical Behavioural Therapy (DBT)

This therapy involves learning skills such as mindfulness, emotional regulation, and interpersonal effectiveness thereby helping individuals to cope with their problems in a healthy manner. 

  • Medications 

Psychotherapy and medications when used together are quite helpful in managing high functioning anxiety. Medications such as SSRIs, benzodiazepines, and beta-blockers are often given. 

While SSRIs may take longer to kick in, they are effective at treating high functioning anxiety. Benzodiazepines, on the other hand, are faster in action but can cause dependence. Lastly, beta-blockers are used to manage increased heart rate.

  • In-patient residential rehab

Residential treatment is also an option for individuals who wish to recover in an isolated setting away from an environment that has stressors. There are multiple options such as luxury residential rehab where impeccable services are provided with state-of-the-art facilities where one can heal and treat their high functioning anxiety state. 

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