Nov 22, 2022
A Guide to High-Functioning Anxiety
Anxiety disorders affect over 40 million adults annually, making it the most common mental illness in the United States. There are seven different types of anxiety, including generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), stress, social anxiety disorder (SAD), specific phobias, and obsessive-compulsive disorder (OCD).
While each of these disorders may present their own unique symptoms, anxiety, in general, is usually associated with persistent feelings of nervousness, uneasiness, and panic.
Does that mean someone without those symptoms doesn't have anxiety? Not necessarily. They might be suffering from something known as high-functioning anxiety.
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What is high-functioning anxiety?
High-functioning anxiety is a term used to describe someone who appears successful, calm, and functioning well on the outside but feels completely different on the inside.
It's not identified as a mental health condition in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). However, it's still critical to recognize and treat its symptoms to improve your quality of life and decrease the risk of burnout.
What are the symptoms of high-functioning anxiety?
Unfortunately, not much research hasn't been done for healthcare providers to pinpoint all the signs of high-functioning anxiety.
However, some possible symptoms may include the following:
an inability to relax
a need for perfectionism
overachieving due to fear of failure or of letting others down
the urge to keep busy all the time
regularly overthinking and overanalyzing situations
experiencing anxiety about what could happen (anticipatory anxiety)
Insomnia and other sleep issues
digestive and gastrointestinal (GI) issues
What causes high-functioning anxiety?
Again, due to a lack of research, it's hard to determine the exact causes of high-functioning anxiety.
Environmental and genetic factors that lead to anxiety disorders and depression may also result in high-functioning anxiety, such as:
Family history of an anxiety disorder
Experiencing stress or trauma at any point in life
Medical conditions like thyroid issues, adult ADHD, and fibromyalgia
Drug and alcohol abuse
Childhood traits of shyness, fear, or nervousness
High-functioning anxiety vs. generalized anxiety disorder (GAD)
Generalized anxiety disorder (GAD) is one of the top disorders diagnosed in the United States. A person with GAD experiences constant and excessive fear that interferes with their personal, work, and social life. The persistent worry may also lead to physical symptoms, like:
restlessness
difficulty concentrating
dizziness
heart palpitations
sweating
muscle aches and tension
The fight or flight response is the most significant difference between GAD and high-functioning anxiety.
People with GAD tend to engage in flight, meaning they use coping behaviors focused on getting away from situations that cause anxiety. They may withdraw from family and friends, mentally shut down, have breakdowns, and develop phobias to prevent anxiety.
Those with high-functioning anxiety in contrast, tend to deal with their anxiety by using the fight response. Therefore, their coping methods include whatever they can use to help them control anxiety-causing situations, such as overachieving, or fixating on productivity, achievements, routines, and habits, and developing a black-and-white thought process.
Treatment options for high-functioning anxiety
People with high-functioning will find many of the same treatment options for anxiety disorders that can help manage their anxiety.
Always speak to your healthcare professional to find your best treatment plan.
At-home care
In conjunction with medications and therapy, making lifestyle changes can play a significant role in reducing anxiety symptoms.
These involve:
Getting regular exercise
Evaluating your current sleep schedule to improve your sleep hygiene
Scheduling daily times of relaxation and meditation
Being mindful of workload, timelines, and due dates
Having a nutritious, well-balanced diet
Decrease or eliminate processed and inflammatory foods
Reduce or quit smoking and drinking
Professional treatment options
Psychotherapy (talk therapy) and prescription medications are often used to manage symptoms, especially in more severe cases of anxiety or when lifestyle changes alone don't help.
Several healthcare professionals, including psychiatrists, psychologists, counselors, and social workers, offer talk therapy to help someone understand and cope with thoughts, feelings, and behaviors. The National Alliance On Mental Illness can help locate a therapist near you.
Certain mental health medications are also effective in controlling anxiety symptoms. Serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), benzodiazepines, antipsychotics, mood stabilizers, buspirone, antihistamines, and beta-blockers are all medication types used for anxiety disorders.
The most commonly prescribed medications for anxiety include:
When to see a doctor
Whether it's high-functioning anxiety, GAD, or another disorder, experiencing any form of consistent anxiety can be debilitating.
The good news, anxiety is treatable. But getting professional help to develop a treatment is essential in managing your high-functioning anxiety. Consult with a doctor or other healthcare provider if you:
experience constant symptoms of anxiety that impact your physical, mental, and/or emotional wellbeing
can't control your symptoms, or they get worse even with treatment
find your anxiety affects relationships, work performance, or self-esteem
are using alcohol or drugs to cope
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