What Is High-Functioning Anxiety?

You may be familiar with social anxiety or generalized anxiety disorder (GAD). In general, anxiety is an intense, persistent, and excessive worry and fear. Everyone experiences anxious feelings to some degree, such as giving a big presentation. However, if your level of anxiety interferes with your ability to function in your daily life, you may have an anxiety disorder. You may not recognize the psychological or physical symptoms of your mental health condition because these distressing feelings have been your norm.

Yet, what is high-functioning anxiety? Although it is not officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), high-functioning anxiety is a term often used for individuals who have an anxiety disorder but appear to function well. With high-functioning anxiety, you often experience a persistent stream of worry and fear over everyday things and situations. However, you still manage to meet the demands of your daily life despite persistent thought patterns, such as rumination and racing thoughts. Additionally, you are typically a high-achieving and detail-oriented perfectionist who excels in your career with a cool, calm demeanor. 

However, your calm and overachieving appearance is a mask for internal struggles with overthinking, self-doubt, negative thoughts, and chronic stress. While high-functioning anxiety disorder may not be officially recognized in the DSM, mental health professionals recognize and understand the impact it has on your quality of life. At Spark Wellness, we realize that supporting our patients' health and well-being extends beyond a diagnosis. We know effective treatment is born in our comprehensive and holistic approach to healing the whole person. Whole-person recovery bridges the gap in understanding and in treatment options that consider every aspect of your life. 

Yet, how do you recognize whether your level of anxiety is typical or high-functioning anxiety? Looking at some of the common behavioral health and physical symptoms of high-functioning anxiety disorder can shed light on how it may be impacting you or your loved one.

Common Symptoms and Signs of High-Functioning Anxiety

The Cleveland Clinic notes in “Signs You Have High-Functioning Anxiety” that it can be challenging to spot high-functioning anxiety in yourself or a family member because you appear confident, outgoing, proactive, helpful, and loyal. Traits such as helpfulness, outgoingness, and attention to detail are typically regarded as positive qualities. The positive characteristics of high-functioning anxiety can feel confusing because you may not associate anxiety disorders like social anxiety disorder with confidence or outgoingness. Although everyone's symptoms are unique to them, you may question why seemingly beneficial traits in high-functioning anxiety reflect serious internal struggles. 

The difference between high-functioning anxiety disorder and, for example, GAD can be seen in the fight-or-flight response. Individuals with a mental health condition like GAD may be driven by flight, while high-functioning individuals are driven by fight. Furthermore, the drive for fight over flight is highlighted in the symptoms of high-functioning anxiety disorder:

Emotional and Cognitive Signs

• Overthinking 
• Racing thoughts
• Constant worry 
• Feeling a sense of impending doom
• Fear of failure 
• Self-doubt
• Perfectionism and high standards
• Fear of criticism 
• Significant self-criticism
• Procrastination despite being a high achiever
• Chronic stress
• Fear of being inadequate or looking foolish
• Rumination
• Feeling unable to enjoy the moment
• Comparing yourself to others 
• Feeling like you always fall short of your and others' expectations
• Fear of disappointing or angering others

Physical Symptoms

• Muscle tension and trembling
• Heart palpitations 
• Racing heart rate
• Sleep disturbances 
• Lightheaded
• Headaches and migraines
• Gastrointestinal issues 
• Excessive sweating
• Tingling or numbness
• Chronic pain
• Fatigue and exhaustion

Behavioral Signs

• Overachieving and over-committing
• Highly organized
• Detail-oriented
• People pleaser
• Always punctual or early
• Proactive
• Difficulty relaxing
• Excessive need for reassurance
• Appearing calm while experiencing internal struggles
• Avoidance behaviors
  • Limited social life
  • Withdrawal
  • Self-isolation
• Addictive behaviors
  • Excessive exercise and work
• Substance use disorder (SUD)

The signs and symptoms of high-functioning anxiety can contribute to distressing behavioral health and physical health challenges. Additionally, high-functioning anxiety can lead to significant mental and emotional distress that impedes your well-being and quality of life. Understanding the impact of high-functioning anxiety disorder on you or your loved one is invaluable to seeking professional help.

How It Impacts Daily Life and Well-Being

Despite your calm and confident demeanor or overachieving success at work or in school, high-functioning anxiety can be detrimental to every part of your daily life. When left unaddressed, high-functioning anxiety can disrupt your relationships, impair your mental and physical health, and impede your goals and desires. In your daily life, you can feel overwhelmed and exhausted by racing thoughts and negative thoughts. Thus, the chronic stress of overthinking can lead to restlessness, other mental health disorders, and physical health issues. The physical symptoms you experience, such as muscle tension, headaches, and fatigue, only increase your distress. Listed below are some of the other ways high-functioning anxiety impacts your work and social life:

• High-achieving and overworking
  • Burnout
  • Loss of productivity
  • Job dissatisfaction
  • Mental and emotional strain
• Difficulty saying no 
  • Poor work-life balance
  • Unhealthy boundaries
• Perfectionism
  • Spend an excessive amount of time on tasks
• Impaired decision-making
• Relationship conflict
• Resentment
• Avoidance and self-isolation 
• Lack of emotional openness
  • Unable to share true feelings
  • Pushing loved ones and others away
• Self-neglect 

The constant need for perfectionism and an overachieving mindset, coupled with excessive negative thought patterns, is devastating to your well-being. Rather than being a tool for success or part of healthy coping strategies, your high standards and anxious feelings become a cage of chronic stress for a poor quality of life. As a result, high-functioning anxiety not only disrupts your daily life but strips away your tools for resilience. 

The compounding of psychological, social, and physical health issues contributes to burnout. Burnout, in turn, makes it harder to engage in self-care and effectively manage your relationships and the other elements of your daily life. Thus, high-functioning anxiety in the long run contributes to a lower quality of life that creates a perpetual cycle of behavioral health, physical health, and interpersonal issues. However, the cycle of struggling can be broken with greater knowledge and understanding of high-functioning anxiety's place with other forms of anxiety disorders.

High-Functioning Anxiety vs. Other Types of Anxiety

One of the most difficult elements of high-functioning anxiety disorder is recognizing that you have it. Due to the positive traits associated with high-functioning anxiety, it is easy to convince yourself that you are fine, despite your internal struggles. Looking at different types of anxiety can give you insight into what maladaptive anxiety looks like to understand better how you experience your anxious feelings. Some of the different kinds of anxiety disorders include GAD, social anxiety disorder, and panic disorder. Some of the differences and shared symptoms between these anxiety disorders include:

GAD

• Feeling persistent levels of anxiety and worry about many everyday things
  • Excessive worry
    • Health
    • Money
    • Relationships
    • Work
  • Symptoms 
    • Restlessness
    • Fatigue
    • Difficulty concentrating
    • Irritability
    • Muscle tension
    • Stomach issues
    • Sleep issues
    • Sweating
    • Difficulty breathing

Generalized anxiety disorder shares numerous psychological and physical symptoms with high-functioning anxiety. Both GAD and high-functioning anxiety are marked by excessive worry and anxiety, along with fatigue, muscle tension, and restlessness. 

Although they share many symptoms, the main difference between GAD and high-functioning anxiety is how individuals engage in maladaptive coping strategies. Individuals with GAD are more likely to engage in avoidance behaviors like self-isolation and even mentally shutting down to avoid their anxious feelings. In contrast, individuals with high-functioning anxiety are more likely to overextend themselves and fixate on their work and other things like their routine, schedule, and checking things off their to-do list.

Social Anxiety Disorder

• A persistent and irrational fear of social situations that may expose you to scrutiny or judgment 
  • Persistent fear that you will be watched and judged
  • You fear you will do or say something embarrassing or humiliating
  • Fear of rejection
  • Excessive worry and anxiety weeks in advance
  • Social situations
    • Attending parties and other social events
    • Speaking in public
    • Eating and drinking in public
    • Job interviews
    • Dating
    • Asking and answering questions in a class or meeting
    • Talking to a cashier
    • Asking for help in public places
    • Using public restrooms
    • Taking or making phone calls
  • Symptoms
    • Trembling
    • Nausea
    • Difficulty talking
    • Sweating
    • Rapid heart rate
    • Difficulty making eye contact
    • Mind blanking
    • Soft voice
    • Avoiding places or situations where you may have to interact with others
    • Excessively analyze your interactions
      • Finding self-perceived flaws in your interactions
    • Expecting the worst outcome from a negative social situation

Social anxiety disorder and high-functioning anxiety share several physical symptoms and internal struggles. Some of the overlapping physical symptoms of social anxiety disorder and high-functioning anxiety include a rapid heart rate, upset stomach, sweating, and trembling. In addition to their shared physical symptoms, social anxiety disorder and high-functioning anxiety also involve overthinking, racing thoughts, rumination, self-criticism, and avoidance. 

Despite some shared symptoms, the focus of the anxiety and its impact on daily life are different for individuals with social anxiety disorder compared to those with high-functioning anxiety disorder. The internal struggles in high-functioning anxiety are not directly tied to social interaction or situations. Instead, individuals with high-functioning anxiety can appear confident and outgoing as they force themselves to excel in their career and or personal life. On the other hand, social anxiety disorder can significantly impair one's ability to interact with others, seek employment, and form friendships.

Panic disorder

• Involves frequent and unexpected panic attacks
  • Panic attacks are sudden and intense feelings of fear, anxiety, or discomfort
    • Occur without the presence of danger
  • Behavioral health symptoms
    • Fear of having another panic attack
      • May avoid places and situations where a previous panic attack occurred
    • Feeling out of control of your thoughts and body
    • Fear that you are dying or having a heart attack
    • Feeling detached from reality
    • A sense of impending doom
  • Physical symptoms
    • Difficulty breathing
    • Feeling like you are choking
    • Racing heart rate
    • Chest pain
    • Trembling or shaking
    • Sweating or chills
    • Upset stomach
    • Nausea
    • Feeling weak or dizzy

High-functioning anxiety and panic disorder share common anxiety symptoms like nausea, trembling, and a rapid heart rate. Yet, the core features of both anxiety disorders are quite different, as the internal struggles of high-functioning anxiety are often hidden. In contrast, panic disorders are difficult to hide when you feel unable to control your body or thoughts during a panic attack. With high-functioning anxiety, you hyper-fixate on your work and or personal life to push your anxiety away. On the other hand, a panic disorder often leads to significant distress and impairment that impedes your ability to function in your daily life. 

It can be difficult to acknowledge the harm high-functioning anxiety has had on you when you have spent most of your life viewing your overachieving and perfectionist behavior as an asset. You may wonder how you arrived at this difficult and overwhelming state in your life. Understanding the causes of high-functioning anxiety can give you insight into the factors that have contributed to your internal struggles. 

What Causes High-Functioning Anxiety?

According to Frontiers in Human Neuroscience, the difference between adaptive and maladaptive anxiety is in the rationale of the response. Adaptive anxiety is a rational response to an imminent threat, while maladaptive anxiety is an irrational state of anxiety that you get stuck in when there is no danger. Yet, what leads to this anxious, stuck state in high-functioning anxiety? Some of the potential causes for high-functioning anxiety include:

• Genetics
• Brain chemistry
  • Imbalances in certain neurotransmitters, like dopamine and serotonin
• Family history of anxiety disorders
• Highly competitive school and work environments 
• Stressors and negative life experiences
  • Work
  • Relationship conflict
  • Financial issues
• Death of a loved one
• Childhood trauma
  • Abuse 
  • Neglect
• Personality traits
  • Perfectionist 
• Growing up in a highly competitive or achievement-focused family or culture 

Some of the risk factors of high-functioning anxiety, like genetics, family history, and childhood trauma, can make you feel like the chips are stacked against you. However, even if your challenges stem from factors outside of your control, recovery is still possible. There is a wide variety of coping strategies and self-care practices that can help you make lifestyle changes to manage your anxiety.

Coping Strategies and Self-Care Practices

Anxiety is not an inherently bad thing, and being detail-oriented or proactive can be positive qualities when they come from a healthy place. Learning how to build coping strategies and incorporating self-care practices can provide a solid foundation for genuine confidence in yourself, your relationships, and your work. Some coping strategies and self-care practices you can incorporate into your daily life include:

• Deep breathing
• Create a mantra
• Mindfulness
• Meditation
• Yoga
• Walking
• Limit caffeine 
• Schedule downtime
• Sleep routine
• Recognize thought patterns 
• Reframe negative thoughts
• Build a support network
• Establish healthy boundaries 
• Identify your core values
• Journaling

Engaging in adaptive coping strategies and embracing self-care can help you make the necessary lifestyle changes for your long-term well-being. Although making lifestyle changes can feel daunting, you are not alone on this journey. Seeking professional help from a mental health professional and support groups can help you build a support network to thrive. 

When to Seek Professional Help

Seeking professional help can be a valuable step on your journey to making positive lifestyle changes. Yet, how do you know if you or a loved one needs professional help? Therapy can offer many benefits for self-awareness, understanding, and growth, even when it seems like you are functioning well. Listed below are some red flags that showcase when your anxiety has taken over your life:

• Your symptoms significantly interfere with your daily life, work, relationships, or physical health
• Heavy reliance on unhealthy coping strategies
  • Alcohol 
  • Drugs
• Overthinking every decision
• Unable to relax
• Excessive worry
• Significant physical symptoms in your daily life

With the support of a mental health professional, you can cultivate self-compassion and self-acceptance to heal and enhance your quality of life. Several comprehensive, evidence-based therapies can offer effective treatment for high-functioning anxiety and other co-occurring challenges. Some of the most effective treatments for anxiety include cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and medication-assisted treatment like selective serotonin reuptake inhibitors (SSRIs). 

Everyone's experiences and needs are unique to them, but with professional help, you can work together to find the right treatment for you. You do not have to be ruled by your anxiety. At Spark Wellness, we are committed to providing each of our patients with the support, safety, and space necessary for sustained recovery.

How Spark Wellness Supports Patients With High-Functioning Anxiety

Here at Spark Wellness, we believe in meeting our patients where they are on their recovery journey. We are committed to delivering a comprehensive and trauma-informed approach to care, fostering whole-person healing. With evidence-based therapies and holistic modalities, we collaborate to develop a personalized treatment program tailored to your specific needs. 

From comprehensive assessments and flexible treatment schedules in our outpatient programs to dual diagnosis treatment and holistic aftercare services, we offer a treatment program tailored to your needs. We are here to help guide you with compassion and understanding. Let us help you spark change in your life to lead the fulfilling life you deserve.

High-functioning anxiety may seem harmless or even beneficial to success in your career and social life due to associated qualities like being outgoing, confident, detail-oriented, and proactive. However, the positive qualities associated with high-functioning anxiety are a mask for intense and distressing thoughts and feelings. The anxiety and fear you experience can impede your physical and psychological well-being, strain your relationships, and contribute to substance abuse. Access to holistic and evidence-based therapies can help address your individual needs for whole-person healing. At Spark Wellness, we provide flexible trauma-informed programs to bridge the gap between treatment and daily life. Call us at (971) 359-4753 to start healing today for the fulfilling life you deserve.

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