high functioning anxiety

High-Functioning Anxiety: What It Is and How to Manage It

High-functioning anxiety has become a buzzword in recent years. It’s in our conversations, online discussions, and media coverage. Yet, it’s important to clarify right from the beginning that high-functioning anxiety is not a clinical diagnosis.


Instead, it’s a concept that has gained prominence as we strive to better understand the intricacies of anxious emotions. 


What is high-functioning anxiety? 


High-functioning anxiety refers to a state where someone experiences persistent anxiety, fear, and worry, yet they manage to excel in their daily lives, fulfil their responsibilities, and even achieve notable success. 


You can imagine high-functioning anxiety as a room filled with tangled, thorny vines that constantly grow and crowd your space. These vines represent your anxious thoughts, worries, and stressors. They seem to be thriving and taking over your room, making it difficult for you to move around freely and comfortably. Yet you still manage to move around and accomplish things, despite the pain of the thorns’ poking.


At first glance, it might seem paradoxical—a person who appears to have it all together but is secretly battling anxiety. This ability to outwardly function well while struggling internally can make it challenging for them to receive the support they may need.


One crucial question that arises is, “What sets apart one anxious individual as ‘high-functioning’ while another as not?” 


While ‘high-functioning’ might seem like a positive label or a goal, it’s not. High-functioning anxiety does not typically mean a person is better at managing their emotions and symptoms but rather that they are better at hiding their struggles. A person’s ability to mask their anxiety and maintain a facade of being unaffected is what constitutes high function. 


A person with high-functioning anxiety will exhibit competence in their daily life, despite experiencing deep, ongoing worry and stress. The capacity to excel in their responsibilities, achieve success, and appear composed to the outside world creates a stark contrast between their inner turmoil and external achievements. This contrast is a hallmark of high-functioning anxiety, emphasising the complex nature of this experience.


The impact of high-functioning anxiety


High-functioning anxiety can have far-reaching effects on a person’s mind and life, significantly affecting their overall well-being.


The concealed nature of high-functioning anxiety can take an additional toll on a person, above and beyond the strain of their anxious thoughts and emotions. People grappling with this state frequently mask their internal turmoil by presenting themselves as competent and composed, making it tough for others to recognize their struggles. As a result, they may be less likely to get the support they need, support that could likely help them function better.


This inability to reveal anxiety can also strain relationships, as those struggling with high-functioning anxiety may find it challenging to express their negative thoughts and emotions. Misunderstandings and feelings of isolation often result. In the workplace, while a person with high-functioning anxiety may excel in their tasks, the ongoing pressure to perform at a high level can be mentally exhausting. Overtime, it can lead to burnout.


In addition to the above strains, a person with high-functioning anxiety is also dealing with the typical symptoms of anxiety. Constant worry and stress can take a toll on the body, leading to physical symptoms such as muscle tension, fatigue, and disrupted sleep. Restlessness, irritability, and a persistent sense of impending doom are some of the emotional effects of high-functioning anxiety.


How can high-functioning anxiety be managed?


Managing high-functioning anxiety involves a combination of strategies and support systems.


Try therapy: Anxiety-specialised mental health care, whether a digital program or a therapist, can help significantly in learning skills to manage high-functioning anxiety and to sort through the need to hide it. Cognitive-Behavioral Therapy (CBT) is a specific type of evidence-based therapy that can be highly effective in treating anxiety. It helps people identify and challenge negative thought patterns and develop healthier coping mechanisms.


Consider medication: For some people, consulting a psychiatrist, who may recommend medication such as antidepressants or anti-anxiety medications, may be the best route to support. Medication can be especially beneficial when anxiety is significantly interfering with daily life.


Practise mindfulness and meditation: Practising mindfulness can help people stay present and reduce overthinking around anxious thoughts. Meditation techniques can promote relaxation, easing physical symptoms, and generally reduce stress.


Use relaxation techniques: Anxiety keeps the nervous system in high gear. Learning and regularly practising deep breathing exercises and progressive muscle relaxation can help calm the nervous system. Techniques such as deep belly breathing or the 4-7-8 method can provide immediate relief during moments of heightened anxiety and serve as a powerful tool for regulating emotions.


Try grounding techniques: These techniques involve focusing on your senses to bring yourself back to the present moment when anxiety strikes.This can include describing what you see, hear, touch, taste, and smell.


Try visualisation: Positive visualisation exercises can help you imagine and achieve a sense of calm and control in challenging situations.


Practise self-compassion and self-care: Practise self-compassion by treating yourself with the same kindness and understanding that you would offer to a friend who is struggling. Prioritise self-care activities that promote relaxation and well-being, recognizing that taking care of yourself is not selfish but essential for managing high-functioning anxiety and maintaining overall mental health.


High-functioning anxiety is a multifaceted experience that challenges the conventional wisdom of what anxiety “looks” like. By understanding its origins, recognizing its impacts, and embracing effective management strategies, we can help those who silently grapple with this complex state. Reducing the stigma around anxiety disorders and encouraging individuals to seek help is a collective responsibility that can lead to greater empathy, support, and improved mental health for all.



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Vidula V Sawant (M.A., M.Phil., CRR No. A80980) is a clinical psychologist with  4+ years of experience and a passion for understanding the complexities of our minds and behaviours.

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