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Signs You Have High-Functioning Anxiety and What to Do About It

Do you overthink or worry a lot? Are you a planner? Are you a perfectionist? Do you always meet deadlines—even earlier than expected?

You could be an high achiever, but you may also have high-functioning anxiety. Behind your calm, Zen-like exterior, there’s a roller coaster of fear, anxiety and self-doubt within.

What is high-functioning anxiety?

High-functioning anxiety is a hidden problem faced by many people who live with anxiety day-to-day but manage to excel at work, at home and in relationships. High-functioning anxiety isn’t recognized as a mental health condition, but that doesn’t mean it should be ignored.

“It’s not recognized as a DSM-5 (Diagnostic and Statistical Manual of Mental Disorder), but it is essential to recognize and treat because these signs and symptoms can affect people’s quality of life,” said Srinivas Dannaram, MD, a psychiatrist with Banner Thunderbird Medical Center in Glendale, AZ.

Anxiety on its own is a natural emotion when it doesn’t affect you or cause distress. It can help you avoid potentially dangerous situations or plan and stay motivated to complete tasks. But if you suffer from high-functioning anxiety, you are like a duck calmly floating on the water with your legs paddling frantically just below the surface. You might appear in control and engaged, but underneath you’re just fighting to get through the day.

“Typically, an individual with high functioning anxiety is a good planner who aims to get things done in time; however, as the person is used to a level of anxiety with all the psychological and physical symptoms hidden, any added stress could lead them to snap out or lose track of things,” Dr. Dannaram said. “People with high-functioning anxiety, due to lack of insight or understanding, suffer from all symptoms silently, always on the brink of burnout.”

What are the signs and symptoms of high-functioning anxiety?

If you’re kicking butt and taking names but are feeling burned out as a result, you may be prone to this type of anxiety. If you say to yourself, “I just have to get through this” or “I’m just going to power through,” this may be commended by your boss or coworkers, but the reality is you may be suffering.

To make a formal diagnosis, you’ll want to see a licensed mental health professional who can rule out other possible factors, but below is a list of 12 signs and symptoms to be aware of:

  • You have persistent feelings of excessive anxiety or worry on most days for at least six months.
  • Your restlessness sometimes makes you jittery or shaky.
  • You are tired or exhausted after a high level of stress.
  • You’re irritable when things don’t go as planned.
  • You have muscle tension, including clenching your fists and jaw
  • You have problems with sleep – either not getting enough, waking up and not falling back to sleep or trouble falling asleep.
  • You are always on edge, even jumpy.
  • You talk fast about multiple things at once.
  • You find it hard to delegate or trust others to complete tasks.
  • You’re a harsh critic or have unrelenting standards.
  • You use alcohol or substances to cope.

“People with high-functioning anxiety may experience some of these symptoms but are still able to function and achieve things in daily life; however, success driven by anxiety is at the expense of overall health and wellness,” Dr. Dannaram said. “This may result in fatigue, tiredness and eventually burnout and depression.”

What causes high-functioning anxiety?

“Causes for anxiety and high-functioning anxiety are generally due to genetic and environmental factors,” Dr. Dannaram said. “Some can be traced back to past experiences growing up.”

Some of the common risk factors for high-functioning anxiety include:

  • A family history of anxiety disorders
  • Certain physical conditions, most commonly related to thyroid issues
  • Growing up in an environment with triggers, such as having parents or siblings who suffer from anxiety
  • Substance and alcohol abuse
  • Shyness in childhood

Tips for treating and coping with high-functioning anxiety

“High-functioning anxiety can be treated the same way that other anxiety disorders, like generalized anxiety disorder (GAD) are treated, through therapy, lifestyle changes and medication, depending on severity,” Dr. Dannaram said.

For mild to moderate symptoms, he suggested the following effective treatments for anxiety:

  • Regular exercise
  • A consistent sleep schedule
  • Scheduled relaxation and meditation
  • Being mindful of workload and timelines

“These aspects improve sleep quality and reduce daytime tiredness and anxiety,” Dr. Dannaram said.

For severe forms of anxiety, using cognitive behavioral therapy (CBT), or talk therapy, and prescription medications can be effective at helping manage symptoms. “A behavioral health specialist can help you understand your anxiety, teach you how to manage symptoms, set goals and assess your progress,” Dr. Dannaram said. “Medications that treat anxiety disorders are helpful. These include selective serotonin reuptake inhibitors (SSRIs) in the long-term and benzodiazepines and beta-blockers in the short-term.”

[Also read: “10 Reasons It’s Time to Seek Help.”]

Bottom line

Don’t just get by with your anxiety, get help. Even if you’re excelling at work or at home, you are doing so at the expense of your overall health and well being. Being overworked and overwhelmed isn’t a badge of honor.

High-functioning anxiety may not be a specific condition, but it doesn’t mean you don’t have something going on in your life. If you’re feeling anxious, burned out or have any of the symptoms mentioned above, reach out to your health care provider or a licensed mental health specialist who can get you on the path toward relief.

Need help treating high-functioning anxiety?

Call the Banner Behavioral Health Appointment Line at (800) 254-4357.

Also read:

Behavioral Health Wellness Anxiety