A Dummy’s Guide to High-Functioning Anxiety

High functioning anxiety is a mental health disorder that is usually not accounted for. Distinguishing and getting help at the right time is very important.

High functioning anxiety is a term we hear not as often, it is not a diagnosed mental health condition. It has more or less evolved into such a term where people who live with anxiety all their lives tend to function normally well in different aspects of life.

According to the National Institute of Mental Health (NIMH), around 19% of adults in the United States have a high functioning anxiety disorder. However, it is rather tough to distinguish whether your anxiety is of the high functioning type.

People with high functioning anxiety may notice that their condition pushes them forward instead of holding them back. On the surface, you appear to be successful, confident, and calm, the typical Type A personality who excels at work and life. But that’s hardly the case, the way you feel on the inside may be very different.

Normally people with high functioning anxiety look like they’ve got it all together. The true definition of success. What others might not know (and what you would never share) is that beneath the surface of a seemingly perfect exterior, you’re fighting a constant churn of anxiety. It may have been nervous energy, fear of failure, and being afraid of disappointing others that drove you to success.

Even though you desperately need a break, and you can’t seem to call in sick or ask for a break because nobody would ever believe something was wrong, because you always portrayed yourself as being fine. If you happen to relate to the conditions below, you’re probably suffering from high functioning anxiety.

There are several positive and negative characteristics of high functioning anxiety.

Do You Have High Functioning Anxiety? | Your Mental Health Experts

Positive Characteristics

The potential benefits of high functioning anxiety can be seen in the outcomes and successes that you and other people observe about you.

Characteristics of people with high functioning anxiety that are often thought of as positive include:

  • Outgoing personality (happy, tells jokes, smiles, laughs)
  • Punctual (arrive early for appointments)
  • Proactive (plan ahead for all possibilities)
  • Organized (make lists or keep calendars)
  • High-achieving
  • Detail-oriented
  • Orderly and tidy
  • Active
  • Helpful
  • Appears outwardly calm and collected
  • Passionate
  • Loyal in relationships

There are several negative aspects as well:

Negative Characteristics

In the case of high functioning anxiety, a struggle often lies beneath that facade of success. The anxiety you feel about your success inevitably does come out.

Similarly, most people often don’t know that these actions are caused by high functioning anxiety and view them as just a part of who they are. These are the struggles you may face on a day-to-day basis:

  • “People pleaser”
  • Talking a lot, nervous “chatter”
  • Nervous habits (playing with your hair, cracking knuckles, biting your lip)
  • Need to do repetitive things (counting stairs or rocking back and forth)
  • Overthinking
  • Lost time (arriving too early for appointments)
  • Need for reassurance (asking for directions multiple times or checking on others frequently)
  • Procrastination followed by long periods of crunch-time work
  • Avoiding eye contact
  • Rumination and a tendency to dwell on the negative (“What if?” thoughts and dwelling on past mistakes)
  • Inability to say “No,” always having an overloaded schedule, being constantly busy
  • Insomnia (difficulty falling asleep or waking early and being unable to fall back asleep)
  • Racing mind
  • Others think that you are “difficult to read” (stoic, unemotional, cold)
  • Limited social life (turning down invitations)
  • Inability to “enjoy the moment” (being unable to relax and be in the present or expecting the worst in any situation)
  • Feeling intimidated by the future
  • The tendency to compare yourself to others (falling short of expectations)
  • Mental and physical fatigue
  • Loyal (to a fault) in relationships
  • Potential for alcohol or substance abuse as an unhealthy coping method


People with high functioning anxiety are usually labeled as overachievers since others fail to account for all the negative characteristics of the disorder.

Your actions are probably distracted by your high functioning anxiety, you never do anything outside your comfort zone. You likely choose activities that calm your thoughts rather than pursuing activities because you would enjoy them, or because they would expand your horizons.

If you have high functioning anxiety, you’ve likely come to terms with presenting a false image or representation to the world and never show your true feelings to anyone. Instead, you keep it all bottled up inside and compartmentalize your feelings with a plan to deal with them later.

How to Determine ‘High-Functioning’ Anxiety

There is very little research on the topic of high functioning anxiety, all we know is that there is an optimal level of anxiety that fuels performance. Based on this concept, your ability to function at a higher level might be increased if you had a mild to moderate level of anxiety in comparison to severe anxiety.

The Process of Getting Help

For people dealing with high functioning anxiety, it’s always good to know that there is help out there. Whenever you feel like, it is too much for you to handle and you’d like some guidance or assistance, you should seek out help.

Even though high functioning anxiety prevents you from seeking help because of the following reasons:

  • You consider it a double-edged sword and don’t want to lose the positive influence of anxiety on your achievements.
  • You are worried that your work will suffer if you are not constantly driven to work hard out of fear.
  • You might think that because you seem to be achieving (strictly from an objective standpoint) it means you do not “need help” for your anxiety, or perhaps that you don’t deserve help.
  • You might think that everyone struggles the way that you do and may think of it as normal. On the other hand, you might believe that you are just “bad” at dealing with life stress.
  • You’ve never told anyone about your internal struggles and your silence has reinforced the feeling that you can’t ask for help.
  • You might believe that no one would support you in asking for or seeking help because they have not seen you struggle.

Many people have a specific image or idea of what it means to have an anxiety diagnosis. We don’t often think of the constant struggle of high functioning anxiety as an internal struggle as being reason enough to seek help.

Treatment Options

If you believe that you are going through all the symptoms or conditions mentioned above, it is best that you consult your doctor and get the relevant treatment. High functioning anxiety disorders can be treated through several methods.

Anxiety and Anxiety Disorder - abhsnow

Anxiety disorders can be treated with cognitive-behavioral therapy (CBT), medications such as selective serotonin reuptake inhibitors (SSRIs), and even techniques like mindfulness training. Moreover, psychotherapy and a combination of all the treatments mentioned above is usually what is used.

We understand that high functioning anxiety can be a double-edged sword. It’s hard to let go of something that feels like it’s part of your personality, but know that you don’t need to be secretly anxious to achieve and succeed. Success does not always have to be the result of your struggle, opening yourself up, and discussing your true feelings can make your experience of the world much better and happier.

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