What Is High-Functioning Anxiety? Signs and How to Cope
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When most people hear the word “anxiety,” they imagine someone visibly distressed. A person with anxiety is probably restless, sweating, and avoiding situations altogether. But anxiety doesn’t always look like that.
In fact, for many, it hides behind a mask of success, ambition, and composure. This is what’s often referred to as high-functioning anxiety—a term not formally recognized in the DSM-5, but widely used in therapeutic circles to describe a specific lived experience.
What Is High-Functioning Anxiety?
A person with high-functioning anxiety experiences anxiety internally but continues to maintain an outward appearance of being in control. They may excel at work, stay organized, and appear calm in stressful situations.
To outsiders, they seem to have it all together. But underneath the surface, they worry excessively, overthink their behaviors, and are perfectionists.
Signs of High-Functioning Anxiety
Because those with high-functioning anxiety often overcompensate to hide their inner distress, the signs can be subtle. Here are some common symptoms:
Overthinking Everything
People with high-functioning anxiety frequently replay conversations in their head, worry about how they’re perceived, or obsess over making the “right” decision.
Perfectionism
They set excessively high standards for themselves and feel like a failure if they fall short. Even small mistakes can trigger shame or panic.
Procrastination
They may put off tasks due to anxiety, only to push themselves into overdrive at the last minute, staying up late or skipping meals to meet deadlines.
A Need for Reassurance
Despite their accomplishments, they often doubt themselves and seek external validation to feel secure.
Trouble Saying No
Fear of disappointing others or being judged can make them overly accommodating, even at the expense of their own happiness.
Staying Busy to Avoid Stillness
Quiet moments of downtime can feel uncomfortable, since their mind often races. Keeping busy becomes a coping mechanism to avoid anxious thoughts.
Physical Symptoms
Muscle tension, fatigue, stomach issues, headaches, and poor sleep are common among those with both anxiety and high-functioning anxiety. These symptoms are often ignored or minimized.
Why It’s Often Missed
Because high-functioning anxiety doesn’t always interfere with professional or academic success, it can go unnoticed by others, even by the person experiencing it. They may not recognize their habits as anxiety-driven, believing instead that they’re just a “type A,” highly motivated person. In fact, many don’t seek help until they’re burnt out, or their physical symptoms become too intense to ignore.
Coping Strategies
The good news is that high-functioning anxiety is manageable. With awareness and the right tools, you can quiet the inner critic and live a more balanced life.
Name Your Anxiety
Awareness is the first step. Identifying what you’re experiencing as anxiety helps separate you from it and opens the door to healing.
Practice Self-Compassion
People with high-functioning anxiety are often their own harshest critics. Try replacing self-judgment with kindness. Instead of “I should’ve done better,” say, “I did my best with what I had today.”
Set Realistic Boundaries
Learning to say no doesn’t make you unreliable. It’s an important skill for everyone to learn. Start small: decline a meeting you don’t need to attend or ask for help with a task.
Schedule Rest
Rest is essential for taking care of your mental health. Block time in your calendar for unstructured rest. Even 10 minutes of mindful breathing can help reduce anxiety.
Challenge Anxious Thoughts
When your thoughts are spiraling, ask yourself: Is this thought true? What’s the evidence? What’s the worst-case scenario, and could I handle it? This kind of cognitive reframing can eventually prevent these thoughts from taking over.
Getting Professional Help
No one should have to live with hidden anxiety. If you’re struggling, schedule a free discovery call today. Anxiety therapy can help uncover the root causes of your anxiety and identify how it’s affecting your life. Together, we’ll develop personalized strategies for managing your mental health.