High-Functioning Anxiety Disorder: The Truth About Living with Anxiety

Anxiety is best known for manifesting and more obvious ways: think panic attacks, mood swings, and excessive rumination, but it can also marinate below the surface. You may feel distressed yet you continue to operate in your day-to-day life, meaning no one around you really knows what’s happening with you internally.

This particular form of anxiety is often referred to as high-functioning anxiety. It’s not a clinical diagnosis, but rather a catchall term to describe the experience of someone living with a sizable amount of anxiety, but without the “functioning” limitations required to meet the criteria for an anxiety disorder, according to Washington-based licensed clinical psychologist Alicia Clark, author of hack your anxiety.

High-functioning anxiety disorder does not physically appear on a patient as they typically do not show signs of anxiety. However, the calm appearance does not make the condition any less serious or painful for those who have it. Instead they have trouble sleeping, overthink late text replies if they did something wrong, and can fixate on little details. These fixations are common for those with high-functioning anxiety. The fear of never being good enough, doing your best, or not doing enough tends to control your life and push you to overachieve your work. 

In order to understand 40 million adults, it is important to understand high-functioning anxiety disorder and the truth about living with anxiety. 

What is High-Functioning Anxiety?

Whenever someone talks about anxiety, it is assumed all cases of anxiety are the same; however, It is not the case. When discussing the disorder instead of the feelings of anxiety everyone gets from time to time, it usually references a large number of anxiety disorders and related conditions. All the disorders share common symptoms including increased incidences of panic attacks and inappropriate, debilitating, or constant feelings of fear. Common symptoms do not mean all anxiety disorders are the same.

The “high-functioning” aspect of anxiety may make it sound like it is a good thing and somehow is easier to be successful. In reality, it only indicates information about the kinds of people who have it and the ways the condition impacts their day-to-day lives. Typically, individuals with high-functioning anxiety are not prevented from achieving success, and the condition may be in part to the great things they are able to achieve. This does not mean problems do not exist nor is the condition the cause of their success. 

A common symptom of anxiety is “anxiety” or “panic attacks” resulting in an elevated heart rate and fast, shallow breaths. A tightness and pain within the chest can occur while the individual feels they may throw up or pass out. Anxiety attacks can include unusual thoughts and feelings, such as, you are losing your mind or your life is outside of your control. 

For individuals with high functioning anxiety, they may not experience anxiety attacks or at least not in the same way. The anxiety attacks those with high-high functioning anxiety face are typically referred to as “silent anxiety attacks.” While experiencing the attack many look calm on the surface, but underneath the practiced calm complexion, their thoughts are running wild. The heart rate can still increase and a tightness allows them to know they are having an attack, but they have perfected the art of suppressing the typical signs. The physical symptoms tend to not be apparent, but the emotional symptoms and the feelings of lost control radiate within the body to an extreme level. 

Crafting their lives around avoiding triggers, people with high-functioning anxiety are able to better avoid uncomfortable situations and anxiety attacks. Fear prevents a majority of individuals suffering with anxiety from pursuing opportunities; however, a person who is in the high-functioning spectrum can be driven by fear to always work or work harder than the average person resulting in a high professional success rate, but unfortunately they typically do not have time or energy left over to maintain healthy relationship or their own physical or emotional health. 

Who Gets High Functioning Anxiety Disorder?

Anyone can get high-functioning anxiety disorder. Anxiety is triggered by chemical imbalances, life events, or a combination of the two as it is an emotional disorder like depression. Causes of high-functioning anxiety are complicated, and it is hard to determine if those diagnosed with the disorder are usually very successful because their anxiety drove them to push themselves or whether they developed anxiety because they pushed themselves to success. A diagnosis for high-functioning anxiety is typically determined within adults which makes study to help determine the causes even more complicated. 

People with the disorder tend to be perfectionists and insist on specific routines leading to developing obsessive compulsive disorder. High-functioning anxiety disorder may be noticed by a care provider because the patient suffers from chronic stress which causes physical symptoms like high blood pressure, heart problems, poor immune system, digestive problems, muscle pain, weight loss or gain, and others. 


Treatment for the disorder can be medications, talk therapy, or a combination of the two. However, anxiety medication can make talk therapy helpful, resulting in an end within months or even years, but talk therapy or medication alone often ends up lasting a lifetime. Therefore, a majority of patients tend to be weary of medication and fear it will change who they are as a person. A big fear is the medication will dull their personality and take away their drive and ability to succeed as it has become a staple in their work ethic and personality. They feat their “overachiever” attitudes will falter.  It is said this is not the case, however, talk therapy is still an option for those wishing not to go the medication route.

Reconnect with Your Body

Anxiety is just as much physical as it is mental. Those with high-functioning anxiety fear success is never going to be enough to quiet the fear. They tend to be plagued with guilt they have not done enough, or have not done it soon enough. This leads to an average of 10 to 12 hours in the office every day with little to no exercise causing them to feel stuck mentally and physically. 

Simple measures like deep breathing during the work day can help circulate oxygen, relax muscles, and lower blood pressure. Stretch at your desk, take walks outside, and exercising in some way will help you not to feel too busy or overwhelmed. 

Intervene with Yourself

Anxiety feeds off anxiety. When you allow it to take control, it is very hard to take your life back. Catching the symptoms in the beginning and intervening can reduce the risk of snowballing. If you find yourself obsessing ang checking and rechecking, stop and walk away. Force yourself to divert your attention before it becomes too much of an obsession. Prioritize your own wellness. Saying “no” and disappointing someone is ok if you need to make time for yourself. If your work week was overly busy, take a relaxed weekend for yourself. Learning to moderate your emotions and behaviors in response to anxiety will help manage symptoms and decrease stress levels. Find a support system you trust within the environment to help calm you down in the moment. Having trustworthy people who understand the situation and are there for you can make a big difference in the end. 

Fear of failure and heightened sense of worry drives a high-functioning anxiety individual into utilizing an extremely high amount of mental energy on even the simplest tasks. Often individuals with the disorder function so well within society they tend to be overachiever and perfectionist flourishing in their work, but when it comes to a social setting, they overthink everything. The brain takes over and dictates everything as worrying makes it seem like everyone is against you. Those with the disorder tend to be high multitaskers meaning over stimulating social gatherings like a party tend to make them shut down especially if they do not know anyone there. 


From an outsider perspective, an individual with high-functioning anxiety tends to be perceived as fun, outgoing, and career driven. It is not until they are put into a social setting where they are uncomfortable those people realize those who are suffering tend to falter and become timid within new conversations as starting them sends out red flags within our heads. Once we know someone and become comfortable, we are able to become the extraverted, fun, and bubbly person the outsider knows, but until then it is common to be an introverted extrovert. An individual with high levels of anxiety tends to procrastinate until the last minute, not because they are lazy, but because they care about the work so much they overthink every detail so much they make themselves sick before writing it. Doing the work last minute tends to be of higher quality than had they started it earlier because it is less overthought. The mind does not relax even during the procrastination stage because it is thinking about all the ways to create what needs to be done until it is perfect. The time of relaxation is at the end of the final project when the item can be checked off a list and not thought about anymore. Even then the brain plays the past over and over trying to find new ways to make it better, make it perfect, so the new ideas can be taken advantage of for the next project. 

The cycle does not end. It is hard for individuals with high-functioning anxiety to find time to settle down and take care of their mental and physical health. Relationships tend to suffer as they are in a committed relationship with their work 24 hours out of the day. Overthinking takes over the worst at night causing little to no sleep. The lack of sleep transfers to high levels of stress resulting in an imbalance within the brain and anxiety spikes. Recognizing symptoms and regaining control will allow for a decrease in the effects of the disorder and lead to a healthier lifestyle.


Meladi Brewer
Meladi Brewer

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