Everything You Need To Know About High-Functioning Anxiety

By Jill Kapil, Psy.D.
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July 14, 2022

Anxiety is a condition where excessive worry, fear, or overthinking happen beyond what a typical stress response may be.

It can happen in stressful situations in the short-term, or it can become a chronic disorder.

High-functioning anxiety is not a medical diagnosis, but a description for some people who have anxiety while seeming to get through daily life as “normal.”

Despite this outward appearance, inside their head they may feel burdened with anxious thoughts, stress, worry, and fear.

Just because someone seems like they are doing well does not mean they do not experience symptoms of  anxiety, and any type of anxiety has its own challenges.

Even if you seem to function well in life and anxiety does not prevent you from work, school, or relationship success, it is still not something you have to live with.

In this article, I’ll talk more about high-functioning anxiety, including its symptoms, causes, and how it can be treated.

I’ll also offer some ways to find the right medical professional.

What Is High-Functioning Anxiety?

High-functioning anxiety is not a clinical term used by medical providers.

Some people who are diagnosed with anxiety may describe themselves as high-functioning, which typically means that they feel they are still able to get through daily life without much disruption.

Anxiety disorders exist in differing extremes, but labeling yourself as high-functioning because you are able to work or get through daily life without challenges does not necessarily mean that you are experiencing a high quality of life.

Some people may also have higher levels of function in some areas of life with anxiety, but struggle more in other areas which may be unseen.

People with high-functioning anxiety may also be better at hiding how much the anxiety affects them, appearing calm when their mind feels tense and anxious.

Anxiety can sometimes drive people to do more at work or in academic pursuits as a way to distract from it.

In this case, a highly successful person could appear driven, but might actually be suffering from relentless anxiety and an inability to find rest in their mind.

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Symptoms

Since high-functioning anxiety is not a diagnosis, there are not necessarily clearly set symptoms for it.

However, some tendencies or traits that may make a healthcare provider wonder if someone is dealing with anxiety could include:

  • Frequent worrying
  • Perfectionism
  • Irritability
  • Mood swings
  • Inability to relax or take time off (“workaholic”)
  • Overachieving
  • Fear of failure
  • Overthinking
  • Sleep problems or insomnia
  • Higher heart rate
  • Appetite changes
  • Digestive symptoms like nausea or diarrhea

These can all be symptoms associated with other conditions or disorders, but a medical provider can ask questions and run tests to rule out other causes.

In some cases, these symptoms indicate someone who has anxiety, but has found ways to remain functional through daily life.

Positive characteristics

Any type of anxiety presents challenges. It can decrease quality of life and make it hard to feel happy and relaxed.

But people with high-functioning types of anxiety may also feel that they have some advantages, like being an overachiever or being able to get a lot done at work or in academics.

They may also be well-liked, be highly attuned to details (which could make them successful at work), and keep a very tidy home. In relationships, they may also be dedicated, loyal, and passionate.

Underneath the appearance of positive characteristics, however, a person with anxiety who functions well in life could still feel tense, scared, worried, or overcome by feelings of anxiety on a regular basis.

Sometimes it is not the ability to function well, but the stigma of being diagnosed with a mental health condition that may prevent someone from seeking help.

Healthcare providers are there to support your quality of life, and if you do not feel happy, relaxed, or able to find a balanced mood, it does not matter how successful your life appears on the outside.

Speak to a medical provider for treatment and help. 

Negative characteristics

Negative aspects of high-functioning anxiety can mean that others in your life do not perceive how anxious you feel, or assume that if you do talk about your struggles, that it does not impact you.

Not being perceived accurately can be a deep mental burden, and can add to anxiety.

Generally, negative aspects of being high-functioning with anxiety may have similar traits as other anxiety conditions:

  • Inability to sleep well
  • Being unable to relax or rest
  • Feeling tense
  • Being a people pleaser (afraid to say no)
  • Being paralyzed by perfectionism or procrastination
  • Having a racing mind

One of the other negative aspects of high-functioning anxiety may be the inability to recognize that you have anxiety.

People usually only seek help if they feel they have a specific condition or problem, but if someone with anxiety believes that they function too well to have a real need for help, they may delay seeking treatment.

When anxiety goes untreated for long periods of time, it can worsen or could impact other mental health conditions. 

Causes

Because high-functioning anxiety is not a clinical diagnosis, there are no specific causes.

However, the causes of anxiety disorders in general can apply.

These include:

  • Genetics and family history: If you have others in your family who experience symptoms of  anxiety or other mental health conditions, you may be more likely to develop anxiety.
  • Underlying health issues: Many health conditions can have anxiety as a side effect. These can include the conditions themselves, like thyroid disorders, other hormone imbalances, being pregnant or postpartum, or having any chronic disorders that impact the nervous system. It can also include side effects of medications that you may take for health conditions, like stimulant medications for ADHD or medication for Parkinson’s disease.
  • Substance abuse: Misusing or overusing alcohol or other illegal substances can affect neurotransmitters in the brain, which may cause anxiety.
  • Exposure to trauma or stress: People who experience trauma in childhood or as adults, or who undergo serious stressful events like the death of a loved one, a serious illness, or other terrifying experiences, may develop anxiety.

Treatment Options

Anxiety disorders are diagnosed by a medical professional.

A physical exam, as well as blood tests and imaging, may be done to rule out underlying physical causes that could lead to anxiety symptoms.

A healthcare provider may refer you for a psychological evaluation after that.

Even if you are high-functioning based on how you are able to live your daily life, if you are open with the medical provider during this process, they are usually able to recognize anxiety patterns and behaviors.

Sometimes a diagnosis may be made.

Other times you may not receive an official anxiety diagnosis.

Anxiety can be treated by psychotherapy.

In some cases, medication may be paired with psychotherapy to improve quality of life.

Psychotherapy

Psychotherapy is an effective way to help address anxiety.

For some, therapy alone can be enough to help someone find relief.

Some types of therapy for anxiety include:

Medication

Several prescription medications are used for treating anxiety.

  • Benzodiazepines like alprazolam (Xanax), lorazepam (Ativan), and diazepam (Valium)

Tips for Living With High-Functioning Anxiety

If you live with anxiety that you consider to be high-functioning, there are still ways you can support your own mental well-being.

These can work even if you are taking medication or seeing a therapist.

  • Spend time each day doing things that help you relax.
  • Find things to enjoy for fun, even if you think they are a waste of time.
  • Pick up hobbies that tap into your creativity, like art, knitting, writing, reading, music, or dance.
  • Avoid things that trigger anxiety, whether it is scrolling social media or watching television shows or movies that are stressful.
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Finding the Right Medical Professional

If you are experiencing signs of high-functioning anxiety, and have never considered seeking medical care, check in with a healthcare provider.

It is understandable that there is a fear of stigma or being diagnosed with a mental health condition.

However, medical providers do not view you differently.

A diagnosis of anxiety means that they can better help you find a better quality of life and relief from symptoms.

Some things to know about finding the right medical professional for anxiety:

  • They will not disclose any diagnosis to anyone else without your permission.
  • They can prescribe medication that can help address your symptoms.
  • They can recommend therapy or other lifestyle changes to improve your quality of life.

How K Health Can Help

You don’t even have to leave your home to start exploring care for symptoms of anxiety.

With a K Health provider, you can take a quick online assessment and chat with a doctor about the symptoms. If needed, they can prescribe medication that can be shipped to your door or picked up at a local pharmacy.

Frequently Asked Questions

What are the signs of high-functioning anxiety?
High-functioning anxiety is not a medical diagnosis, but someone may describe themselves that way if they deal with anxiety thoughts but are still able to keep a job, succeed in academics, or maintain healthy relationships.
How is high-functioning anxiety treated?
Anxiety is treated the same, regardless of how a person seems to function in life. If someone receives a diagnosis of anxiety, there are several effective medications, therapy options, and lifestyle changes that can help.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jill Kapil, Psy.D.

Dr. Jill Sorathia Kapil is a Licensed Clinical Psychologist in California. She completed her undergraduate degree in Psychology with a minor in Education from the University of California, Irvine; and received her Doctorate in Clinical Psychology from CSPP, San Diego (California School of Professional Psychology). Dr. Kapil completed her predoctoral and postdoctoral training at various College/University Health Centers across California, and has been licensed as a Psychologist since 2016.

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