High Functioning Anxiety

Last Updated: July 4, 2023

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The physical and mental tolls of stress and anxiety can affect an individual’s everyday functioning. High-functioning anxiety can take on various forms and manifest uniquely from one person to another.

Anxiety can disguise itself through certain attitudes, habits, or behaviors, making it challenging to recognize high-functioning anxiety. A person’s outward appearance or demeanor may seem ordinary, but they may be experiencing symptoms that make everyday tasks such as completing work tasks incredibly challenging.


What is High Functioning Anxiety

what is High-functioning anxietyHigh-functioning anxiety is when a person experiences anxiety but can still manage daily life requirements at home and work. It can affect a person's quality of life and should be treated to help them cope with life’s challenges and stressors.

High-functioning anxiety isn't identified as a mental health disorder in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). When it comes to high-functioning anxiety, you may be able to perform duties yet experience high levels of anxiety that manifest into physical symptoms. Despite this, you keep your struggles hidden and suffer silently.


Generalized Anxiety Disorder

Generalized Anxiety Disorder (GAD) is an anxiety disorder characterized by persistent feelings of worry that affect everyday functioning. GAD makes it challenging for people to relax and concentrate on tasks. If you have GAD, you might experience sweating, restlessness, difficulty swallowing, and an increased urgency to pee.


The Difference Between Normal vs. High-Functioning Anxiety

Anxiety is a natural feeling that, although unpleasant, should not cause too much distress and affect daily functioning. With normal anxiety levels, people can still be motivated to engage in tasks, focus and be alert. High-functioning anxiety makes you look engaged and controlled, but you exhibit some physical signs of stress and may feel like your mind is in complete chaos.


Causes of High-Functioning Anxiety

High-functioning anxiety can stem from various factors in an individual's life, including genetic and environmental factors and personality traits that have developed over time. You might not be able to pinpoint what causes your anxiety, but a therapist can help you to understand what triggers your anxious thoughts.


Stressful Life Events

Stressful or adverse events can occur at any point in your life. You can be affected by witnessing or experiencing traumatic events like the death of a loved one, war and violence, diagnosis of a severe illness, living in a dangerous area, or a natural disaster. Highly-stressful jobs or work environments, like a hospital or a corrections facility, can also trigger high-functioning anxiety. Other examples of stressful life events include financial or legal problems, an injury, or being laid off or fired.



You might feel stress starting at a young age when you live in a critical and demanding household. You may have a genetic history of anxiety disorders in your family. The breaking up of a partner, friend, or divorce also contributes to high-functioning anxiety.



You may have experienced or seen abuse during childhood or your adult life from a family member or partner, coworker, classmate, or people online. It can affect you emotionally, socially, and sexually. Substance abuse, especially with a stimulant like caffeine, medications for ADHD, or cocaine, can increase anxiety levels.


Mental Health or Other Health Issues

Mental health or mental illness is also a risk for high-functioning anxiety. Underlying health problems, such as a thyroid or heart disorder, can worsen high-functioning anxiety signs.


Symptoms of High-Functioning Anxiety

Symptoms of High-functioning anxiety

Anxiety can range from mild to severe symptoms and vary in length and obscurity. Symptoms look different for each person. Some people can hide their symptoms well and appear calm. Others may hold back from pursuing things and act defeated. You might feel scared or worried and overthink. Obsessive thoughts don't allow you to feel relaxed. Anxiety symptoms can have long-term impacts on your health and relationships.


Physical Signs

Anxiety's physical symptoms may be unnoticed at first by yourself or others. Physical signs might be confused with something medically wrong, creating more stress. The stress hormone cortisol is released when you experience anxiety. When cortisol levels are enabled, it affects the body in countless ways. If left untreated, symptoms can lead to severe mental and physical health issues like depression, a heart attack, and drug abuse. It's harder to hide behind physical signs.



You may feel tiredness or exhaustion after experiencing a high level of stress. You may even feel periodic insomnia, leading to headaches and tremors.


Nervous Habits

Engaging in nervous habits can serve as a way to relieve anxiety. These habits may include biting your nails, knuckle cracking, chewing your lip, shaking your leg, or doing repetitive movements to funnel your nervous energy.


Muscle Tension

Muscle tension may also be a symptom of anxiety. Signs of muscle tension include clenching of your fists and jaw, and other muscles. The muscles may remain in semi-contracted positions for a lengthy period, which can cause small lumps or knots to form.


Non-Physical Signs

While high-functioning anxiety may cause someone to appear calm on the outside, internally, it can be quite the opposite. Commonly people with high-functioning anxiety will overthink a lot of situations. A common non-physical sign of high-functioning anxiety is never wanting to disappoint others and being a people pleaser. You may start having difficulty saying no, even at your own expense.

Often, uncertainty or high standards lead to periods of procrastination followed by periods of last-minute work. Procrastinating is a high-functioning avoidance technique because it allows your anxiety to be productive in an inefficient way. You spend all your time doing other things instead of the task you need to complete to avoid dealing with it. This habit then increases the level of anxiety.


Fear of Failure

You are harsh on yourself and set continually high standards to strive for perfection. You may find it difficult to delegate tasks to others. You may also need help completing tasks independently as you are scared of not reaching the standard of perfection.


Sleeping Problems

People with high-functioning anxiety tend to have difficulty waking up or falling asleep. Your thoughts could keep you up at night and not allow you to get enough sleep, causing excessive tiredness during the day.


Excessive Worry

Excessive anxiety lasts for days and goes on for at least six months. Your thoughts may become dark or sad, making you feel depressed or inadequate. Your mind never stops thinking about what could go wrong.


Treatment Options

Prescriptions Medications

You can speak to psychiatrists, nurse practitioners, primary care physicians, or a medical professional to discuss options on medication to treat anxiety disorders and dosage to control your symptoms. Before prescribing any medication, a doctor should take you through an extensive anxiety disorder diagnosis process.

These medications can increase calmness by regulating chemicals in the brain:

  • Antidepressants such as serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and serotonin-norepinephrine reuptake inhibitors (SNRIs)

  • Beta-blockers, buspirone, an anti-anxiety drug, and benzodiazepines for short-term anxiety relief


Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a form of talk therapy that can help reduce anxious thoughts by confronting situations that trigger high-functioning anxiety. A therapist or counselor can also help you understand your symptoms and teach techniques, such as meditation and muscle relaxation, that help manage anxiety symptoms. Cognitive behavioral therapy is the most commonly used therapy to treat high-functioning anxiety and better understand behavior.


Frequently Asked Questions

Are There Other Forms of Anxiety?

Panic disorders consist of panic attacks and sudden flashes of terror without forewarning. It causes shortness of breath, chest pain, dizziness, and heart palpitations that feel like an oncoming heart attack.

Social anxiety disorder usually occurs in social settings and arises when engaging in discussions or conversations. You start to worry excessively and overthink what you're going to say, debating if it will humiliate you.

Post-traumatic stress disorder (PTSD) is when a person experiences various symptoms, such as nightmares, flashbacks, a decrease in mood, anxiety, and avoidance following exposure to a traumatic event like abuse, violence, and illness. A person may seek treatment such as cognitive-behavioral therapy or medication treatments.

Obsessive-compulsive disorder (OCD) is when a person experiences obsessive and intrusive thoughts. They also do extensive rituals that are aimed at reducing anxiety disorder. It was formerly classified as an anxiety disorder.


What are Some Other Tips for Dealing with High-Functioning Anxiety?

Exercise regularly to stay healthy and feel energized during the day. Stretching and moving your body also allows you to disconnect from what's causing stress and improve your mental health.

Proper sleep hygiene and a consistent sleep schedule are beneficial for dealing with the symptoms of high-functioning anxiety disorder. There are several ways you can combat insomnia and sleep deprivation, including:

  • Showering or reading a book to calm down your mind and body
  • Set a proper bedtime to ensure you get eight hours or more of sleep

Scheduled relaxation and meditation can also reduce stress levels. Consider the pros and cons when discussing choices with a friend, mentor, mental health professional, or counselor.

When stressing over a task or assignment, weigh the advantages, such as knocking it off your to-do list, and the disadvantages of leaving and rushing to complete it later. Setting realistic goals will help you feel more relaxed and help you complete tasks better. Be mindful of workload and time/deadlines.










The contents of this article are provided for informational purposes only and are not intended to substitute for professional medical advice, diagnosis, or treatment. It is always recommended to consult with a qualified healthcare provider before making any health-related changes or if you have any questions or concerns about your health. Anahana is not liable for any errors, omissions, or consequences that may occur from the use of the information provided.


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