What Is High Functioning Anxiety Disorder?

High-functioning anxiety refers to the experience of appearing confident, organized, and well-functioning on the outside while feeling internally anxious. With high functioning anxiety, you may feel fearful, worried and be in a state of constant self-doubt and self-criticism, all the while being prone to pushing yourself to work harder as a way to try to overcome these feelings. This differs from the avoidance or withdrawal that is common with other anxiety conditions.

It can be challenging to recognize high functioning anxiety in others because the person in question may try to mask it by taking control of a situation or appearing very confident even when they aren’t.

Do I Have High Functioning Anxiety?

High functioning anxiety is not a diagnosable disorder. Rather, it fits under the umbrella of anxiety disorders such as generalized anxiety disorder. If you experience high functioning anxiety you may have a form of generalized anxiety disorder or an unspecified anxiety disorder.

People with high functioning anxiety tend to be outgoing, detail-oriented, organized high achievers who proactively approach tasks. You may feel fearful in certain situations (such as those that might invite criticism from others or cause you to feel incompetent), worry about not performing well, feel significant stress, have a sense of impending doom, experience physical signs of anxiety such as increased heart rate or sweating, and have difficulty functioning and getting things done even if you continue to do so and others cannot tell you are anxious.

High functioning anxiety leads to over-pushing and over-functioning. You may be constantly working and taking on more and more. This can take a toll on your relationships and quality of life and lead to burnout. Those with high functioning anxiety may struggle to take breaks or take care of themselves which can cause sleep problems or lead to other health problems such as digestive issues, chronic fatigue or pain.

Those with high functioning anxiety may feel as though they are putting on an act. The outside world sees them as confident, capable, and successful yet they feel insecure, overwhelmed, and perhaps incompetent. High functioning anxiety, and fear of incompetence, can lead people to overly personalize or internalize feedback from others making it difficult to accept any feedback. This article from Mayo Clinic Health System provides an overview of high functioning anxiety. 

To have an anxiety disorder, anxiety symptoms need to be excessive, ongoing, and cause significant distress or impairment in daily functioning. Factors that can contribute to high functioning anxiety include a family history of anxiety, and negative or stressful life events. Even if you do not have a disorder, you may still experience problematic anxiety and benefit from therapy.

How To Treat High Functioning Anxiety

Therapy – including cognitive behavior therapy and acceptance and commitment therapy – can help you learn coping skills to effectively manage high functioning anxiety. For example, it is beneficial to learn to notice, challenge, and reframe anxious thoughts to be more neutral and helpful and practice behaviors that do not fuel or maintain anxiety. It is natural to have an urge to battle anxiety which just makes it stronger. Through acceptance-based strategies aimed at making room for anxiety and not fighting against it, you can learn to lessen its intensity.

Exploring your values and what is most important to you, and taking steps to engage in values-based behaviors vs focusing on what you think you should be doing or what others are doing, can enhance quality of life. Other helpful high functioning anxiety coping skills include practicing self-care in realistic and sustainable ways, setting helpful boundaries around work and tasks, and learning mindfulness skills that help you to refocus on the present moment when caught in a loop of worries or thoughts about the future.

To learn more about treating high functioning anxiety, please contact us at CBT Denver.