High Functioning Anxiety: Symptoms, Causes & Treatment



In today’s fast-paced and demanding world, many individuals experience anxiety. However, a specific type of anxiety often goes unnoticed: high-functioning anxiety. This article aims to shed light on this silent struggle, providing a comprehensive understanding of what high-functioning anxiety is, its symptoms, its causes, and how it differs from other forms of anxiety.

Furthermore, it will explore various treatment options for high-functioning anxiety. If you suspect you or someone you know may be dealing with this condition, it is crucial to seek help and support from a medical professional.

Getting Help For High-Functioning Anxiety

Recognizing and addressing high-functioning anxiety[1] is paramount for individuals with this condition. Consulting a healthcare professional, such as a psychologist or psychiatrist, can provide the necessary guidance and support to manage your anxiety effectively. These professionals may use various diagnostic tools, including high-functioning anxiety tests, to evaluate your symptoms and their impact on your daily life. These tests can help identify specific patterns and behaviors associated with high-functioning anxiety, enabling your mental health provider to tailor a treatment plan to your unique needs.

What Is High-Functioning Anxiety?

High-functioning anxiety is characterized by individuals who appear to function well in their daily lives but experience pressure internally. These individuals are often high achievers, driven by perfectionism and a fear of failure. On the outside, they may seem calm, collected, and in control, but internally, they constantly battle worry, self-doubt, and relentless stress.

People with high-functioning anxiety tend to overthink and constantly anticipate the worst possible outcomes of any situation. They may have difficulty relaxing and always fear letting others down or not meeting their high expectations.

A link between anxiety and depression is often found, as those who struggle with excessive anxiety may also experience depressive symptoms and vice versa. While they may be successful in their careers or personal lives, their internal anxiety can affect their mental and emotional well-being. They may come across as having nervous energy.

In clinical practice, the term “high-functioning anxiety” is not formally recognized as an official diagnosis. The Diagnostic and Statistical Manual of Mental Disorders[2], which is the standard classification of mental health conditions, does not specifically include this term. Instead, anxiety is typically measured on a sliding scale based on the level of impairment it causes in an individual’s daily life. Those who experience mild levels of impairment[3] may be considered to have “high-functioning” anxiety without a formal diagnosis.

Symptoms And Signs Of High-Functioning Anxiety

High-functioning anxiety signs manifest differently in each individual, but there are common symptoms[4] to look out for. These may include:

  • Restlessness and an inability to relax: People with this condition often find it challenging to unwind and relax, even during leisure time. They may constantly feel the need to be productive to complete essential tasks and have difficulty quieting their thoughts.
  • Perfectionism: Individuals with anxiety often have exceedingly high standards for themselves. They strive for perfection in everything and may become overly self-critical when they fail to meet their expectations.
  • Constant worry and overthinking: People with anxiety tend to have racing thoughts and a constant need to analyze every detail of a situation. They may repeatedly review past conversations, past mistakes, obsessively plan for the future, and anticipate potential problems.
  • Physical symptoms: This condition can manifest in physical symptoms such as muscle tension, heart palpitations, headaches, digestive issues, shortness of breath, and difficulty sleeping. These symptoms may exacerbate the individual’s anxiety and impact their overall well-being.
  • Anxiety at night: Anxiety can be caused by various factors, including stress, worry, and fear. This type of anxiety can make it difficult to fall asleep, leading to fatigue and decreased productivity during the day. Identifying the underlying causes and developing effective coping strategies to address the concern at night is essential. These may include relaxation techniques, such as deep breathing and meditation, cognitive-behavioral therapy, and prescription medication.

Causes Of High-Functioning Anxiety

The causes of high-functioning anxiety are multifaceted and can vary from person to person. Some common contributing factors include:

  • Genetic and environmental factors: Evidence suggests that certain genetic factors[5] may predispose individuals to anxiety disorders, including high-functioning anxiety. Additionally, growing up in an environment where anxiety is prevalent within the family can increase the likelihood of developing this condition.
  • Early life experiences: Traumatic experiences during childhood or adolescence, such as abuse, neglect, or significant life changes, can contribute to the development of high-functioning anxiety.(Source for this please).
  • Personality traits: Certain personality traits (such as perfectionism, high conscientiousness, and a tendency to overthink) may make individuals more susceptible to high-functioning anxiety.(Source for this please).
  • Environmental factors: High levels of stress, pressure, and demands in one’s personal or professional life can contribute to developing or exacerbating high-functioning anxiety. Work-related stress, relationship difficulties, or significant life transitions can all contribute to heightened anxiety levels.
  • Hormones: Hormones can cause anxiety. Hormones such as cortisol, adrenaline, and thyroid hormones play a crucial role in the body’s stress response, and an imbalance in these hormones can cause anxiety symptoms.

High-Functioning Anxiety Vs. Other Forms Of Anxiety

High Functioning Anxiety
Generalized anxiety disorder is characterized by excessive and persistent worry.
Photo: Shutterstock

It is essential to differentiate high-functioning anxiety from other forms of anxiety, as the treatment approaches may differ. While individuals with high-functioning anxiety may outwardly appear to have their lives together, they still experience anxiety internally. This contrasts with individuals with other anxiety disorders, who may have visible signs of distress or greater levels of impairment in their daily functioning.

High-functioning anxiety often coexists with other mental health conditions,[6] such as generalized anxiety disorder, social anxiety disorder, or obsessive-compulsive disorder. It is crucial to consult a professional for an accurate diagnosis and to determine the most appropriate treatment plan based on your specific symptoms and needs.

Generalized Anxiety Disorder

​​Generalized Anxiety Disorder[7] is a mental health condition characterized by chronic and excessive worry, fear, and tension, even when there is no apparent reason for concern. People with GAD may experience physical symptoms such as:

  • Restlessness
  • Muscle tension
  • Fatigue
  • Irritability
  • Difficulty concentrating
  • Sleep disturbances

5.7% of U.S. adults[8] have experienced generalized anxiety disorder at some time.

Social Anxiety Disorder

Social Anxiety Disorder[9] is a mental illness characterized by intense fear, nervousness, and discomfort in social situations. Individuals with SAD often experience extreme self-consciousness and fear of being judged or evaluated negatively by others. They may also worry excessively about embarrassing themselves or behaving in a socially unacceptable way. The symptoms of SAD can significantly interfere with an individual’s daily life, leading to social isolation, avoidance of social situations, and difficulty maintaining relationships.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder[10] is a type of anxiety disorder affecting millions worldwide. It is characterized by recurring, unwanted thoughts (obsessions) or repetitive behaviors (compulsions) that are often time-consuming and interfere with daily life.

People with OCD may feel compelled to perform specific actions, such as washing hands repeatedly or checking locks multiple times, to alleviate anxiety caused by their obsessive thoughts. However, these compulsions provide temporary relief an

High-Functioning Anxiety Treatments

High-functioning anxiety can be treated through a combination of practices.
Photo: Shutterstock

Fortunately, various treatment options are available for individuals living with high-functioning anxiety. These treatment approaches aim to alleviate symptoms, improve daily functioning, and enhance overall well-being. Some common treatments include:

  • Therapy: Psychotherapy, such as cognitive-behavioral therapy[11], is highly effective in treating high-functioning anxiety. CBT helps individuals identify and challenge negative thought patterns, develop healthy coping mechanisms, and learn relaxation techniques to manage anxiety.
  • Medication: In some cases, medications such as beta-blockers and selective serotonin reuptake inhibitors may be prescribed to manage the symptoms of high-functioning anxiety. Antidepressants and anti-anxiety medications can help regulate brain chemistry and reduce symptoms. It is essential to consult a psychiatrist to determine if medication suits your situation.
  • Lifestyle modifications: Incorporating healthy lifestyle habits can play a significant role in managing high-functioning anxiety. Regular exercise, proper sleep, stress management techniques (meditation or deep breathing exercises), and a balanced diet can reduce anxiety symptoms. (Source please)
  • Self-care and stress reduction: Engaging in self-care activities, such as hobbies, spending time with loved ones, or relaxation techniques, can help individuals with anxiety reduce stress and improve their overall well-being. It is crucial to prioritize self-care, address negative thoughts, and set boundaries to manage anxiety effectively.


High-functioning anxiety is a challenging condition that often goes unnoticed due to the external appearance of those affected. However, the internal struggles are real and can significantly impact an individual’s well-being and daily tasks. By understanding the symptoms, causes, and treatment options for high-functioning anxiety, individuals and their loved ones can seek appropriate help and support.

If you suspect you or someone you know may be dealing with high-functioning anxiety, do not hesitate to seek mental health treatment from a healthcare professional. Proper guidance and treatment make it possible to manage high-functioning anxiety and lead a fulfilling and balanced life.

Frequently Asked Questions

What is high-functioning anxiety?

High-functioning anxiety is an anxiety disorder where individuals appear to function well in their daily lives despite experiencing intense anxiety. They may be highly successful in their careers, have active social lives, and appear to be in control of their lives, but they feel overwhelmed and stressed.

What are the symptoms of high-functioning anxiety?

The symptoms of high-functioning anxiety include excessive worry, difficulty sleeping, racing thoughts, and physical symptoms such as headaches, muscle tension, and stomach problems. However, individuals with high-functioning anxiety may also experience perfectionism, a strong need for control, and a fear of failure.

How is high-functioning anxiety diagnosed?

High-functioning anxiety can be challenging to diagnose because individuals may not exhibit the outward signs of anxiety. A mental health professional will likely perform a comprehensive evaluation, including a clinical interview and possibly other assessments, to determine if an individual meets the criteria for high-functioning anxiety.

What are the treatment options for high-functioning anxiety?

Treatment options for high-functioning anxiety may include therapy, medication, or a combination of both. Cognitive-behavioral therapy is a common therapeutic approach that can help individuals learn how to manage their anxiety. A healthcare provider may also prescribe medications such as antidepressants or anti-anxiety medications.

Can high-functioning anxiety be cured?

While there is no cure for anxiety disorders, including high-functioning anxiety, treatment can be highly effective in managing symptoms and improving overall quality of life. With the proper treatment and support, individuals with high-functioning anxiety can learn how to manage their stress and lead fulfilling lives.


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