You take pride in your productivity and pay attention to meeting work deadlines. You are always there for your friends at social gatherings and even pursue your hobbies. On the outside you appear organized and successful, but on the inside you are feeling overly worried and stressed. Experts call this high-functioning anxiety – when the constant hectic pace masks the symptoms of generalized anxiety.
Although high-functioning anxiety is not an official diagnosis according to DSM-5, the classification of mental disorders, it is a more subtle and less obvious form of anxiety. You may have heard the term describing people who function at high levels despite symptoms of anxiety.
People with high-functioning anxiety are typically high achievers, perfectionists, and “Type A,” whose symptoms of generalized anxiety are less visible and therefore more difficult to treat.
“Maybe they’re still excelling in their careers, have lots of friends and maintain strong relationships,” says Dr. Neha Chaudhary, a child, adolescent and adult psychiatrist at Massachusetts General Hospital and Harvard Medical School and a senior physician at Harvard Medical School Modern health. “But internally, they may be struggling with common anxiety symptoms such as restlessness, excessive worry, difficulty sleeping or fatigue.”
People with high-functioning anxiety can cope by engaging in behavior that makes them appear more productive or successful.
“The same personality traits that drive people to perform at their best often increase symptoms of anxiety,” says Dr. Michael Louwers, associate medical director at Reset Medical and Wellness Center. “It often starts with good intentions, such as setting goals and rigorous planning. However, people who suffer from this type of anxiety tend to set incredibly high and unrealistic goals, which leads to procrastination or constant worry.”
Manage fears by showing up more Productivity is more common among women and minority groups who are “used to ignoring their pain and discomfort in order to be there for others,” says Dr. Judith Joseph, psychiatrist and author of the book High functionality. “Women are often used to enduring physical pain during periods, postpartum and menopause, and this puts them at risk.” [high-functioning anxiety] because they feel like they have to show up despite everything they’re going through physiologically.”
Many of the specific signs of high-functioning anxiety are synonymous with burnout, which is no coincidence because those who overexert themselves are at higher risk of burnout.
According to mental health experts, subtle signs of high-functioning anxiety are
- Overload and unwillingness to take breaks
- Trouble slowing down or taking days off
- Feeling guilty or ashamed for minor mistakes or setbacks
- A resistance to delegating tasks
- Easily irritable
- Negative self-talk
- Micromanagement
- Sleep disorders
How to deal with high-functioning anxiety
It’s important to take high-functioning anxiety seriously before it leads to other conditions – and not to view overachievement as the only way to relieve the physical and mental symptoms of anxiety.
“People with high-functioning anxiety and depression “I will have the symptoms, but I can actually overexert myself to appear functional,” Joseph says. “If we wait until these people lose their ability to function, it could be too late. Many of them burn out, develop clinical depression or anxiety, abuse substances or develop medical problems if they are not treated and supported.”
Some people may benefit from talk therapy, medication, or a combination of both. There are also everyday tools that can be helpful.
5 Tools to Manage High-Functioning Anxiety
- Give yourself some grace that not everything gets done every day. “Recognizing when anxiety is increasing and taking breaks can be very helpful, whether at work or even social engagements,” says Chaudhary.
- Practice diaphragm exercises breathe deeply every day: Inhale for four seconds, hold for four seconds and exhale for four seconds
- Eat brain-boosting foodsThese include those rich in omega-3 fatty acids, B12, vitamin D and magnesium. Brain food not only reduces inflammation, but can also improve mood by helping maintain energy. Consider adding berries, nuts and fish to your diet.
- Set aside 30 minutes every day just for you. Experts recommend taking a break — going for a walk, listening to music, calling a friend — to calm the nervous system and slow the spiral of worrying thoughts. It’s about an intentional reset to shift your attention to something else.
- Learn the art of delegating and saying no. To be one collaborative, people-centered leader will give you more time to take care of yourself and engage in other things that bring you joy.
“If you recognize the signs and symptoms and are having difficulty, know that you are not alone and that resources are available,” says Louwers.