Updated on 2/10/22

Anxiety is the most common mental health condition, with 18 percent of the US population dealing with it every year. We tend to think of anxiety as an all-encompassing, debilitating experience — which it is for many people. However, high-functioning anxiety is also common, where we walk through life silently carrying the burden of anxiety issues while outwardly living successfully. 

Mind reeling, blood pumping, heart pounding, arms sweating, face flushing, leg bouncing, hands wringing, shoulders tensing, jaw clenching. 

These are just some sensations of anxiety that go unnoticed by others when you’re high-functioning in daily life. You might be thriving academically, socially, and professionally, despite feeling anxious feelings internally and facing severe mental health struggles. 

In this article, we’ll explain what high-functioning anxiety looks like, how it differs from typical anxiety, and how to cope with it.

What Is High-Functioning Anxiety?

High-functioning anxiety is a mild type of anxiety that impacts an individual physically and mentally but does not inhibit their ability to function in daily life. High-functioning anxiety is not a clinical psychological diagnosis, but these anxious feelings are still very real for anyone experiencing it. 

This mental health condition occurs on a spectrum. With anxiety, the spectrum runs from no anxiety issues to debilitating anxiety on either end. In reality, most people fall somewhere in the middle. High-functioning anxiety falls in that middle ground. 

“High-functioning anxiety impacts an individual internally, but does not get in the way of their everyday functioning. The individuals do not show any outward signs of anxiety so no one else knows what they are going through.”

Talkspace therapist Bisma Anwar, MA, MSc, LMHC

One of the main struggles of high-functioning anxiety is that it’s often dealt with alone. It does not have to be though, there are resources and anxiety treatment available.

Life transitions, genetic predisposition, or other stressors can lead to this type of constant internal worry for many people. Because of the high-functioning nature of this anxiety, individuals may cope with it without even realizing; they may never be diagnosed with a mental health condition. The anxiety could worsen, though, and lead to problems that need special attention. That’s why it’s something worth paying attention to.

Physical Symptoms of High-Functioning Anxiety

Anxiety is an intense physical as well as mental experience that comes with many symptoms. Because mental illness is a spectrum, symptoms occur in varying degrees of severity, with some meeting psychologists’ diagnostic criteria and others not. No matter to what degree you experience anxiety, it is a valid feeling.

You may have a form of anxiety if any of these symptoms impact you:

  • Rapid heart rate
  • Sweating profusely 
  • Increased adrenaline and fight-or-flight response
  • Muscle tension
  • Physical and mental fatigue 
  • Upset stomach or indigestion 
  • Headaches 
  • Fidgeting 
  • Flushed skin 

If you have any or all of these anxiety symptoms frequently but are still externally functioning well, you likely have high-functioning anxiety. Any level of these anxiety symptoms will impact you greatly, so don’t minimize these sensations, even if they don’t seem severe enough. 

Common Behaviors of High-Functioning Anxiety

Because anxiety floods you in an intense physical and mental way, symptoms lead to challenging thoughts, behaviors, and habits. High-functioning anxiety comes with thought patterns of insecurity and perfectionism, also contributing to difficulty sleeping and burnout. 

Main behaviors of high-functioning anxiety include:

  • Intrusive thoughts that worsen anxiety
  • Lack of sleep or poor sleep
  • Fear of failure
  • Burnout
  • Difficulty saying no
  • A constant need to stay busy
  • Perfectionism and overachievement
  • Overthinking and rumination 

Most of these are internalized experiences that others around an individual experiencing high-functioning anxiety don’t recognize. This is why increasing awareness of the forms high-functioning anxiety takes is important in helping you or a loved one.

Another sign to watch out for is frequently using unhealthy coping mechanisms to ease anxiety such as substance abuse, the misuse of food and exercise, or other harmful habits. These can be ways someone with high-functioning gets through the day, but if these behaviors go on unchecked, it could lead to a more serious mental health crisis.

High-Functioning Anxiety vs Typical Anxiety

There’s a fine line between a touch of anxiety that pushes you to deal with stressors and debilitating anxiety that impairs your ability to function. That line is typically the difference between high-functioning anxiety and a clinical diagnosable anxiety disorder.

“High-functioning anxiety does not impact a person’s ability to take care of their daily tasks and responsibilities,” says Anwar. “This type of anxiety is not diagnosable as a mental health illness. Other types of anxiety fit the criteria for a diagnosis as they impact daily functioning of an individual and can cause more serious impairment.”

Clinical anxiety disorders include generalized anxiety disorder, social anxiety disorder, panic disorder, and phobias, among others outlined in the Diagnostic and Statistical Manual of Mental Disorders. Someone with a diagnosable anxiety disorder may have panic or anxiety attacks that impact their ability to work and take care of responsibilities. If you think you may be struggling with anxiety, consult a doctor or therapist as they can provide a proper diagnosis. 

Those with high-functioning anxiety likely won’t be admitted to an inpatient hospitalization program, as could be the case for those with more serious anxiety disorders. Individuals with high-functioning anxiety can still greatly benefit from outpatient therapy and incorporating healthy coping skills to manage their anxiety. 

Coping Strategies for High-Functioning Anxiety

There are many strategies that offer relief from dealing with anxiety. In the moment, anxiety feels overwhelming. By learning healthy coping skills and striving for balance, anxiety becomes more manageable. According to Anwar, some great strategies for coping with high-functioning anxiety include:

  • Foster a healthy lifestyle and work-life balance
  • Prioritize getting enough, good quality sleep 
  • Make sure to eat a balanced diet regularly throughout the day 
  • Engage in mindfulness and meditation to relax
  • Practice self-care to ensure you’re taking care of yourself and your basic needs
  • Regularly engage in activities that bring you joy to help avoid burnout and ease stress

The list goes on as there are many tried-and-true practices available for dissipating anxiety. Different strategies work for everyone, just as everyone’s anxiety takes varying forms. Consulting a mental health professional can help you find what

When to Seek Treatment for High-Functioning Anxiety

Someone dealing with any level of anxiety can benefit from talk therapy and possibly medication for anxiety to help ease their struggles. Even if you do not have a formal diagnosis, therapy can help anyone to process their life and foster good mental health. Especially if you are struggling with anxiety alone internally, reach out for mental health professional help and support.

All levels of anxiety are impactful and you deserve help if it’s harming your mental health in any way. Early intervention also prevents your anxiety and mental health from getting worse. Anxiety is highly treatable and many effective treatment options are available.

CBT for high-functioning anxiety

Specifically, cognitive-behavioral therapy and dialectical behavioral therapy work well in treating high-functioning anxiety. “Cognitive behavioral therapy (CBT) helps address negative thoughts and core beliefs that get in the way of managing anxiety,” says Anwar. “Cognitive-behavioral therapy helps recognize anxious thoughts and works towards changing these thoughts to more positive ones.” Cognitive behavioral therapy is an effective anxiety treatment. 

DBT for high-functioning anxiety

Another great therapy modality for treating high-functioning anxiety is dialectical behavioral therapy (DBT) which “helps address feelings and thoughts that are related to anxiety and teaches skills to help manage them,” says Anwar. Dialectical behavioral therapy is a more skills-based therapy structure that works well for many clients.

Medication for high-functioning anxiety

Additionally, anxiety medication is an option. Antidepressants or anti-anxiety medications may help you if you’re struggling. This anxiety medication can bring your physical and mental state to a more stable level so you can work through the deeper issues causing your anxiety.Even if you are high-functioning and your anxiety isn’t debilitating, you are worthy of support and treatment. Starting your mental health journey can be overwhelming. Talkspace therapy makes it easier with affordable, online therapy available in just a few clicks. If you’re struggling with any level of anxiety, Talkspace therapists are here to help.

Medically reviewed by: Dr. Karmen Smith, LCSW, DD

Reviewed On: May 22, 2019