I’ve been an anxious person for as long as I can remember. And I mean this literally – some of my earliest memories, dating back to kindergarten, are of me panicking over things that you wouldn’t want a child to obsess about (excessively worried that I could make a mistake, get in trouble at school, or disappoint my parents, as examples).
I assumed that this was a pretty obvious trait that I had. It didn’t change throughout adolescence, through my 20s and 30s, and I wouldn’t say it was something I made an active effort to hide, either. Which is why I am always thrown off when someone refers to me as “calm”, or “easy going”. These are compliments, but definitely not words I would use to describe myself.
Just recently, I was talking to my spouse about how exhausted I felt all the time, and that I had come to the conclusion that it was due to the constant energy it took to control the overwhelming, racing thoughts that flooded my mind all day every day (I always compared the feeling to someone flooring a gas pedal, in my brain, and me fighting hard to remain in control, or not to scream when it felt out of control).
I was truthfully a little shocked, and hurt, when he half chuckled and said: “But you’re not an anxious person?”. This, from someone who I had been living with for nearly 10 years. Someone who I had assumed, knew me well, and was at least a little perceptive to the things that I struggle with. I tried to explain that I was actually quite anxious on the inside, and that it was something I worked really hard at (I have been working with a psychologist for several years, have read a mountain of self-help books, and diligently use my coping skills). He was still pretty dismissive, saying things like “It’s not like you can’t get out of bed in the morning”, and pointed out that I was still able to succeed in my career, and have successful relationships.
After watching Kati Morton’s video on high-functioning depression, it occurred to me to research high-functioning anxiety. Sure enough, I found a wealth of information, and realized that there were tons of other people feeling exactly like I was – people who even had difficulty convincing therapists how terribly they felt on the inside, because they were able to function so well on the outside. As this article from Headspace explains: “While a person with high-functioning anxiety can appear as though in control and actively engaged in the daily tasks of life, underneath this confident exterior, it is a fight to make it through the day”.
This Mayo Clinic article further elaborates how we can hide behind a mask: “To an outside observer, people with high-functioning anxiety may appear to excel and be in control. They don’t appear to avoid or retreat from life. They may have successful careers, participate in many volunteer or community activities and have strong personal relationships. Yet behind this facade, these people have persistent thoughts of worry, fear and high-stress levels or feel on edge.”.
It’s important to understand that high-functioning anxiety isn’t a clinical term, nor is it recognized as a its own separate disorder in the Diagnostic and Statistical Manual of Mental Disorders. It also shouldn’t be seen as a more prestigious or desirable form of anxiety *4. The terms “high-functioning” and “low-functioning” don’t have judgement attached to it, and should be seen as neutral descriptors in this post – terms that describe how someone is experiencing anxiety. It doesn’t imply that the high-functioning person is more intelligent or stronger, for example. Only that the anxiety manifests itself in a different way, for different reasons (outlined below).
What was most interesting to me is considering how the very nature of this type of anxiety causes the so-called “high-functioning” – because we are harshly critical of ourselves, fear failure, and are so afraid of disappointing other people, this drives us to keep it all together, and almost forces us to succeed at work, home, or in relationships. This makes it trickier and more difficult to spot.
Take Amy Marlow, for example, who describes how she graduated magna cum laude and “excelled at every job I’ve held” But that despite the outward appearance of success, “working so hard and caring so much were wearing me down. They seemed like positive traits, not symptoms of a disorder, but while some are frozen by anxiety, I am propelled by it at a million miles an hour…my symptoms are masked in overdoing, overthinking, and overperforming”. I would strongly encourage everyone to check out her tips for coping with high-functioning anxiety.
It was incredibly validating to read the explanations, and see that there was at least a term, clinical or not, to help me understand what I was feeling. Why I could feel a severe amount of anxiety and distress on the inside, that remained mostly undetected (or worse, minimized) by those around me.
Many of the symptoms fit me perfectly*. Below are only a handful that jumped out to me, and things people might not immediately associate with underlying anxiety, such as:
- Persistent feelings of being “on edge”
- Feeling like you constantly need to be doing something
- Being afraid of disappointing others
- Difficulty concentrating
- Being a perfectionist
- Being tired all the time (even if you sleep well – because your mind is always going)
- You have repetitive habits or tics (mine is twirling my hair, and I caught myself doing it as I typed this)
- You startle, or get stressed and irritated easily (which makes sense, as our nervous-system is constantly amped up)
The causes and treatment for high-functioning anxiety are similar to other anxiety disorders. Which is great, because there are lots of well-researched tools and techniques that we can take advantage of like counseling, mindfulness and meditation, stress management techniques, or medications*2, 3
It might feel overwhelming, as if you don’t even know how to start tackling this. But keep in mind that the changes can be small. I’ve personally tried to link mindfulness to routine activities – like when a brush my teeth, I try to empty my mind and focus on the sounds & sensations happening in the present moment. Or when I have my morning cup of coffee, I take the time to enjoy the taste and smell, and do some deep breathing. It can be baby steps, at first.
That being said, as this article from Shape.com reminds us that: “Working on lessening high-functioning anxiety and bettering yourself, however, is a daily process and hard; it’s like each time you have the opportunity to fall into behavior, you have to do the opposite action”. I am realizing that it will take a real commitment for me to live my life a little differently. There were a few strategies and suggestions that stuck out to me as being particularly relevant in this regard.
Such as:
- Doing less, and being less “available” *3, 4. There is a balance, of course, but now that I’m learning to tune into my thought, I realize that what immediately comes to mind are thoughts like “If I don’t answer this email right away I’m a bad employee”, or “If I don’t respond to this text immediately I’m a crummy friend”. It might seem unbelievable to some, but it’s the default way my brain is wired, constantly scanning for a threat and over-reacting to the tiniest thing, and causing constant, panicked moments (see above reference to the people-pleasing and fear of disappointing others). It’s a ridiculous amount of pressure to put on yourself. I’m experimenting with taking longer to respond, and learning to sit with the anxious thoughts. It makes me squirm a little bit, but I’m hoping that eventually I’ll learn that I don’t need to act on the anxiety. At least not in a knee-jerk-reaction kind of way Better yet, I’m also training people to expect a little less from me.
- Reducing comparisons, and embracing a lifestyle that works for me *3, 5. Especially one that respects my own energy levels. I cannot tell you the number of times I have felt guilty taking an afternoon to read, or watch TV, when others around me seemed to promote a go-non-stop/hustle lifestyle. Or how many times I am frustrated with myself for feeling tired and drained, when someone else with kids, or other responsibilities, seems to effortlessly manage piles of other things on their plates. The comparisons simply aren’t helpful. They aren’t taking into account each person’s unique personality, level or resilience, or energy styles. Now, I practice declining things that don’t fit my needs and lifestyle (maybe instead of rushing to meet my friends for breakfast in the morning, I take it slow, and enjoy a cup of coffee in silence, along with some journaling).
- It’s also been really helpful for me to explore where my attitudes and core beliefs are coming from, and reflect on what my true values are, instead*4,5 (hint: it’s even better to get a therapist to help you flesh this out). I’m realizing that a lot of the problematic messages stem from what I learned in my childhood. Maybe a parent accused me of being “lazy” or “wasting time” when I was relaxing (promoting the idea that my worth was only in being productive); frequently hearing phrases like “what will people say/think?!” also primed me to care far too much about being liked, and gaining other people’s approval. It’s important to challenge these ideas. Instead, I try to consider how much better I feel, and can offer people, if I prioritize rest, and make time for peaceful moments during my day. Or how I value making time for creativity, and feel energize by activities like writing this blog.
If I can leave you with a few reminders, the first would be to remember that it’s not your fault for reacting a certain way, or having these tendencies. It’s not a switch we can simply flip off (as awesome as that would be). Our brains are fundamentally wired differently. For that reason, we have to have realistic expectations. I have made peace with the fact that I will always be an anxious person. That being said, while anxiety can’t be cured completely, it can be well-managed and you can make great improvements.
The second, most important takeaway is that you are worthy of help. A frequent reminder Kati Morton delivers in her podcasts are that there is “plenty of pain to go around”. Your struggling and suffering doesn’t take away, invalidate, or minimize what someone else may be going through. You don’t need to downplay it, or “white knuckle” your way through life, because you feel guilty for seeking out support. As this article from Talkspace points out: “All levels of anxiety are impactful and you deserve help…Early intervention also prevents your anxiety and mental health from getting worse”.
You deserve to have the best quality of life possible! So – if you’re feeling any of this, I cannot encourage you enough to seek out help, and know that you don’t have to struggle on your own.
Footnotes & further reading:
*1 Psychology Today: 15 Signs of a Secretly Anxious Introvert
*2 Headspace: What it’s like to have high-functioning anxiety
*3 Mayo Clinic: Behind the mask: Managing High-Functioning Anxiety
*4 Shape.com: What Is High-Functioning Anxiety
* 5 Mayo Clinic: Q&A – Understanding High-Functioning Anxiety
*TalkSpace: What is High-Functioning Anxiety
*Healthline: 6 Daily Hacks That Help Manage High-Functioning Anxiety
Kara Foster blogs 
wow!! 111High-functioning anxiety: what I’ve learned
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