High-functioning anxiety: Symptoms and causes

Anxiety is considered to be a normal emotion that causes fear, increased blood pressure or a rapid heart rate. Some people also have high-functioning anxiety, which is not really a clinical diagnosis. People living with high-functioning anxiety often appear very successful at work. They have a seemingly perfect exterior, but they are constantly fighting anxiety. Wondering if you have high-functioning anxiety? Read on to know the symptoms of high-functioning anxiety and what to do about it.

What is high-functioning anxiety?

High-functioning anxiety is not a clinical diagnosis, but a term used to describe people who experience persistent anxiety while being able to manage their daily tasks and responsibilities successfully, says clinical psychologist Dr Rituparna Ghosh. It is usually diagnosed as generalised anxiety disorder. Given that anxiety disorders, which are the most common mental disorders in the world, affected 301 million people in 2019, according to the World Health Organization, it calls for attention.

What are the symptoms of high-functioning anxiety?

Right from physical symptoms like fatigue and muscle tension to behavioural patterns like overthinking and people-pleasing, internal struggles of people with high-functioning anxiety can manifest in various ways. Here are some signs:

1. Drive to overachieve

People with high-functioning anxiety are driven by a relentless need to succeed and often set excessively high standards for themselves and others. They strive for perfection in their work and can become easily frustrated by setbacks.

2. People-pleasing behaviour

The desire for approval and fear of disappointing others can lead to people-pleasing behaviour. They may prioritise others’ needs over their own, struggle to say no, and avoid confrontation or conflict, says the expert.

3. Overthinking and lack of mindfulness

With excessive worry and negative thoughts, these people may replay past events, anticipate future problems, and overanalyse situations. These may lead to difficulty in relaxing and being in the present moment.

4. Physical symptoms

The constant state of alertness and worry can take a toll on the body. Common physical symptoms include fatigue, insomnia, headaches, muscle tension, digestive issues, and increased heart rate, says Dr Ghosh.

What causes high-functioning anxiety?

The exact cause of high-functioning anxiety is not known, but it likely involves a combination of many factors. The causes are similar to general anxiety and can include genetic predisposition, personality traits, past traumatic events, and ongoing stressful life circumstances, says the expert. Environmental factors and pressures at work or school also contribute significantly.

• There may be a family history of anxiety disorders or other mental health conditions which increases the susceptibility.
• Certain personality traits, such as perfectionism, and high sensitivity, are associated with an increased risk of developing anxiety.
• Imbalances in neurotransmitters, such as serotonin and dopamine, which regulate mood and anxiety, may play a role.
• Stressful life events, such as trauma, abuse, or major changes in life, can trigger or exacerbate anxiety. Chronic stress from work, relationships, or financial concerns can play a major role in its development.

What are the pros and cons of high-functioning anxiety?

Here are the positive and negative effects of high-functioning anxiety:

Pros of high-functioning anxiety

Pros include high productivity, strong organisational skills, and meticulous attention to detail. The drive to succeed and fear of failure can fuel ambition and lead to high levels of accomplishment in various aspects of life. Individuals with high-functioning anxiety are often skilled at anticipating problems and finding solutions due to their tendency to overthink and analyse situations. Naturally, they are considered to be valuable assets in an organisation due to these reasons.

Cons of high-functioning anxiety

The constant pressure to perform and the internal struggle with anxiety can lead to chronic stress with physical and emotional exhaustion, increasing the risk of burnout as well as physical health issues such as cardiovascular disease, digestive problems, and weakened immune function. Social isolation and a diminished quality of life may also result from the constant internal turmoil. They may find it challenging to develop lasting relationships and form genuine connections due to their people-pleasing and avoidance behaviours.

What are the ways to treat high-functioning anxiety?

Depending on severity, antidepressants or anti-anxiety medications may be prescribed to manage anxiety symptoms. Other options are:

1. Therapy

Therapy, particularly cognitive behavioural therapy, can help people identify and challenge negative thought patterns and develop coping mechanisms to manage anxiety. During therapy, the focus can be on accepting difficult thoughts and feelings.

2. Mindfulness

Getting sufficient sleep, and opting for mindfulness practices play a crucial role in managing the symptoms. Meditation can help people become aware of their thoughts and feelings without any judgment, promoting a sense of calm as well as acceptance, says the expert.

3. Physical activity

It releases endorphins, which have mood-boosting effects and can help reduce anxiety and stress. Also, eating a balanced diet, which means consuming vegetables, whole grains, and fruits, can provide the body with essential nutrients for optimal mental health.

How to help someone with high-functioning anxiety?

Be supportive and understanding. You should listen to them with patience and without judgment. Avoid minimising their feelings and help them create a less stressful environment by assisting in prioritising tasks and setting realistic goals. Being a consistent and reassuring presence is beneficial for them, says the expert.

People with high-functioning anxiety may be battling anxious thoughts and feelings internally, but appear calm and collected on the outside. They are often successful and capable in different aspects of life. However, beneath the surface, they suffer from constant worry and fear and face self-doubt. It is important to see a doctor when anxiety starts to interfere significantly with daily life, causes distress, or leads to physical symptoms.