High Functioning Anxiety

With the increase in personal and professional stressors, experiencing elevated levels of anxiety is an all-too-common experience for many people.

One form of anxiety is often overlooked.  It’s referred to a high-functioning anxiety (HFA).

People with high functioning anxiety are able to successfully manage daily responsibilities despite experiencing chronic internal anxiety.

To the outside world, they appear to be organized, confident, and accomplished, someone who is succeeding and “has it all together.”

However, on the inside, they often have relentless worry and ruminating thoughts, fears of failure, and perfectionist tendencies, all of which can drive them to burn out or close to it.

There can be many reasons for it.  Sometimes it can be traced back to childhood.  For example, if someone was raised in a demanding, or perhaps highly critical environment, love, safety, or validation may have been tied directly to their accomplishments or performance as a child.

Another contributing factor may be a genetic disposition. A family history of anxiety disorders or mental health conditions can predispose people’s nervous systems and this results in them constantly operating in a heightened state of arousal.

Living in this high-alert state can make you more reactive to stressful events and even prone to expecting things to “go wrong,” And so the message on a subconscious level is that you always need to be ready to respond in case things do go wrong.

High functioning anxiety may be a learned coping behavior.   You may have learned or subconsciously trained yourself to channel the nervous energy into productivity. Classic examples include over-preparing, overworking, and people-pleasing to reduce anxiety or anxious thoughts.

Major life transitions, high-pressure work, stressful personal environments, and even the stresses of daily life can all contribute to this as well.

Plus, society’s expectations can also be at play because we often think that being accomplished, driven, organized, and detail-oriented are necessary for us to be successful so it’s something we strive for.

High functioning anxiety shows up in many forms –  cognitive, emotional, behavioral, and physical.

Do you recognize any of these signs in yourself?

Constant Overthinking: Ruminating over past conversations or obsessively planning for future “what-if” scenarios.

Perfectionism & Fear of Failure: Setting impossibly high standards and being deeply self-critical when those expectations are not met.

Imposter Syndrome: Feeling like a fraud despite documented achievements and success.

A Need for Control: Feeling on the verge of losing control, leading to an inability to switch off the brain or enjoy downtime

People-Pleasing: Difficulty saying “no,” over-committing, and intensely fearing disappointing others.

Nervous Habits: Engaging in repetitive actions such as nail-biting, pacing, or hair-twirling to release tension.

Procrastination: Sometimes delaying tasks due to intense pressure, followed by extreme bursts of last-minute productivity.

Reassurance Seeking: Frequently asking others for validation on the quality of their work or decisions

Muscle Tension: Clenching the jaw or holding severe tension in the neck and shoulders.

Sleep Disturbances: Racing thoughts make it difficult to fall or stay asleep, often leading to chronic fatigue.

Digestive Issues: Experiencing frequent stomachaches, indigestion, or other stress-related gut discomforts.

Hyper-arousal: Quickened heart rate, shallow breathing, sweating, or sudden headaches, nervous tics, and potentially a need to be in motion

So what can you do about it?

First and foremost, give yourself permission to rest. Reframe rest as an investment; it is essential for long-term health, focus, and performance. Listen to your body. Recognize the physical and mental signs of exhaustion. If you feel a drop in energy or loss of concentration, allow  yourself to step away from your to-do list, even temporarily.

Reassure your inner critic. If feelings of guilt creep in when you stop working, consciously remind yourself: “Resting now allows me to show up better later,” or “Everything can wait.”

Start small; you do not need an entire weekend off to recharge. Start with 10-minute breaks and practice deep breathing or unplugging from your phone. Create boundaries, treat your designated rest time the same way you treat a mandatory appointment, block it off in your calendar, and honor your time.

If you’re a people-pleaser, setting boundaries with others is probably difficult. It might help to practice saying no. We are so busy living for everyone else’s demands that we have no time to meet our own needs. The more we can practice mindfully considering what we choose to say “yes” and “no” to, the more we can practice setting boundaries and learning to live with others potentially being frustrated when we set those limits.

Saying “no” will also allow you to see what it feels like to sit with someone else’s disappointment and recognize that setting a boundary doesn’t have to derail your world. The way to break out of the high-functioning anxiety cycle is to realize that you can be both a loving and kind person as well as one who doesn’t do everything for everyone all of the time.

Try giving yourself a 24-hour window before responding to requests whenever possible; that way, you’re not just responding out of the need for approval.

Redefine Perfectionism. Perfectionism is often the fuel for high-functioning anxiety. Define what “good enough” (e.g., aiming for 80% instead of a mythical 100%) looks like so you know when to stop tinkering and move on safely.

Try brain dump journaling. When your thoughts are swirling, get them out of your head onto paper. Writing down every fear and every item on your to-do list without judgment creates immediate mental distance.

Other things you might try include adjusting your lifestyle. Anxiety often manifests physically as pent-up energy. Regular exercise (running, yoga, or even a brisk walk) helps burn off stress hormones and release natural endorphins. Be mindful of your consumption of caffeine and other stimulants. Caffeine and nicotine trigger physical “fight or flight” responses that mirror and worsen anxiety symptoms.

Lastly, consider booking a therapy session.  We use a variety of therapies to target and reduce anxious thoughts and feelings, thereby improving your overall functioning and capacity to manage stress.

Sometimes, medications are necessary high-functioning anxiety in order to reduce mental and physical symptoms without causing daytime drowsiness. Finding the right medication involves balancing your specific symptoms and medical history with the help of a healthcare provider.

Remember…you don’t have to keep working more, harder or faster.  

Thanks for your interest…I hope you found this helpful.
Murray 

Murray Heintz, Registered Psychologist

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