High functioning anxiety. You’ve probably heard the term before, perhaps lumped together with the terms “anal retentive” or “Type A personality.” People with high functioning anxiety may seem like overachievers, perfectionists, work-driven, or one of many other traits considered positive in our society. 

But what is high functioning anxiety, and how do you recognize it?

What is Anxiety?

Before we get into the specifics of high functioning anxiety, let’s look at anxiety across the board. 

According to the American Psychiatric Association (APA), anxiety is a “normal reaction to stress” with an evolutionary basis. Anxiety helps us recognize the danger and respond to threats. In fact, almost everyone feels anxious at some point in their lives, such as when they’re giving a speech or about to ride a big rollercoaster. 1

Anxiety disorders, however, go far beyond these normal feelings of anxiety. The APA states that anxiety reaches the level of a disorder when a person’s anxiety: 1

  • Is inappropriate for their age or current situation
  • Hinders their ability to function 

For instance, being nervous about riding a rollercoaster is normal. But a person with an anxiety disorder may refuse to enter a theme park that has roller coasters out of fear of having an anxiety attack. Taking action to avoid triggers, experiencing panic attacks, and suffering academically, socially, at a job, performance is all signs that a person’s anxiety may qualify as a disorder. 1

The DSM-5, or the current edition of the Diagnostic and Statistical Manual of Mental Disorders, recognizes several types of anxiety disorders, including: 1

  • Social anxiety disorder 
  • Generalized anxiety disorder 
  • Panic disorder
  • Separation anxiety disorder 
  • Specific phobias 
  • Agoraphobia 

However, you’ll notice that high functioning anxiety is not on this list. That’s because high-functioning anxiety is not currently recognized as its own diagnosis. But that doesn’t mean that it’s not real – or that it’s not difficult to live with. 2

What is High Functioning Anxiety?

The reason that high functioning anxiety fails to meet the criteria of a disorder is in the name. As discussed above, the APA requires that a person’s ability to function be compromised as a result of their anxiety. However, with high functioning anxiety, some sufferers actually accomplish more with their day due to their nervous energy. 1

As a result, high functioning presents in many different ways, but there are often commonalities. Many people with high functioning anxiety live successful, if stressful, lives. They may do well at work or school, be well-liked in the community, and maintain active social calendars. However, these individuals often perform so well out of fear: fear of not being the best, fear of failure, or fear of being a disappointment. 2 3 4

According to Jonathon Sikorski, assistant professor of psychiatry at the University of Nebraska Medical Center, many people with high functioning anxiety have the features of anxiety disorders. However, they fall just shy of the criteria to officially warrant receiving a diagnosis. 2

Signs and Symptoms of High Functioning Anxiety

Because high functioning anxiety is not an official diagnosis, there is no master list of symptoms or criteria. But there are still several signs that may indicate that a person has high functioning anxiety. These include: 2 4

  • Constant worry
  • Racing thoughts
  • Poor sleep
  • A lower quality of life

High functioning anxiety may present with other symptoms of anxiety disorders as described by the DSM-5. However, they may not occur often or long enough to qualify as a “true” mental disorder. 2

Furthermore, there are several other – often more specific – struggles that a person with high functioning anxiety may experience. While these don’t necessarily constitute an anxiety disorder, they can be just as difficult to work through. Additional “signs” include: 3 4

  • Being a people pleaser for fear of letting others down
  • Nervous habits or tics such as biting your nails
  • Procrastination followed by periods of intense work
  • A severely limited or abundantly overflowing social life
  • Mental, physical, and emotional exhaustion
  • Substance abuse (including alcohol) to cope with daily life

Coping Mechanisms for High Functioning Anxiety

Although high functioning anxiety isn’t an official diagnosis, it’s still possible to treat or cope with its signs and symptoms. In fact, doing so can help individuals live a better quality of life – without impacting their ability to knock out their daily tasks. 2

Cognitive Behavioral Therapy

One common treatment for anxiety is attending cognitive behavioral therapy (CBT) with a licensed mental health professional. According to the APA, this is a type of psychological treatment that aims to change a person’s thinking patterns and resulting behaviors. There are several strategies a therapist may employ in CBT, such as: 5

  • Recognizing and reevaluating distortions in thought processes
  • Using problem-solving skills as a coping mechanism
  • Facing fears head-on
  • Gaining confidence in one’s own abilities
  • Learning more about the behaviors and motivations of others
  • Using meditative or deep breathing practices to calm the body and mind

Lifestyle Choices

Outside of the therapist’s office, there are many ways a person with high functioning anxiety can ease their symptoms. The effectiveness of these strategies may vary from person to person, but in general, taking these steps can reduce stress overall: 6

  • Eating healthy foods and drinking plenty of water
  • Avoiding alcohol and other mind-altering substances
  • Sticking to an exercise routine
  • Getting plenty of sleep
  • Using visualization, meditation, or yoga to relax
  • Socializing in a relaxed setting with friends and family
  • Take up a calming hobby

Medication and Herbal Supplements

Individuals who don’t meet the DSM-5 criteria for an anxiety disorder diagnosis may still benefit from other more intensive treatments, as well. Therapists may prescribe short- or long-term medication regimens, including antidepressants, beta-blockers, or benzodiazepines. 6

For those who prefer more a more natural approach to coping with anxiety, there are plenty of alternatives to traditional medications. Herbal supplements such as Xanfree contain vitamins, minerals, and herbs that can combat the symptoms of high functioning anxiety, such as:

  • Lemon balm
  • Rhodiola
  • L-Theanine
  • Passionflower
  • Valerian root
  • Hawthorn leaf
  • Chamomile

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References

  1. https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
  2. https://www.health.com/condition/anxiety/high-functioning-anxiety-disorder-symptoms
  3. https://www.verywellmind.com/what-is-high-functioning-anxiety-4140198
  4. https://www.healthline.com/health/anxiety/hacks-high-functioning-anxiety
  5. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
  6. https://www.mayoclinic.org/diseases-conditions/generalized-anxiety-disorder/diagnosis-treatment/drc-20361045

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