10 Signs of High-functioning Anxiety

Medically reviewed by Mark Hrymoc, MD

Signs of high-functioning anxiety may include constant overthinking, a tendency to worry excessively, perfectionism, a need for reassurance, difficulty in saying no, over-commitment, restless sleep, and physical symptoms like headaches or stomachaches. Despite these, individuals often maintain successful, seemingly ‘normal’ lives, masking their internal struggles.

The 2023 Census Bureau’s Household Pulse Survey found that 32% of American adults have anxiety symptoms, with nearly 50% being between 18 and 24. The second highest percentage, 38%, is with adults between 25 and 49 and 29% of those between 50 and 64. 

According to statistics, the age group between 25 and 54 is the prime working age, with 76% working full and part-time jobs. Five percent are unemployed but searching for a job. 

These statistics suggest that many people with anxiety symptoms work full and part-time jobs. They fall into a “high functioning” group, meaning they have a mental health disorder but continue to meet professional, personal, academic, and social responsibilities.

Signs of High-functioning Anxiety

Just because someone is meeting their responsibilities despite having anxiety doesn’t mean the symptoms of anxiety aren’t interfering and causing problems for them. The Workplace Stress and Anxiety Disorder survey results suggested that 72% of participants report anxiety moderately interferes with their lives at home and work. Participants also said anxiety negatively impacts their relationships with family, supervisors, and co-workers. 

Here are some of the most common signs of high-functioning anxiety:

1. Lacks Quality Sleep

You may find it difficult to fall asleep or stay asleep, or you may wake up in the middle of the night and struggle to fall back asleep. Your mind is likely racing, thinking of everything you’ve got to do the next day. Without quality sleep, you can experience anxiety and its effects, including feeling tired, irritable, and lacking focus. 

2. Strives for Perfectionism

The high-functioning person with anxiety is an overachiever who strives for perfection at work, home, and everywhere. You typically agree to take on new projects despite their full schedule, meet deadlines early, and take work home. You may also experience unrealistic expectations, overthinking, and burnout. Striving for perfection is one of many signs of low self-esteem, a common sign of anxiety.

3. Feels Physical Aches and Pains

Anxiety-related symptoms affect the body just as much as the mind. Physical symptoms may include headaches, muscle tension, nausea, and gastrointestinal issues. Most people with anxiety have increased heart rate, faster breathing, higher blood pressure, and changes in appetite and weight.

4. Prioritizes Others Before Themselves

If you have high-functioning anxiety, you are likely a people pleaser, often putting others’ needs above yours. You may say “yes” often, even when you are overscheduled and exhausted because you fear someone will get mad at you. You do not realize that saying “yes” increases your anxiety. If you overextend yourself at work, home, and all other areas of your life, your mental and physical health worsens. 

To cope, you may cancel some of the things you agreed to do at the last minute, explaining why you can’t do it.

5. Appears to Have it All Together

High-functioning anxiety doesn’t always appear anxious. They seem to be hard-working individuals who are great at caring for work, home, school, and social duties without problems. The opposite is true, however. You likely arrive early for work and stay later than anyone else to complete a project. Although you get little sleep, you always seem to have energy. You may be secretly using substances to support your energy levels.

6. Misuses Substances

Some with high-functioning anxiety may also have high-functioning addiction. Whether they misuse alcohol, prescription medicines, or illicit drugs, they rarely miss a workday and show up for all their obligations. It may be the substances that prevent fatigue or quiet physical and mental symptoms.

7. Needs to Be in Control

Do you reject co-workers, friends, and family who offer to help you with tasks? If so, one reason may be your fear of letting go of control. You may feel the project will not get done correctly if you do not do it yourself. You think it will take more time to teach someone else how to do it than it would for you to finish it. In reality, you are anxious about appearing as if you need help, looking weak, and being unable to control the outcome.

8. Has a Full Calendar

If you have high-functioning anxiety, your schedule is packed. You rarely have downtime because you agree to participate in many projects, events, and other happenings. Being so busy helps you avoid caring for your needs and adequately cope with anxiety. Unfortunately, a lack of self-care will worsen your anxiety symptoms.

9. Likes a Planned Routine

You prefer to have a plan for everything you do; for the most part, you want your days to be routine. High-functioning anxiety is a sign that your life feels chaotic and disordered rather than routine. You are happy when you have your day planned out and know what to expect. You get annoyed and sometimes upset when your routine is interrupted or unexpectedly changed.

10. Cannot Relax

Being able to destress and relax is a must for overall well-being. This is difficult for people with high-functioning anxiety, which is why you may experience the effects of stress more than others. Staying in constant anxiety impacts your nervous system, neurotransmitter communication, hormones, and other body functions. Over time you can experience inflammation, nerve damage, cognitive dysfunction, and additional mental illnesses.

Help for High-Functioning Anxiety

If you can relate to any of the above signs, you can overcome it with the help of a mental health professional. Avoid thinking that anxiety must be a part of your life or you can never get rid of it. There are multiple paths to overcoming high-functioning anxiety.

The first step is to schedule an appointment with a mental health professional. High-functioning anxiety most closely resembles generalized anxiety disorder (GAD). Then, work with a therapist.

Therapists and counselors have numerous techniques to help you boost confidence, reduce stress, improve sleep, prioritize activities, and set boundaries. Make yourself a priority and start working on your anxiety today.