High Functioning Anxiety: Signs and Coping Skills

Medically Reviewed by Mark Hrymoc, M.D., Chief Medical Officer, double-board certified in General & Addiction Psychiatry

High-functioning anxiety refers to the ability to perform daily tasks and responsibilities despite experiencing anxiety. People with this condition may seem outwardly calm, confident, and competent, but internally, they’re dealing with intense feelings of worry, fear, and nervousness. This type of anxiety can manifest in different ways, and it’s often mistaken for being “productive” or “driven,” when in fact, it may stem from an overwhelming need to control, fear of failure, or perfectionism.

Unlike traditional anxiety, which might lead someone to avoid certain situations or withdraw, those with high-functioning anxiety often push through and appear to be managing it well. However, this can be mentally and physically exhausting in the long run.

Recent Research on High-Functioning Anxiety

Recent studies have shed light on various aspects of high-functioning anxiety:

• Prevalence and Impact: A 2024 poll by the American Psychiatric Association revealed that 43% of U.S. adults feel more anxious than the previous year, indicating a rising trend in anxiety levels.
  psychiatry.org
• Physical Manifestations: Research published in Nature in 2024 highlighted that individuals with anxiety disorders, including high-functioning anxiety, exhibit increased activation in brain regions such as the bilateral insula and medial prefrontal cortex.
  nature.com
• Co-occurring Conditions: Studies have found that high-functioning anxiety often co-occurs with depression, leading to feelings of hopelessness and sadness.
  positivepsychology.com

Signs of High-Functioning Anxiety

The signs of high-functioning anxiety may not always be obvious, especially when compared to other forms of anxiety. But if you’re familiar with the condition, there are several key traits to look out for:

1. Constant Worrying:

   people with high-functioning anxiety often find themselves trapped in a cycle of excessive worrying. They may worry about performance at work, meeting expectations, or even social interactions, though they may not outwardly show these concerns.
   

2. Perfectionism:

   striving for perfection can be a double-edged sword. While aiming for high standards can fuel success, it can also result in chronic stress. High-functioning anxiety is often linked to a need for everything to be perfect — from how things look to how tasks are completed.
   

3. Overthinking and Second-Guessing:

   individuals with this form of anxiety may constantly second-guess their decisions, worry about what others think, and overanalyze their actions, even when there’s no immediate cause for concern.
   

4. Difficulty Relaxing:

   even during downtime, those with high-functioning anxiety may find it difficult to relax. Their minds are often racing with thoughts about the next task, goal, or responsibility, preventing them from fully unwinding.
   

5. Physical Symptoms:

   while many people with high-functioning anxiety appear outwardly calm, their bodies are often in a constant state of tension. Physical symptoms may include tight muscles, headaches, gastrointestinal issues, or sleep disturbances.
   

6. People-Pleasing Tendencies:

   the desire to meet expectations, both personal and professional, may lead someone with high-functioning anxiety to go out of their way to please others. This can lead to an overwhelming fear of disappointing people and may result in them saying “yes” to everything, even when it’s too much to handle.
   

7. Overworking:

   many people with high-functioning anxiety push themselves hard to stay busy, thinking that if they work harder or stay occupied, they can avoid or manage their anxious thoughts. This can lead to burnout and exhaustion over time.
   

8. Irritability or Mood Swings:

   the constant pressure and stress from managing anxiety can result in irritability or sudden mood shifts. Small annoyances might feel like overwhelming challenges when someone is already mentally drained.

    

Managing High-Functioning Anxiety

Here are some strategies that can help manage its symptoms and improve quality of life. Here are some effective ways to cope:

1. Practice Mindfulness and Meditation

   Mindfulness techniques can help you stay grounded in the present moment and reduce the constant cycle of worrying. Meditation, breathing exercises, and body scanning can help you become more aware of your physical and emotional states, allowing you to release tension and quiet your mind.
   

2. Set Realistic Expectations

   Perfectionism can be a driving force behind high-functioning anxiety. Learning to accept that not everything needs to be perfect is essential for managing stress. Start by setting realistic, achievable goals and recognizing that it’s okay to make mistakes or fall short sometimes.
   

3. Set Boundaries

   People-pleasing tendencies can make it difficult to set boundaries. However, it’s crucial to learn how to say “no” when necessary and recognize that taking on too much will only increase your anxiety. Establishing clear boundaries helps reduce overwhelm and ensures you have time to honor your needs.
   

4. Physical Exercise

   Regular physical activity is one of the most effective ways to reduce anxiety. Exercise releases endorphins, which act as natural stress relievers. Whether it’s a daily walk, yoga, or strength training, moving your body helps clear your mind.
   

5. Practice Self-Compassion

   Self-criticism and negative self-talk are common for those with high-functioning anxiety. Learning to treat yourself with kindness and understanding can significantly reduce anxiety levels. Replace self-critical thoughts with affirmations and reminders that it’s okay to be imperfect.
   

6. Journal

   Writing down your thoughts and feelings can help you process and release pent-up emotions. Journaling allows you to reflect on your worries, identify patterns, and gain clarity on how to manage stress more effectively.
   

7. Prioritize Rest

   Getting enough rest is vital for managing anxiety. The combination of physical exhaustion and mental overdrive can make symptoms worse. Make sleep a priority and try to establish a consistent routine to ensure you’re well-rested.

Seek Support

There are times when people need professional support as they manage high functioning anxiety. The Mental Health Center in Los Angeles works with kind and qualified mental health professionals to deliver the best care possible.

For more information about the services we offer, visit Mental Health Center or contact us at (310)601-9999. Your journey toward healing and recovery starts today!