High functioning anxiety is similar to other types of anxiety in the sense that you’ll experience symptoms, such as:

• Excessive fear
• Overthinking
• Worrying

However, people with this form of anxiety are able to maintain daily functions. In fact, they may even excel in certain aspects of their lives, such as their careers and schooling.

What is High Functioning Anxiety?

Since the medical community doesn’t recognize high functioning anxiety as a type of disorder, there’s a lack of research regarding the condition. Still, there are many out there who struggle with anxiety, but are able to maintain their lives. These people are considered high functioning.

It’s difficult to fully comprehend anxiety disorders because they exist on a spectrum. In other words, one person may feel mild bouts of stress while others experience excessive apprehension. ¹

While some medical professionals explain high functioning anxiety as a mild form of the condition, others believe these individuals have subclinical anxiety. This is when people experience anxiety symptoms, but don’t meet the diagnostic criteria for anxiety. For example, someone who struggles with insomnia likely has certain symptoms of anxiety, but isn’t necessarily struggling with an anxiety disorder. ²

Subclinical anxiety symptoms can appear as:

• Atypical
• Brief (but recurring)
• Hidden
• Mild

High functioning anxiety works differently for everyone. For example, someone with social anxiety tendencies may find they can hide symptoms and appear calm or confident.

Regardless of these circumstances, anxiety still causes it’s typical symptoms – from excessive worrying and fears to overthinking. In turn, high functioning anxiety may affect other areas of an individuals life, from appetite to sleep patterns.

Without treatment, symptoms of anxiety can be detrimental to a person’s health. For this reason, it’s important to consult a medical professional even if you’re high functioning.

Signs and Symptoms of High Functioning Anxiety

Since there’s a lack of research, it’s unclear exactly what symptoms are associated with high functioning anxiety. However, most medical professionals agree that this form comes with a multitude of anxiety symptoms along with symptoms only present in high functioning, including: ³

• Anticipatory anxiety (feeling anxiety before an event)
• Changes in appetite
• Desire to stay busy
• Digestive issues
• Fear
• Inability to relax
• Increased heart rate
• Irritability (frustration)
• Overachieving
• Overthinking (overanalyzing)
• Over-worrying
• Perfectionism
• Rapid breathing
• Sleep problems (i.e. insomnia)
• Thoughts of failure and judgement

People who struggle with high function are likely to only experience a selection of symptoms on this list. Not to mention, they may also experience other symptoms not presented here.

What Causes High Functioning Anxiety?

Currently, there’s a lack of research in the causes of anxiety, including high functioning. However, it’s believed to have to do with one or more of the following:

• Exposure to Stress – Large amounts of stress may lead to an anxiety disorder. This is especially true of trauma which could lead to post-traumatic stress disorder (PTSD). ⁴

• Genetics – Those with a family history of anxiety are more likely to struggle with anxiety themselves. For example, if your parents have anxiety, you’re at a higher risk of developing it. ⁵

• Health Complications – Certain health conditions can lead to anxiety, such as digestive issues and heart complications. ⁶ ⁷

• Personality Traits – Childhood characteristics, such as shyness or nervousness, can lead to an anxiety disorder later in life. ⁸

• Substance Use Disorder – Abuse of drugs and alcohol along with subsequent withdrawal symptoms can lead to anxiety. ⁹

Is High Functioning Anxiety Connected to Depression?

The National Alliance of Mental Illness (NAMI) recently discovered that 60% of those who struggle with anxiety also show signs of depression. Furthermore, those who already struggle with anxiety and stress and do not seek treatment are at an increased risk of depression. ¹⁰

Since people with high functioning anxiety tend to manage symptoms and their lives, they’re less likely to seek out treatment. In turn, symptoms may spiral out of control and lead to an increased risk of depression.

Currently, there is no research to suggest that high functioning anxiety leads to depression. In fact, since those with this type of anxiety may develop tendencies of overachieving or perfectionism, they may also view their anxiety as a positive trait. However, if you experience symptoms of depression, it’s important to seek out treatment.

How is High Functioning Anxiety Treated?

Currently, there is no treatment specifically geared towards high functioning anxiety. If you struggle with this condition, it’s likely a doctor will recommend other treatment options typical of anxiety disorders.

Diagnosis

As of this time, the DSM-5 doesn’t recognize high functioning anxiety as a mental illness. With that said, a mental health professional is unlikely to diagnose you as such. Instead, they may find that you struggle with another form of anxiety, such as obsessive-compulsive disorder (OCD), and diagnose you accordingly.

As mentioned, anxiety disorders exists on a spectrum and there’s a good chance your struggle is a mild form of a type of anxiety.

To determine your diagnosis, a mental health professional will run a series of tests. These include a: ¹¹

• Family history
• Physical exam
• Psychological evaluation

Since those with high functioning anxiety may not present enough symptoms for a diagnosis, a doctor may find their condition to be inadequate for treatment. In such cases, it’s vital for you to discuss exactly how you feel and how anxiety effects your life.

Even if your doctor doesn’t come to a diagnosis, there are still treatment methods and coping mechanisms to help you deal with this condition.

Medication

If you’re diagnosed with an anxiety disorder, there are certain medications that can help ease symptoms. These include: ¹²

• Antidepressants
• Benzodiazepines
• Buspirone

While each of these medications can limit anxiety symptoms, they aren’t a cure for these disorders. Rather, they can help to provide temporarily relief while you undergo other treatment methods.

Psychotherapy

Psychotherapies (also known as talk therapies) are designed to help you manage anxiety symptoms. While there are several talk therapies to choose from, the most common is cognitive behavioral therapy (CBT). This allows you to identify anxious thought patterns and confront situations that cause your anxiety. ¹³

Your therapist can help you manage anxiety through different grounding techniques, such as breathing exercises, meditation, and lifestyle changes. However, you may find one form of therapy better than another depending on the type of anxiety you struggle with.

Other Coping Mechanisms for High Functioning Anxiety

Beyond traditional treatment methods, there are several ways to cope with high functioning anxiety. Here are just a few examples:

• Diet – Research has found that our diet plays a big role in our mental health. Certain foods may fuel anxiety disorders, such as sugars, fried foods, processed foods, food additives, and caffeine. ¹⁴

• Herbal Supplements – Certain herbal remedies have found to be helpful for anxiety, including kava kava, passionflower, valerian, chamomile, lavender, cannabidiol (CBD), and green tea. ¹⁵

• Holistic Therapy – Beyond traditional therapy options, there are alternative therapies for those who seek more counseling. These include mind-body therapies (meditation), animal-assisted therapy, nature-based therapy, aromatherapy, and music therapy. Studies have found these therapies work great alongside traditional therapies. ¹⁶

• Lifestyle Changes – Just like our diets, our lifestyles can indicate how much stress we build. For people with high functioning anxiety, they may find themselves in a constant work grind that only leads to stress. It can help to develop certain habits, such as exercising, to help reduce stress and anxiety. ¹⁷

You may find a combination of traditional treatment methods and alternative coping mechanisms to be the most beneficial for you.

Final Word

The difficulty with high functioning anxiety is the fact that you’re likely able to manage symptoms. With that, a mental health professional may not be able to diagnose you and give you the proper treatment.

However, if you believe you struggle with this form of anxiety, it’s vital to seek out treatment options. Untreated high functioning anxiety could lead to worsening symptoms and eventually inhibit your day-to-day life.

If you’re unable to get the help you need from a doctor, you can still manage high functioning anxiety by enrolling in therapy, making lifestyle changes, and finding herbal alternatives as a substitute for medication.

References

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² Spira AP, Friedman L, Aulakh JS, Lee T, Sheikh JI, Yesavage JA. Subclinical anxiety symptoms, sleep, and daytime dysfunction in older adults with primary insomnia. J Geriatr Psychiatry Neurol. 2008 Mar;21(1):56-60. doi: 10.1177/0891988707311043. PMID: 18287171.

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¹⁰ Kalin NH. The Critical Relationship Between Anxiety and Depression. Am J Psychiatry. 2020 May 1;177(5):365-367. doi: 10.1176/appi.ajp.2020.20030305. PMID: 32354270.

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¹⁴ Murphy M, Mercer JG. Diet-regulated anxiety. Int J Endocrinol. 2013;2013:701967. doi: 10.1155/2013/701967. Epub 2013 Aug 20. PMID: 24027581; PMCID: PMC3762204.

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