How is high-functioning anxiety different from general anxiety?

Everyone feels anxious sometimes. Maybe you get butterflies in your stomach when you think about public speaking. Or maybe your heart rate speeds up in new social situations or as you’re walking through a dark parking lot alone. From an evolutionary perspective, anxiety is a stress response designed to help us manage uncertainty and keep us safe. 

However, excessive, chronic anxiety can be a sign of something more serious like generalized anxiety disorder (GAD). GAD is a clinical mental health condition that impacts a person’s ability to function in daily life. But GAD isn’t the only form of intense anxiety. Some people face an internal battle with anxiety without experiencing a loss of functioning. They can power through their fears and attend to their responsibilities without outward signs of distress. 

This pattern of symptoms is sometimes referred to as high-functioning anxiety, and learning more about it can help you know when it might be time to reach out for help. 

What is high-functioning anxiety?

High-functioning anxiety is not a medical diagnosis. It’s a popular term that’s used to describe a person’s ability to function in important parts of their lives despite living with chronic anxiety. On the surface, the person might look like they’re doing just fine and even excelling in their roles. They can meet expectations at work or school, maintain social relationships, and practice self-care. But this outward image often conceals a difficult internal struggle.

People with high-functioning anxiety are typically good at masking their fears, and they don’t avoid activities that cause discomfort. So to the outside observer, it might seem like the person is in total control. 

Sadly, some people think that as long as their functioning isn’t impaired, their situation isn’t worthy of seeking professional help. But the truth is, while an interruption in functioning is required to be diagnosed with certain conditions (like generalized anxiety disorder), anyone experiencing anxiety deserves support.

Hashtag or diagnosis? A disclaimer about high-functioning anxiety

Some experts have expressed concern about labeling anxiety as “high functioning,” especially among young people. Lucy Foulkes, an academic psychologist at Oxford University, cautions that the increased use of non-clinical terms like “high functioning anxiety” could convince young people “that they have a mental illness when they don’t.” 

Foulkes says that increased awareness on social media, although well intentioned, can potentially oversimplify or even popularize mental health conditions. This can lead to something Foulkes calls “overinterpretation,” where people self-diagnose and interpret normal daily struggles as signs of a mental health condition. The result, Foulkes says, is a self-fulfilling prophecy. “If you think you have anxiety, you avoid uncomfortable situations. Ironically, this makes you more anxious in the long term.” 

Foulke’s critique of the “high-functioning” label serves as a reminder that accessing mental health content online can be helpful, especially if it helps you better understand yourself and feel less alone. But it doesn’t take the place of therapy. Getting an accurate diagnosis from a mental health professional is a critical first step in ensuring that you get the right care for your symptoms.

What is the difference between anxiety and high-functioning anxiety?

Anxiety is a normal human emotion that everyone experiences sometimes. But according to Lolly Coleman, MS LMFT, high-functioning anxiety is different from the temporary, situational anxiety we all experience occasionally.  

Sometimes diagnosed as unspecified anxiety disorder, high-functioning anxiety causes a daily internal battle with worry and self-doubt underneath a facade of control. However, since it doesn’t cause the severe, persistent impairment associated with generalized anxiety disorder (GAD), high-functioning anxiety can be hard to detect. 

“Whereas GAD impacts a person more globally, high-functioning anxiety tends to linger under the surface. And people are typically able to ‘power through’ it more easily,” says Coleman.

Regardless how evident your anxiety might be to others, know that if your anxiety is negatively affecting your life in any way, it’s OK to ask for help.

Symptoms of high-functioning anxiety

High-functioning anxiety can take many forms. But some of the most common signs and symptoms include:

Physical symptoms

• Sleep problems
• Numbness or tingling in the hands or feet
• Aches and pains
• Stomach issues
• Rapid heart rate
• Heavy sweating
• Migraines or headaches
• Feeling dizzy or off balance

Emotional symptoms

• Feeling constantly stressed
• Persistent worry and fear
• A sense of dread or impending doom
• Strong perfectionist tendencies
• Frequent self-criticism
• Fears of seeming inadequate or not being in control
• Irritability 

What causes high-functioning anxiety?

Since high-functioning anxiety isn’t an officially recognized mental health condition, we have limited information on its causes. However, there are a few factors that might increase your risk of developing an anxiety disorder, including:

• Genetics: Having a close relative, like a sibling or parent, who has an anxiety disorder could increase your risk of anxiety disorders, including generalized anxiety disorder (GAD).
• Biology: People with clinical anxiety may have abnormalities in their brain structure and brain chemistry.
• Substance use: Cigarette smoking has been shown to contribute to the onset of anxiety disorders like GAD.
• Trauma: Experiencing stressful or traumatic events may make you more likely to develop anxiety.

What treatments are available for high-functioning anxiety?

Treatment for high-functioning anxiety is similar to treatment for other anxiety disorders, like GAD. Treatment tends to involve therapy and, depending on the person, medication. 

The most common treatment options include:

• Cognitive-behavioral therapy (CBT): CBT helps people identify and deconstruct unhelpful thought patterns and discover new ways of coping with anxiety. It can also help reduce your response to triggers and change the way you react to stress.
• Medication: You may not need medication to manage your high-functioning anxiety. But your provider can talk to you about whether this option is right for you. 
• Lifestyle: You can nurture your mental health and manage your anxiety by getting adequate sleep, eating a balanced diet, and making time for regular exercise.

Find care with Rula

While it may not be noticeable to others, living with high-functioning anxiety can take a toll on your mental and physical health. But fortunately, you can learn to manage your symptoms with the right support. 

With help from Rula, you can find a therapist who takes your insurance and offers the specialized treatment you deserve in just a few clicks. No matter the mental health concern you’re facing, we can help you find the right provider for your needs. When you’re ready, we can connect you with a therapist you can meet with from the comfort of home as soon as tomorrow.

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