When everything looks fine from the outside, it can be easy to overlook what might be going on internally. Anxiety is often associated with panic attacks- sweaty palms, difficulty breathing, a racing heart, and other symptoms that can be visible to others. In reality, anxiety doesn’t always look this way. Sometimes it looks like showing up to work, fulfilling responsibilities, maintaining relationships, and getting everything done while struggling to stay afloat beneath the surface. 

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What high functioning anxiety can look like 

High functioning anxiety can be described as anxiety that happens internally without others noticing its presence. It often presents as perfectionism, people pleasing, overthinking, difficulty relaxing, a high level of organization/preparedness, high productivity, and/or seeking frequent reassurance. These are just some of the ways anxiety can appear to others as if you “have it all together,” while actually being driven by internal anxiety. This can sometimes be based on a fear of failure or of letting other people down, which leads to an intense desire to perform well or make others happy in order to avoid those things. 

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The burden of being the one to “have it all together” 

It takes a toll to always be striving for perfection. Partially because it’s actually not possible, despite what your anxiety might be telling you. Continuously setting expectations for yourself that are unrealistic sets you up to fail because ultimately, there will be moments when you can not meet those expectations. You and I are human beings, and we all need time to rest and room to make mistakes. 

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Signs you may be functioning through anxiety

Here are some questions you can ask yourself:

• Do you spend a lot of time worrying about things that haven't happened yet?
• Do you have difficulty enjoying the present because you are thinking about what comes next?
• Do you feel guilty when you rest?
• Do you frequently replay conversations or worry about how others perceive you?
• Do you feel like you have to be prepared for every possible outcome?
• Do you appear calm to others but feel overwhelmed internally?
• Do you keep yourself busy to avoid sitting with uncomfortable thoughts or feelings?

If you answered yes to any of these, you might consider that high functioning anxiety could be impacting you. While the answers to these questions do not serve as a diagnosis, they can be helpful in identifying patterns in your behavior and deciding whether further assessment may be necessary.

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Anxiety disguised as productivity

Because high functioning anxiety can often present as high productivity, it can easily hide behind a busy schedule. While keeping a full calendar can give anxiety what it wants- a sense of control- for a while, it can often lead to burnout and exhaustion that creates even more anxiety. This cycle often repeats and keeps the anxiety fed while making it difficult to break.

From functioning to thriving 

While you may be functioning externally, you deserve to feel safe internally too. When pushing through has been your default, it can be scary to think about taking a break or doing less. Leaving space for your own thoughts and fears to exist can leave you feeling vulnerable and exposed. However, there are ways to build your tolerance to the discomfort that comes with giving yourself a break and to manage the anxiety you’re experiencing. 

1. Identifying anxious thought patterns

Building awareness around anxious thoughts that come up for you can be an important first step in identifying patterns and understanding how anxiety may be impacting your daily life. Anxious thoughts can sometimes be so automatic that you don’t even notice they are based in anxiety and instead recognize them as facts. A good starting place to bring awareness to anxious thoughts can be to use journaling as a tool to document them as they come up. It may also be helpful to note when the thought came up and what circumstances were happening around you when you noticed the thought. 

2. Practicing boundaries around work and responsibilities

Boundaries can be challenging when you experience high functioning anxiety, but they can be an important part of reducing burnout and protecting your mental health. This might mean saying no more often and recognizing when you don’t have the capacity to do as much as you expect yourself to be able to do. Here is some further reading on boundaries that may be helpful in learning how to implement them: Setting Boundaries: How to say "no"

3. Building intentional periods of rest.

Scheduling time for rest and relaxation is vital in managing high functioning anxiety. When you are used to being productive all the time, it may feel odd at first to take space for yourself. However, in the long run this can be an important piece of the puzzle for reducing anxiety. 

4. Learning grounding, mindfulness and relaxation strategies. 

Grounding techniques can help regulate your nervous system and reconnect you to the present moment. Relaxation strategies can also be beneficial in helping you learn how to relax your body which in turn reduces anxiety. Practicing mindfulness is another way to keep yourself present. Here are a few options you can try as a starting point: 

• Grounding Techniques
• Relaxation Strategies
• Leaves on a Stream

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You don’t have to fall apart in order to deserve support

Because high functioning anxiety is often hidden, many people wait until they are completely burned out or visibly struggling to seek support. By recognizing the ways anxiety presents for you and paying attention to signs that you may be experiencing high-functioning anxiety, you can become more aware of your needs and seek support before you reach a breaking point. This can look like leaning on your support system and/or reaching out for professional help. Therapy can be an important part of navigating high-functioning anxiety, providing a space to better understand your thought patterns, develop coping skills, and practice healthier ways of managing stress and uncertainty. 

Recognizing that you are struggling is an important first step toward improving your well-being and mental health. You don’t have to carry this alone.

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Sources

• Verywell Mind. The Characteristics of High-Functioning Anxiety 
• Mayo Clinic Health System. Managing high-functioning anxiety
• UCLA Health. What does high-functioning anxiety look like?