• High-Functioning Anxiety 101

    “We suffer more often in imagination than in reality”


    Anxiety is one of many psychological challenges that can present in various ways. One such type of anxiety, although not in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-V) and not a “formal” diagnosis, is high-functioning anxiety (HFA). Having HFA refers to someone who suffers from or experiences anxiety but still can navigate through and manage their daily life exceptionally well.

    Individuals with HFA are often successful and well-balanced in their jobs, life, and home, and, in fact, very well put together in many aspect of their lives. They may appear well-composed, stress-free, and accomplished on the surface level.  But deep within, they also may be dealing with obsessive thoughts,  overwhelming stress, and excessive worrying.

    One of the first steps to treating HFA is to understand the signs and symptoms that accompany it. Let’s look at some of the signs that tell if you are dealing with HFA, steps that you can take to calm your thoughts, and other necessary details that may be useful.

    What Are the Signs and Causes of High-Functioning Anxiety?

    The signs and symptoms of HFA that one might experience do not feel all differently from general anxiety disorder, or panic disorder or social anxiety disorder, they just may seem often less obvious. One difference is that HFA will not paralyze the person, (in contrast to someone having say, a panic attack), but instead will cause them to push harder and carry on.

    It’s difficult to understand HFA, especially since it’s not a diagnosis and only little research has been done on it. It’s sometimes linked with perfectionism and need for approval.  Here are a few signs that may be indicative of HFA; some of these signs are more distinct than others:

    • You appear/are organized and pay attention to detail  (sometimes to the point of perfectionism), but inside experience excessive worry and negative thinking.
    • You appear to others as having boundless energy but inside you’re absolutely exhausted, not just from being uber-productive, but also from having to keep up appearances.
    • You present as always pleasant, funny, and willing to help, but your inner experience is feeling never quite good enough and perhaps irritable and resentful.
    • You appear refreshed and full of energy,  but you actually are sleep deprived at times because your thoughts prevent you from falling asleep, or wake you up several times during the night.
    • People think you’re calm and collected all the time, but inside you sometimes feel like a ball of  muscle tension and restlessness.

    HFA may be caused by many factors, sometimes genetic, biological, environmental or learned. However, we don’t inherit an “anxiety gene,” just a propensity to deal with stress and anxiety in a specific way.

    Some causes, which are common to any garden variety anxiety disorder may include:

    • A family history of anxiety
    • Stressful life events
    • Substance abuse
    • A physical condition
    • Nervousness and a high need for approval from as early as 10 years old
    • Brain chemistry, for example a serotonin deficiency in a specific part of the brain

    How Do You Quell High-Functioning Anxiety?

    If you are struggling with HFA, here are a few actions (many of which you likely already know)  you can do on your own to feel better:

    • Learn what your symptoms or triggers are
    • Take action instead of overthinking situations
    • Challenge the thoughts that make you anxious
    • Embrace a good diet, regular exercise, and meditation for a healthier mind
    • Find someone you’re confident in sharing your thoughts and feelings with
    • Don’t suffer alone; ask for help (and accept it)

    HFA can be treated in basically the same way you treat most anxiety disorders; talking with a licensed therapist, taking prescription medications or both. Your therapist will help you challenge thoughts that may have become distorted, exaggerated and negative and replace them with more realistic thoughts. Simple concepts, yet not so simple to execute.

    You Too Can Live Free

    Sometimes, you may think that your feelings and emotions are inconsequential, especially when the rest of your life is going so well. But you’re suffering from anxious, obsessive and disruptive thoughts on the inside. Don’t be fooled into thinking, “everyone feels way.” You don’t have to go through this alone. How you feel matters, and finding help is not a sign of weakness. Book an appointment  with a therapist to discuss what’s going on and see the tools you can learn.  You can be successful and not have to experience high tension buzzing in your brain all the time.

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