What is High-Functioning Anxiety?

You can go to work, get the job done, and are often considered successful, accomplished, and even celebrated for your dedication. But unbeknownst to the rest of the world, anxiety is sitting on your shoulder, constantly rooting against you. 

Anxiety itself comes in many shapes and forms. In 2014, the Canadian government estimated that 11.6% of Canadians reported that they had mood or anxiety disorders, and of those three million people, 27% reported that it affected their life in a measurable way.

But while those statistics are illuminating, they’re limited to those that self-report their anxiety. High-functioning anxiety often goes unreported, in part because those who have it sometimes consider the traits that their anxiety brings to light, like being detail-oriented or always busy, part of their success and don’t want to risk losing it. Others simply haven’t identified that what they experience might be high-functioning anxiety.

So, what is high-functioning anxiety?

While it might not be an official diagnosis, those that identify with having it will tell you that it’s both serious and real.

As its name would indicate, it is the existence of an anxiety disorder, but those that have it can function despite (or, in spite of) its presence. Those with it appear to operate normally within society, they can accomplish the tasks they set out to do — and often they do them well — but internally, it’s a different story.

They might feel things like a consistent, inevitable impending doom, a racing mind, have trouble sleeping, and even experience gastrointestinal issues like heartburn. But, instead of avoiding situations that cause these things, many who experience high-functioning anxiety tend to run towards them, full speed ahead.

What does high-functioning anxiety look like?

High-functioning anxiety is one of those things that hides in plain sight. It often appears disguised as over achievement, high ambition, hard work (even sometimes too much), perfectionism, and being busy.

While those descriptors don’t necessarily mean that you have high-functioning anxiety, or an anxiety disorder at all (you should always talk to your doctor for an official diagnosis), many individuals who do suffer from it bear those traits.

From the outside, folks with high-functioning anxiety are often the people we look up to. They’re always on the go, rushing up the corporate ladder, coming up with great ideas, and doing amazing things. They have the drive that pushes them to excel in life, and that same drive is probably why we have a hard time identifying who does and doesn’t have it.  

Symptoms of high-functioning anxiety

Like other forms of mental illness, high-functioning anxiety comes in many shapes and forms. Yours might not look like anyone else’s — you might think it’s nothing or another issue entirely — which is why seeking professional medical advice is so important.

That said, there are a number of symptoms common among those who have high-functioning anxiety, and knowing what those are could help you identify if there's something you should seek help for. 

“Positive” traits

It’s a tricky thing, anxiety. Especially for those who seemingly function in a normal (or, in the case of positive traits, above average) manner. Many of the “symptoms” that could be classified as high-functioning anxiety carry positive notions when viewed by society.

You’re dedicated to your job, incredibly detail-oriented, and so organized you have impeccable colour-coded lists — you ooze the outward appearance of success (and often feel it). But then you lie in bed failing to get valued shut-eye because you’re worried about that mounting to-do list, your thoughts are racing thinking of that one line you should have said differently during the presentation on Monday, and that impending dread is leaking through because you’re not sure if you’re going to make the Q3 deadline.

High-functioning anxiety often has the outward appearance of a life well put together. High achievement, success, and dedication, are all valued traits held by the best-of-the-best, so you should be thankful you have them, right? 

Some of these high-functioning anxiety symptoms that often carry positive connotations can include:

• Detail oriented
• Deeply caring (can be negatively portrayed as “overly sensitive”)
• Highly organized
• Professional and career success
• Loyal (sometimes to a fault)
• Always on time
• Outgoing
• High achieving or ambitious
• Full schedule
• Active
• Calm and collected outward appearance

It’s important to note that just because others might think these are positive symptoms (like keeping your schedule super busy or being overly active), if they’re impeding your ability to perform a crucial task (like, say, sleep) or having other negative effects on you (like giving you a constant state of heartburn or making it feel like an elephant is sitting on your chest) then they’re probably an issue. And treating them doesn’t mean you’ll lose your drive to succeed, suddenly become terrible at your job, or lose your bubbly, outgoing personality.

“Negative” traits

Not all of the symptoms associated with high-functioning anxiety come off in a positive light. 

While you might be dedicated to your job, you could be known for being a serious procrastinator, perhaps you’re consistently unsettled and have problems committing to or completing projects, or you’re very helpful but you constantly need reassurance that you’re doing something correctly.

Anxiety disorders are a multi-headed dragon that work similar to Newton’s Third Law where everything (or many things, in this case) has an equal and opposite reaction. Overly helpful means you can’t say no. Deeply caring means you might be overly sensitive. Always on the go could mean that you’re constantly unsettled.

Some of the negative traits that are associated with high-functioning anxiety disorder include:

• Inability to say no (this could be masked as a positive trait like being overly or always willing to help)
• Insomnia or the inability to sleep
• Overly sensitive (can be positively portrayed as “deeply caring”)
• Consistent unsettlement (you’re uncomfortable in your own skin)
• Procrastination
• Consistent need for reassurance, especially when making difficult decisions
• Racing thoughts or a constantly running mind
• Restlessness
• Constant overthinking
• Unable to be “in the moment”
• Limited social life

Sometimes it’s easy to put up with the negative side of things because you want the positive drive to keep going. If being successful means having a racing mind, so be it. You get less sleep than everyone else, but you get more done.

Challenges with high-functioning anxiety disorders

At the end of the day, if you do have high-functioning anxiety, what you really have is an anxiety disorder. While you might be able to blend into the normal ebb and flow of life, and even excel to the point your hard work or success is celebrated, you’ve sacrificed something for that. 

It could be a clear head at the end of a long day before you close your eyes to get some well-needed shut-eye, or perhaps a long-desired vacation because you’ve taken on too many responsibilities to be able to step away. Whatever it is, it would probably be nice to have a taste of it.

Coming to terms with the fact that your body or brain might act in a way that’s atypical to what we’ve become accustomed to can be a challenge. Which makes attaching a term like “high functioning” to it attractive — I might be anxious, but clearly only a little bit because I function fine. 

It’s easy to stave off getting help because it doesn’t seem like it’s that much of a problem. But beyond the interruption to your life, especially in the case of something like lack of sleep or the inability to make difficult decisions, high-functioning anxiety could lead to more serious issues.

Anxiety often goes hand-in-hand with other mental health conditions. While it's not guaranteed that someone suffering from high-functioning anxiety will experience other mental health illnesses like depression, it's possible that you might (or already do). 

High-functioning anxiety has also loosely been linked to alcohol and substance abuse. While, again, there is no guarantee that you will ever face it, both can have significant detrimental effects on your body, mind, and life overall. 

Getting help

If you experience any form of anxiety disorder — or even think that you do — you can and should seek advice from a doctor. This article was written for informational purposes, so unlike your doctor, it cannot give you advice or treat your symptoms.

Many individuals who experience the symptoms of anxiety don’t seek help because they don’t identify those symptoms of a problem. Or, for those who have a high functioning form, they believe they’d have to give something up — like their drive to excel — to do so.

How is anxiety treated?

The world has come a long way from when cocaine was the treatment of choice for toothaches, heroin helped with coughs, and vibrators took care of the excessive “wandering wombs” problem they thought they had on their hands. 

Much of the treatment for anxiety today involves therapy and counselling, including cognitive behaviour therapy. It’s not about taking away your ambition or drive, it’s about getting to the root of the problem and giving you the tools to cope with anxiety and function better in situations that trigger it. 

There’s also no one-size-fits-all treatment, so what’s recommended for your anxiety will be unique to you. Taking the time to treat an anxiety disorder or other mental health illness can go a long way to improving your quality of life. So, if you do find that you experience anxiety symptoms, reach out to a health professional that can help point you in the right direction of getting a diagnosis and finding a treatment.

Treatments for anxiety vary, and no one but a doctor can provide insight on how they’ll affect you. But it’s probably true that if you’ve never sought treatment for anxiety you have no idea what you’re missing out on. If you’ve only ever had sleepless nights, a sound sleep might be just around the corner. Medication can be an effective treatment but most do come with side effects so be sure to discuss that with your healthcare practitioner.

Want to discuss your treatment options? Connect with one of Felix's healthcare practitioners today.

If you or someone you know is having suicidal thoughts and needs immediate assistance, call 911 or go to your nearest emergency department. You can also call the Canada Suicide Prevention Service at 1-833-456-4566 (available 24/7) or text 45645 after 4pm EST. Check out our list of 90+ mental health resources in Canada here.