Anxiety is a term often associated with debilitating fear, panic attacks, and an inability to function in everyday life. However, not all anxiety fits this description. High-functioning anxiety is a lesser-known but equally impactful condition where individuals appear to manage their daily tasks efficiently, often excelling in their professional and personal lives, while internally grappling with anxiety. Often presenting as overachievers, perfectionists and highly motivated, these individuals mask a continuous state of stress and unease.

The symptoms and visible signs of high functioning anxiety are often less evident than the visible anxious person due to the ability to excel and appear highly competent.

The main characteristics of high-functioning anxiety can include:

1. Inability to Relax & Restlessness – struggling to unwind and enjoy downtime, often feeling guilty or anxious during moments of rest.
2. Fear of Failure - An intense fear of making mistakes or not meeting expectations.
3. Overthinking - Frequently worried about various aspects of life with a tendency to overanalyse situations.
4. Constant need for reassurance – Needing external validation to confirm ‘I am doing ok’, ‘I’m not overreacting’ and so on.
5. High Achieving - setting and pursuing ambitious goals, often exceeding expectations.
6. Planning ahead: often being highly organized and always preparing ahead for all eventualities. Leaving little to chance.
7. Defining self-worth based on productivity – I only bring value if I am ‘doing’.
8. Detail-Oriented  - paying close attention to details and ensuring that tasks are completed to a high standard.
9. People-Pleasing -  Struggling to say no and often take on too many responsibilities to please others. Often this is driven by a need to not push people away.
10. Sleep Issues - trouble sleeping due to racing thoughts and excessive worry.

The Role of Psychotherapy

Therapy can be a helpful tool in managing high-functioning anxiety by:

• Helping us to identify and challenge self-critical thought patterns and behaviours. For example, do we seek perfection because making mistakes feel like failure and this is experienced as intolerable?
• Understanding where and when we learnt that we have to be excelling at all times and why it’s so difficult to let anyone see our difficulties or vulnerabilities.
• Addressing our self-judgments to encourage inner self acceptance. Rather than trying ‘to stop or get rid of’ the anxiety, as is often stated as the goal of therapy, working on our critical inner critic to understand the drivers that recreate these patterns of behaviour.
• Identify our strengths and building resilience to help manage fears and feelings of things being out of control.
• Learning to be more compassionate and considerate towards ourselves and attending to our needs.
• Learning to set boundaries, saying no and prioritising tasks to avoid overstretching and overcommitting.
• Learning to reach out to others when feeling overwhelmed and asking for help.

High-functioning anxiety is a complex and often misunderstood condition. While individuals with high-functioning anxiety may appear successful and in control, they often struggle internally with constant worry and stress. Recognizing the signs, adopting pro-active strategies and seeking therapy can help manage and alleviate the symptoms of high-functioning anxiety.

If you or someone you know is struggling with high-functioning anxiety, reaching out for support is a crucial first step towards well-being and a more balanced outlook.