High-Functioning Anxiety: Masked Distress, Outward Success

High-functioning anxiety: A cut-out of a head with a tangled yarn extending from the top to signify a jumbled mind.

High-functioning anxiety: Anxiety disorders are among the most common mental health conditions affecting individuals worldwide, characterized by intense and uncontrollable fear or worry disproportionate to the actual threat or situation. They may have recurring intrusive thoughts and physical symptoms such as rapid heartbeat, sweating, trembling, and a persistent feeling of unease despite nothing changing in their surroundings to trigger a sense of dread. In the worst cases, they lead to panic attacks, which are intense episodes of extreme fear with severe physical symptoms.

Among the various forms of anxiety, high-functioning anxiety is gaining recognition as a unique manifestation. High-functioning anxiety is when individuals still experience intense anxiety but can manage life’s challenges with some success. They may be accomplished professionals, seemingly well-put together, composed, high-achieving strivers, while internally experiencing non-stop worry and unease.

Fortunately, anxiety is a highly treatable condition. At Integrative Health Center, we aim to help you be the best version of yourself, free from needless worry that can affect your relationships, career, and well-being. But to address a problem, we first must recognize it exists. This article will shed light on the often-overlooked condition of high-functioning anxiety, what it is, the diagnosis process, and how it differs from regular anxiety. Furthermore, we will explore the available treatment options.

1. Distinguishing High-Functioning Anxiety




There are many anxiety disorders, including generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and specific phobias. While high-functioning anxiety has similarities, certain benchmarks set it apart and help experts identify it.

  • External Appearance: One of the key distinguishing factors is how individuals with high-functioning anxiety appear on the outside. Despite experiencing intense anxiety internally, they often present themselves as competent, composed, and successful. They may excel in their academic or professional endeavors, maintain strong relationships, and engage in various activities without showing signs of distress. On the other hand, regular anxiety may be more visibly apparent, with individuals displaying overt signs of worry, nervousness, or avoidance.
  • Perfectionism and Overachievement: High-functioning anxiety often goes hand-in-hand with high achievement. Those with this condition may set impossibly high standards, striving for perfection in all aspects of their lives. They may relentlessly seek validation, fear failure, and consistently push themselves to meet or exceed expectations. External success and functionality are what sets this condition apart from normal anxiety.
  • Coping Mechanisms: Individuals with high-functioning anxiety tend to develop sophisticated coping mechanisms such as meticulous planning, organization, and preparation to minimize uncertainty and control their environment. These methods of navigating life help mask their internal turmoil.
  • Societal Expectations: The pressure to conform to societal expectations can contribute significantly to high-functioning anxiety. The fear of being seen as weak or vulnerable may drive individuals to work harder, achieve more, and maintain a façade of confidence.
  • Internal Conflict: Those with high-functioning anxiety often experience a deep internal conflict. Since individuals suffering from this condition don’t believe in expressing their anguish publicly, their internal conflict lacks an outlet for catharsis and worsens. Individuals may be preoccupied with potential negative outcomes, catastrophizing even the smallest uncertainties and overanalyzing past events. They struggle with self-doubt, and a constant fear of failure, feeling misunderstood and isolated as their emotions don’t align with their external accomplishments.
  • Physiological symptoms: The inner pressure of hidden anxiety can manifest in consistently troublesome physical discomfort. These can be nagging pains like muscle tightness, clenched jaw, tooth grinding in sleep, digestive issues, and headaches. An emotional manifestation of this is irritability.

2. How is High-Functioning Anxiety Diagnosed?




Diagnosing high-functioning anxiety can be a complex process, as it involves understanding the individual’s internal experiences and evaluating the impact of anxiety on their daily functioning. Mental health professionals employ various diagnostic tools and techniques to assess and differentiate it from other anxiety disorders. The diagnostic process typically considers the following elements:

  • Clinical Interview: A thorough clinical interview is fundamental to diagnosing high-functioning anxiety. The mental health professional will talk with the individual to gather information about their symptoms, experiences, and personal history. The interview aims to understand the nature and intensity of anxiety symptoms, potential triggers, and their impact on different areas of life.
  • Standardized Questionnaires: Mental health professionals often utilize standardized questionnaires or assessment scales to measure anxiety symptoms and functioning. Commonly used scales include the Generalized Anxiety Disorder 7-item (GAD-7) and the Beck Anxiety Inventory (BAI).
  • Diagnostic Criteria: High-functioning anxiety is not a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, mental health professionals may use existing diagnostic criteria for anxiety disorders, such as generalized anxiety disorder (GAD) or panic disorder, to identify and evaluate high-functioning anxiety. These criteria typically involve the presence of anxiety symptoms discussed above.
  • Functional Assessment: Assessing the impact of anxiety on daily functioning is crucial in diagnosing high-functioning anxiety. Mental health professionals explore how anxiety affects various areas, such as work, relationships, academic performance, and social activities. They examine the individual’s ability to maintain a high level of functionality despite experiencing significant anxiety internally.

3. Treating High-Functioning Anxiety


There are many proven ways to treat high-functioning anxiety. Managing the condition can be accomplished through one or several of the following methods:

  • Therapy: Cognitive Behavioral Therapy (CBT) is often effective in treating high-functioning anxiety. CBT helps individuals identify and challenge maladaptive thoughts and behaviors, develop healthier coping strategies, and manage anxiety symptoms more effectively. Additionally, techniques such as mindfulness-based therapies can promote self-awareness and emotional regulation.
  • Biofeedback Therapy: This innovative therapy helps individuals control their physiological responses to stress. By providing real-time feedback on heart rate, muscle tension, and other bodily functions, individuals can gain awareness and learn to regulate their responses, reducing anxiety levels over time.

Living with high-functioning anxiety can be challenging, as individuals often navigate their daily lives while silently battling intense internal distress. However, there is hope for those experiencing high-functioning anxiety. Recognizing and acknowledging the condition is an important first step toward seeking the support and treatment needed to manage and overcome its impact.

Integrative Health Center and High-Functioning Anxiety

While high-functioning anxiety may create the illusion of strength and capability, it is crucial to remember that seeking help is not a sign of weakness. Integrative Health Center’s professional mental health support can provide invaluable guidance and strategies to address anxiety symptoms, develop healthier coping mechanisms, and improve overall well-being.

Through therapeutic interventions like cognitive behavior therapy and talk therapy,  in addition to other novel techniques, we can help you achieve holistic wellness.

Call (855) 599-9987 or contact us on our website to learn more.

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