What Is High Functioning Anxiety? Is It Real?
Applied Psychology

What is high functioning anxiety and is it real?

Oct 29, 2018

Although it isn’t an official diagnosis, high functioning anxiety is real and has a negative impact on one’s health and interpersonal relationships.

Key takeaways:

  • Even though high functioning anxiety is not a recognised diagnosis it is real and should be taken seriously
  • Functioning means different things to different people and, as a result, high functioning anxiety is difficult to officially diagnose.
  • Living with high functioning anxiety can be detrimental to one’s physical health, mental well-being and interpersonal relationships.
  • There are various behaviours and signs to help you recognise if you have high functioning anxiety.
  • Treatment is available, and a more balanced life can be achieved.

You’re constantly anxious. You arrive early at appointments out of fear of being late. You struggle to go with the flow. Despite this however, you’re high-functioning. Your work is done well and on time. People commend you for being so organised…Does this sound like you? If so, you may be suffering from high functioning anxiety.

High functioning anxiety isn’t listed in the Diagnostic Statistical Manual of Mental Disorders (DSM), but that doesn’t mean that it isn’t real and shouldn’t be taken seriously. Part of the difficulty in making high functioning anxiety an official diagnosis is because being functional is so subjective. Also, a disorder is meant to impair your functioning and those with high functioning anxiety appear to be coping with their daily lives and responsibilities. As a result, the key difference between high functioning anxiety and a recognised anxiety disorder is that while all the symptoms of anxiety may be present, even panic attacks, the person is still high functioning. Debra Kissen, PhD, Chair of the Public Education Committee for the Anxiety and Depression Association of America, illustrates this when saying, “Many people are walking around with extremely high levels of anxiety that are near meeting the criteria for anxiety disorders, but they’re white-knuckling their way through it. They’re still waking up. They’re still getting themselves to work.”

The danger of high functioning anxiety however is that you are not functioning as well as you appear to be. Behind your organised façade lies fear, worry and panic, which is detrimental to your physical and mental health and more than likely reducing the quality of your work and your interpersonal relationships. As a result, like a more widely recognised anxiety disorder, high functioning anxiety does in fact impair function, it is just subtler about it. David Roane, MD, Chairman of Psychiatry at Lenox Hill Hospital in New York City, summarises this when saying, “Generally, a psychiatric diagnosis is made when someone has ‘functional impairment,’ but difficulty functioning isn’t always obvious. Sometimes you have to dig pretty hard to see how [the anxiety] is affecting work, family, or relationship performance.”

We live in a society that encourages being busy, rushing from one place to the next. Plus, a certain level of anxiety is normal. It motivates us and keeps us moving forward. How do you know however when normal anxiety is turning into something more severe? Here are five ways to identify if you have high functioning anxiety.

1. You’re constantly busy

People with high functioning anxiety struggle to relax. They’re always busy doing something and never seem to take a time-out. They are the ones that cannot sit still and joke that they must be busy to be happy. As a result, they are often exhausted and are key candidates for burn-out.

2. You’re a perfectionist

Those with high functioning anxiety like things to be done their way and they must be done perfectly. They are the ones we refer to as having a type A personality. They are often known for their ambition, determination and ability to get things done.

3. You’re not sleeping well

High functioning anxiety sufferers often struggle to sleep. Instead they lie awake at night thinking of all the things that still need to be done. Tossing and turning over the little things that they feel they didn’t do right. Worrying about what may come tomorrow.

4. You can’t say no

Someone with high functioning anxiety struggles to say no. They have a crippling fear of disappointing others. They often take on more than they can handle, which is detrimental to both their physical and mental health.

5. You do things to ‘numb’ yourself

People with high functioning anxiety often soothe their feelings of fear with some type of numbing behaviour such as eating, smoking or exercising. While we all turn to a familiar crutch during difficult times, those with high functioning anxiety are often very reliant on their numbing activity and, as a result, they can use it to the extreme.

While things may be getting done and goals achieved, high functioning anxiety can be detrimental to one’s physical health, mental well-being and interpersonal relationships. Living with this type of anxiety is often not sustainable and, at some point, the crash may come. There are various forms of therapy and even medications that can assist those living with high functioning anxiety to lead a more balanced life. If you’re exhausted, pushing yourself to edge while taking on more and more it might be time to contact a councillor or professional that can help you ease the load.

Interested in learning more about counselling? SACAP offers a range of courses, including part-time and full-time as well as distance learning options. For more information, enquire now.

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