How to spot the signs of high-functioning anxiety

Calm and collected on the outside, but a whirlwind of worry underneath. If that sounds familiar, you may want to know more about high-functioning anxiety.

Imagine being a successful, driven, type-A personality, but underneath the perfect exterior lies a constant battle with feelings of anxiety, from worry to panic attacks and a racing mind.

That’s the reality of a person living with high-functioning anxiety.

Anxiety has been identified as the most common mental health condition in Australia, with the National Health Survey reporting it affects around 3.2 million people.

While high-functioning anxiety is a non-clinical term, it refers to those who on the outside look like they’re successful in many areas of their lives and have things under control, but internally feel very anxious.

“High-functioning anxiety is a contemporary term to describe the anxiety felt by people whose anxiety does not interfere with their everyday functioning,” says psychotherapist Jane Daisley-Snow, academic lead at the Australian College of Applied Psychology.

“This is often kept hidden from others and despite still managing everyday tasks it can be debilitating.”

What are the signs of high-functioning anxiety?

Those with high-functioning anxiety experience life as a double-edged sword. Outwardly they can be:

  • High-achieving
  • Detail oriented
  • Organised
  • Calm and collected
  • Orderly and tidy

But they can often be quietly experiencing feelings of anxiety such as:

  • Agitation
  • Catastrophic thinking and rumination
  • Disturbed sleep
  • The inability to say “no” or set boundaries
  • Trouble with prioritising and decision making

Anxious but not disordered

High-functioning anxiety isn’t listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or International Classification of Diseases (ICD-10), and as such isn’t officially classified as a mental health disorder.

“If you can function well with these common anxiety symptoms, then you are not ‘disordered’,” says Dr Michael Musker, senior research fellow, mental health and wellbeing, at the South Australia Health and Medical Research Institute.

The challenges of high-functioning anxiety

Despite a lack of official recognition as a disorder, high-functioning anxiety is a condition that can still affect quality of life.

Some of the biggest challenges can be “the impact on their body and mind from constantly experiencing anxiety,” says Twiss Psychology founder and psychologist Amelia Twiss.

“Physical impacts can include tension in the body, low energy, gut issues, trouble sleeping or an inability to relax,” says Amelia.

“Psychologically, the tendency to ruminate or worry that comes with anxiety has an impact on perception, reasoning and problem solving.”

How can high-functioning anxiety be treated?

Dr Musker says treatment for high-functioning anxiety may include a lifestyle audit.

This can involve reviewing sleep and diet, monitoring alcohol intake, finding opportunities for relaxation and noting how much tension a person experiences in a day.

A wellbeing and resilience course may also help develop strategies and exercises to deal with anxiety.

Jane says identifying specific mental and emotional stress triggers is useful in addressing anxiety.

These can be things such as health, work, family or finances.

Ultimately, addressing anxiety may require seeking professional help.

“(Working) with a therapist (can help you) to process the underlying feelings that are causing the anxiety and to learn how to regulate your emotions more effectively,” says Amelia.

Written by Tania Gomez.