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Writer's pictureAlexander James

Do You Have High-Functioning Anxiety?

It’s a common trope seen in mental health campaigns, where someone appears to be smiling and fine on the outside, but on the inside, they’re breaking, but for anyone who has high-functioning anxiety, this is exactly how they feel.


Medically speaking, high-functioning anxiety is not recognised as an individual condition, it is anxiety. Those who suffer from the condition still feel they are able to function normally in life, excelling at work, or being an attentive friend, but there are telltale signs that they are not as well as they seem.


These sufferers can hide their anxiety symptoms to the extent that they appear to be unaffected, and when someone presents themselves as capable and functioning and even excelling, they could be experiencing the debilitating symptoms of anxiety disorders, such as fear, a feeling of impending doom, extreme worry, and hyper-vigilance.


It can physically manifest itself with high blood pressure and heart rates, insomnia, and gastrointestinal issues.


That ability to hide and even thrive in external life means that for some people, post-lockdown life provides the perfect context in which high functioning anxiety can exist. With high functioning issues, there is a façade to be wary of as the affected person might be more likely to not get the help they need.


What does high functioning anxiety look like?


With the façade presented by those with high-functioning anxiety, the signs can appear to be unrelated to anxiety at the first glance. A common one is striving to be presenting themselves as a perfectionist, or being fearful that they are not being good enough or getting things wrong, and a ‘workaholic’ disposition.


Due to high functioning anxiety being characterised by a degree of pretence and keeping up appearances, signs can look to be unrelated to anxiety at a first glance.


It can also manifest as controlling behaviour when it is actually being driven by fear rather than ego, but if you’re on the receiving end of such toxic behaviour, it is difficult to see anything other than control and power.


Other signs can include restlessness, irritability, an inability to assert boundaries, always being busy, and an insistence that they are happy despite going through difficult times. Many sufferers have a history of depression, trauma, low confidence, feelings of unworthiness and fear of rejection. They may even have substance abuse issues or an eating disorder.


If these words ring true, there are some things to consider:


• Ask for help, including professional help

• Look at your belief systems and challenge them

• Learn to say no and that the drive for perfectionism is one of destruction

• Put in boundaries, limiting the time you spend trying to achieve everything.

• Engage in ‘slowing’ down activities, such as walking, yoga, dancing, gardening, holistic therapies, and anything creative, as this shuts down the anxiety response in your brain.

• Telling people that you trust you are struggling, and this can include your GP who can refer you for further support including psychotherapy, CBT, and mindfulness.

• Quit negative self-talk.


High functioning anxiety doesn't have to be a life sentence, but it requires dropping the act enough to acknowledge the need for change - functioning well on the outside while struggling internally can only be sustained for so long.


If you’re looking for a mindful therapist online, get in touch today.

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