What is high-functioning anxiety?
Do you know about high functioning anxiety?
Often when we think of mental health and diagnoses, such as anxiety and depression, we imagine the cliche image of depression that pharmaceutical companies use to market antidepressant medications: people with dark rain clouds overhead, unable to smile as they go about their daily activities.
But what if I told you that depression and anxiety don’t always look this way? There is a brand of anxiety that looks the complete opposite of what you may see in a tv commercial – and that brand is called high functioning anxiety.
High-functioning anxiety, also known as "hidden anxiety" or "smiling depression," is a term used to describe those who manage to excel in their daily lives despite experiencing constant anxiety. They may excel in their careers, maintain strong relationships, and engage in various activities, all while concealing their internal turmoil.
People who experience high functioning anxiety often feel like they are wearing a mask to the rest of the world – but a mask that has helped them do well in face of the pressures of the society we live in. When external forces ask a person with high functioning anxiety to jump, their coping mechanism is not only to respond, “how high?” but also “what more do you need me to do after I jump?”
People with high-functioning anxiety often develop coping mechanisms to hide their inner struggles. They might identify as perfectionists, overachievers, or workaholics, constantly striving for success to distract themselves from their anxiety. These individuals are skilled at appearing confident, calm, and composed, even when their minds are racing with worry.
Most notably, high-functioning anxiety can often go undetected due to the anxiety-performance feedback loop. Most people excel due to their anxiety pushing them to extreme perfectionistic behaviors. When they are praised for their efforts, it reinforces the anxiety state; thus, the anxiety is not identified as a problem in the person’s life. However, living with high-functioning anxiety can be a constant inner struggle and lead to intense burnout.
Individuals with high functioning anxiety are experts at self-doubt, often replaying scenarios in their minds, fearing criticism or failure. They might overthink even the smallest decisions, worry about future events, or dwell on past mistakes. This unrelenting mental chatter can be exhausting, yet it often goes unnoticed by others who perceive the person suffering to be doing well in life.
Despite their outward appearance of looking like they have it all together, individuals with high-functioning anxiety still experience various physical and emotional symptoms such as muscle tension, restlessness, insomnia, irritability, and mood swings. Their untreated anxiety may be the source of substance use, eating disorders, obsessive thoughts and compulsive behaviors, isolation, or feeling like no one truly knows them despite how their social life may look. There may be a trauma in their life that has propelled them to constantly live with the need to prove them self to others, resulting in chronic stress and constant fight-or-flight state. All of these symptoms and stressors circling around thehigh-functioning anxiety canresult in physical health issues if left untreated.
If you identify with any of the symptoms above – you are not alone, and there is ample support around you. Do not hesitate to reach out to a therapist who can help you learn to cope with or process what you are experiencing! This post will is the first of many that I will be writing regarding high-functioning anxiety. Follow along for more in-depth information on how you can manage your high-functioning anxiety in practical ways.
Emily Hope Pettengill, MA is a remote therapist from Massachusetts and owner of Emily Hope Counseling. Emily Hope Counseling specializes in working with mental health in emerging adults — specifically twentysomethings or thirtysomethings. People in this life stage may be experiencing major life transitions or stressors, and may identify as college students, graduate students, young professionals, or young adults. These folks oftentimes are undergoing stress, depression, and anxiety – especially if they are high achievers or have had high expectations for their life goals. The transition from childhood to adulthood presents unique challenges of self-exploration, identity crises, and neurodevelopmental growth unmatched to any other stage of the life span.
With over ten years of working with students of all ages, from international high school students to college students and to adult English learners, Emily Hope understands the unique challenges that high achieving individuals face when it comes to balancing their mental health and prioritizing their goals. From balancing the demands of her own educational and career journey to navigating the changes and transitions that come with each stage of adulthood, she provides a compassionate and non-judgmental space for early adults, young professionals, and college students to explore their feelings and experiences while learning skills and strategies to support their mental health and overall wellbeing.
Emily Hope’s approach is rooted in evidence-based therapies, including cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), mindfulness-based therapy, and motivational interview (MI) while using a trauma-informed feminist lens. Emily Hope is dedicated to empowering individuals to better understand their mental health, learn to cope with the ups and downs, and understand their sense of purpose.
