2020 was a challenging year for many of us. This year, I worked with clients on depression, relationship issues, sexual dysfunctions, anxiety, parenting, and trauma. Due to the global pandemic, overall anxiety levels have increased as expected. What I was not expecting was how frequently high functioning anxiety came up in my therapy sessions this past year.
What we clinically define as anxiety does not have to be a crippling feeling. Just like every other emotion, your anxiety serves a function. If you are struggling with high functioning anxiety, how you feel inside may be different than how you look on the outside.
While people who know you see you as someone who is outgoing, driven, detail-oriented, hardworking, overachieving, helpful, motivated, calm, loyal, active, friendly, organized, and punctual; what you may feel on the inside is a need for control, guilt from taking time off for yourself, fear of failure, overthinking, reassurance seeking (fear of being unworthy), having poor boundaries, perfectionism (thinking that mistakes are signs of failure), inability to slow down, second guessing yourself, people pleasing (fear of saying no) and catastrophic thinking (assuming the worst-case scenario).
Anxiety varies. While anxiety disorders are mental health diagnoses, high functioning anxiety is not an official mental health diagnosis. “Anxiety disorder” is an umbrella term that we use to describe six different types of anxiety, which are separation anxiety disorder, specific phobia, social anxiety, panic disorder, agoraphobia, and generalized anxiety disorder. You may have any of these anxiety disorders and high functioning anxiety as well. And even if you do not experience any of these anxiety disorders, you can still have high functioning anxiety. Please note that high functioning anxiety does not mean high level of anxiety. If you are experiencing high functioning anxiety, you can get things done and have a productive day. You can be a social and an outgoing person who enjoys spending time with others.
The following examples can help you to determine if you are experiencing high functioning anxiety:
- On the outside, others may think that you have a strong work ethic. However, on the inside you may struggle with a fear of being fired or disappointing your boss.
- On the outside, others may think that you are good at planning. However, on the inside you may feel like you always need to be prepared in case something bad happens. Also, for people with high functioning anxiety, procrastinating can be followed by long periods of hard work to the point of burnout.
- On the outside, others may think that you are so kind and helpful. However, on the inside you may find saying no to others challenging. Believing that if you say no to others, you are going to make them sad or disappointed, or that you are going to drive them away may lead to people pleasing behaviors. A person with high functioning anxiety may keep themselves overly busy due to the fear of saying no.
- On the outside, others may think that you are always on time. However, on the inside you may experience an instant stomachache when you think about running late. Note that for people with high functioning anxiety, it is common to experience GI issues such as stomach cramps or diarrhea before an anxiety provoking situation such as going to a job interview. Often, you may not be able to get a medical diagnosis from your GI doctors since high functioning anxiety may go unnoticed.
- On the outside, others may think that you are calm and collected. However, on the inside, you may feel like you are not able to be present and enjoy the moment due to being unable to relax. If this is the case, you may also be experiencing a fear of missing out (FOMO) which recently started to become more common as we compare our lives with others over social media.
High functioning anxiety is defined as a continuous loop of overthinking, self-doubt and uncontrolled worry hidden behind a mask of achievements and fulfilled obligations. If you are avoiding your feelings by keeping yourself busy, doubting your abilities even when you succeed (see my blog titled with “Why Do You Self-Sabotage” to learn more about this concept), overthinking or dwelling on the smallest things, canceling plans last minute, having disturbed sleep patterns, or fixating on worst-case scenarios, you may have high functioning anxiety.
If you think that you may have high functioning anxiety, please contact us. Let’s explore how you can continue to be the best possible version of yourself in 2021.
Happy new year everyone!
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