As a clinician I don’t love anything that’s coined “high functioning” if I’m being honest. For me that reads that you have adapted to your circumstances really well and you can mask your symptoms and suffering a little too well.
High functioning anxiety (HFA) is a catch-all term used to describe those who experience anxiety but continue to function quite well in their daily lives. Unlike some other forms of anxiety that are more obvious, high functioning anxiety can be less noticeable to others, as those affected often excel in their responsibilities and appear outwardly successful.
Key Characteristics of High Functioning Anxiety:
Overthinking: You tend to overanalyze situations, events, and your own actions. This constant overthinking can lead to feelings of self-doubt and a fear of making mistakes.
Perfectionism: There is a strong desire to achieve perfection in various aspects of life. This drive for perfection is a source of stress and there is an intense pressure to meet your exceptionally high standards.
Fear of Failure: There is a persistent fear of failure, and you may go to great lengths to avoid making mistakes or falling short of expectations. This fear can be a powerful motivator but can also contribute to heightened stress levels.
Difficulty Relaxing: Even during moments of leisure, you may find it challenging to fully relax. Your mind races with thoughts and concerns, preventing you from fully enjoying downtime.
Physical Symptoms: While not always as pronounced as in other anxiety disorders, HFA can still manifest physical symptoms such as tension, GI issues, restlessness, fatigue, and difficulty sleeping.
Masking: You’re likely very good at concealing your inner struggles from others. You may present a composed and put-together exterior, making it challenging for others to recognize the internal turmoil they may be experiencing. A hallmark sign is that your internal experience does not match at all what you present on the outside (see below).
It's important to recognize that mental health and fitness exists on a spectrum, and individuals with HFA still benefit from support and understanding even though it isn’t an official diagnosis. Using more accurate and comprehensive language to describe the challenges individuals with anxiety face can help them to feel less alone and articulate their needs better. Last year I wrote about how to support a woman with high functioning anxiety, which you can read here.
Steps to Improve Your Symptoms:
Improving high functioning anxiety involves several strategies. When a client comes to me and their umbrella complaints are “stress” “anxiety” and “overwhelm” those are typically cover problems. Or if you think of an iceburg, those are just the top of it, or the part we can see. In order to improve those things, we need to figure out what’s going on under the water.
If I’m generalizing, what I uncover is usually a massive lack of boundaries in this person’s life, both personally and professionally. They can’t (or won’t) say “no”, struggle with self awareness despite thinking they’re very self aware, struggle with emotional regulation, have no tools to help them relax or recharge, feel responsible for everything, cannot manage their time well, struggle to take care of their physical self, and have unreasonable expectations of themselves.
If you read that and thought “yeah that sounds like me!” then you’re on to something. Breaking it down, here are some bit sized steps I would consider to improve your experience of HFA.
Self-Awareness:
Acknowledge and accept that run anxious: You can’t manage it effectively if you don’t accept it.
Identify triggers: Recognize situations, thoughts, people and activities that tend to exacerbate your anxiety.
Relaxation & Downtime Habits:
Practice some kind of habit or hobby that allows you to decompress and disengage. This doesn’t have to be meditation but it can be. It can be anything that brings you joy and allows you to get a break from your regular life roles and duties. Prioritize self-care: Dedicate time for activities that bring you joy and relaxation.
Deep breathing exercises: Incorporate deep breathing exercises to help calm the nervous system and reduce physical tension. Mediation, exercise, walking, etc are all good options.
Establish Healthy Boundaries:
Learn to say no without guilt: Set realistic limits on your commitments to avoid overwhelming yourself.
Internal boundaries with yourself and external boundaries with others are the key to reducing your anxiety. Limits that are communicated and enforced by you cut down on overwhelm and stress.
You cannot improve HFA until you start identifying your needs and creating boundaries around protecting those needs. Typically when your boundary practice gets healthier, your HFA starts to decline.
Effective Time Management:
Break tasks into smaller steps: Divide larger tasks into more manageable components to prevent feeling overwhelmed.
Prioritize & triage tasks: Focus on the most important tasks first and avoid spreading yourself too thin. Always assume something will take longer than you think.
Stop Isolating:
Talk to someone: You aren’t an island-share your feelings with friends, family, or a therapist. Connection is key because it gets you out of your own head. with others can provide valuable support.
Ask someone for help and delegate. People want to help you.
Take Care of Your Physical Well-Being:
Regular exercise: Engaging in any kind of physical activity that you enjoy releases built-up tension and negative feelings from your body and nervous system. This helps you to feel BETTER.
Healthier lifestyle: Consider that your overall lifestyle impacts your anxiety and eating a more balanced diet of things you like, getting enough rest for your body, and drinking water will all help to improve your anxiety.
Mindful Information Consumption:
Limit exposure to stressors: Be aware of the information and stimuli you consume and allow yourself to be exposed to. Boundaries around the news and social media will reduce your anxiety almost immediately.
Don’t underestimate that consuming your friends’ and families’ social media posts can absolutely impact your anxiety.
Take breaks from screens: Unplugging periodically is good for your brain (i.e. dopamine levels) and setting limits around your screen consumption close to bedtime will also impact your anxiety positively.
A parting note-
Most self help books and resources (just like this post) place the burden on the individual to regulate their own nervous system rather than acknowledge that high functioning anxiety is in part due to people crushing under the weight of broken systems and structures that only value what we produce without complaining. Telling you how to fix your symptoms is just one more thing to do and you already have a lot going on. I’m just one person and I can’t fix all of the screwed up societal structures and messaging that have conditioned us to be this way, but it feels wrong to at least not acknowledge it.