Table of ContentsView AllTable of ContentsPrevalenceDefinitionCharacteristics and SignsSymptomsCauseStrategiesTreatment
Table of ContentsView All
View All
Table of Contents
Prevalence
Definition
Characteristics and Signs
Symptoms
Cause
Strategies
Treatment
It can be difficult to spot high-functioning anxiety. From the outside, a person with high-functioning anxiety may appear driven, hardworking, and perfection-seeking. But if they are agonizing over decisions or pushing themselves too hard, or they have trouble sleeping because they can’t stop thinking, they might be coping with high-functioning anxiety.
High-functioning anxiety can have a negative impact on work, relationships, and someone’s overall mental health. There are many ways to treat the condition, however, ranging from therapy and exercise to medication.
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Anxiety Statistics in America
General anxiety disorder is the most common of these disorders, affecting about 6.8 million U.S. adults (about 3% of the population).Unfortunately, many people with generalized anxiety aren’t aware they have it, and if they are aware, many of them do not receive treatment for it. Only about 43.2% of people with GAD receive treatment.
Of adults with any anxiety disorder, approximately 43.5% experience mild impairment, 33.7% have moderate impairment, and 22.8% have serious impairment.
Anxiety vs. High-Functioning Anxiety
The main difference between clinical anxiety disorders and high-functioning anxiety is in the ability of people with these disorders to function. This can be difficult to discern since “functional” is subjective.
Difficulty in living with high-functioning anxiety isn’t always obvious, even to the person experiencing it. It likely affects their quality of life, their physical and mental health, and their relationships, but in less obvious ways than are present with clinical anxiety disorders.
Unlike many people withgeneralized anxiety disorder (GAD), people with high-functioning anxiety are able to get things done and seem to handle situations well. Because they often channel their anxiety into productivity, people with high-functioning anxiety may even appear from the outside to be functioning better than the average person.
What’s the Baseline?
In addition to excessive worrying and other symptoms, one of the criteria in the fifth edition of the “Diagnostic and Statistical Manual of Mental Disorders”(DSM-5) to diagnose an anxiety disorder is its disruption or impairment of life activities. In other words, people with anxiety disorders experiencesymptoms that are severeor intrusive enough to make it difficult for them to function.
People with high-functioning anxiety do not officially meet this criterion because they are observed as still being able to function well in areas such as work, school, personal lives, and finances. This doesn’t mean that they are not struggling or that their quality of life is not impacted. It means that they are functioning well enough—at least outwardly—not to meet the criteria of having an anxiety disorder.
Some professionals feel that high-functioning anxiety should be classified as mild anxiety instead.
Unofficial Definitions
Despite its lack of an official diagnosis, high-functioning anxiety is a very real condition.
People with high-functioning anxiety appear to function normally, or even more productively than most, but they also experience the symptoms of an anxiety disorder internally.
High-functioning anxiety is most likened to GAD because of its ambiguous but omnipresent nature. As with people with GAD, people with high-functioning anxiety may experience intense feelings of fear, dread, and impending doom, and other symptoms associated with anxiety disorders.
Unlike GAD and other anxiety disorders, high-functioning anxiety does not cause such intense physical symptoms. Some may be present, such as elevated heart rate, but they usually are not enough to influence behavior, limit activity, or be noticeable to others. People with high-functioning anxiety are also less likely to avoid situations that trigger their anxiety than people with anxiety disorders.
People with high-functioning anxiety tend to “push through” and manage what they need to do, although they feel the discomfort and effects of anxiety while doing so.
Default DiagnosisHigh-functioning anxiety is a “default diagnosis.” This means that if a healthcare or mental health professional notes the symptoms of anxiety, but the person does not meet the criteria for a diagnosis of an anxiety disorder, the label of high-functioning anxiety may be given.
Default Diagnosis
High-functioning anxiety is a “default diagnosis.” This means that if a healthcare or mental health professional notes the symptoms of anxiety, but the person does not meet the criteria for a diagnosis of an anxiety disorder, the label of high-functioning anxiety may be given.
While it may not obviously impair functioning, high-functioning anxiety affects people in a number of ways.
Personality and Personal Effects
People with high-functioning anxiety tend to:
Work Life
At work, people withhigh-functioning anxietymay:
Relationships
High-functioning anxiety can also affect relationships. When interacting with others, people with high-functioning anxiety may:
How do people with high-functioning anxiety act?Those with high-functioning anxiety often overwork, push themselves too hard, and generally overwork. They tend to be people pleasers and may have trouble sleeping or relaxing.
How do people with high-functioning anxiety act?
Those with high-functioning anxiety often overwork, push themselves too hard, and generally overwork. They tend to be people pleasers and may have trouble sleeping or relaxing.
The overachieving nature of people with high-functioning anxiety can make it seem like having high-functioning anxiety is beneficial. While there are positive effects of it, high-functioning anxiety can have a significant negative impact as well.
Effect on Mental Health
People with high-functioning anxiety feel consistent— even constant—discomfort and regularly feel unsettled. This feeling is so omnipresent that people with high-functioning anxiety consider it part of their daily experience.
While this is part of what drives their productivity, it isn’t sustainable and eventually takes its toll on the person’s mental, emotional, and physical health.
People with high-functioning anxiety may:
Chronic anxiety, including high-functioning anxiety, can be associated with other mental health conditions, such as:
Physical Effects of AnxietyAnxiety problems can contribute to a number of physical conditions, including:Heart diseaseGastrointestinal problemsMigraines or headachesThyroid diseaseRespiratory illnesses likeasthmaSleep difficulties
Physical Effects of Anxiety
Anxiety problems can contribute to a number of physical conditions, including:Heart diseaseGastrointestinal problemsMigraines or headachesThyroid diseaseRespiratory illnesses likeasthmaSleep difficulties
Anxiety problems can contribute to a number of physical conditions, including:
The exactcause of anxiety disordersisn’t known but may be related to a combination of:
High-functioning anxiety may also be linked to personality traits and life experiences.
Self-Help Strategies
In addition toseeking helpfrom a mental health professional, there arethings you can doto manage your high-functioning anxiety.
Validating Yourself
Acknowledging how you are feeling is powerful. Saying, “I am feeling overwhelmed,” or “I am overcome with worry,” can help you manage the emotions you are experiencing. This can be said to yourself or to a family member, friend, or therapist.
Doing this helps you take some responsibility and gain some control over your anxiety.
Mind and Body Exercises
Because people with high-functioning anxiety are constantly on the go (sometimes physically, always mentally), taking time to relax the body and mind can be challenging, but it is important.
Some exercises that may help include:
People with high-functioning anxiety oftenstruggle with getting quality sleep, which can impact their mental and physical health. Some ways tofoster healthy sleepinclude the following:
What do you do during an anxiety attack?Ways to helpstop an anxiety attackinclude the following:Remind yourself anxiety attacks usually go away within a short period of time.Do relaxation exercises such as deep breathing techniques.Exercise, such as going for a walk.Visualize a place, real or imagined, that makes you feel calm.Use sensory stimuli, such as touching an ice cube or smelling something strong like peppermint oil.
What do you do during an anxiety attack?
Ways to helpstop an anxiety attackinclude the following:Remind yourself anxiety attacks usually go away within a short period of time.Do relaxation exercises such as deep breathing techniques.Exercise, such as going for a walk.Visualize a place, real or imagined, that makes you feel calm.Use sensory stimuli, such as touching an ice cube or smelling something strong like peppermint oil.
Ways to helpstop an anxiety attackinclude the following:
As do people with anxiety disorders, people with high-functioning anxiety can benefit from treatment from mental health professionals.
Therapy
Psychotherapy (talk therapy) can be highly effective for treating anxiety, particularlycognitive behavioral therapy(CBT) andacceptance and commitment therapy(ACT).
Medication
Medication may be helpful for some people with high-functioning anxiety and may be used in combination with therapy.
The classes of medications most commonly prescribed for anxiety include:
Social Support
While not a substitute for professional or medical advice, joininga support groupfor people with high-functioning anxiety can help you connect with others who understand and can relate to your experiences. It can also be a place to share resources.
Summary
High-functioning anxiety is not a clinical diagnosis, but it is a form of anxiety that has a significant effect on those who experience it. People with high-functioning anxiety appear to function well and are often highly productive, but they struggle with symptoms of anxiety in less obvious ways.
Treatment for high-functioning anxiety is similar to that of other anxiety disorders. Options include talk therapy, medication, and/or social support resources like support groups.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anxiety and Depression Association of America (ADAA).Did you know?National Institute of Mental Health.Any anxiety disorder.Locke AB, Kirst N, Shultz CG.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.AFP. 2015;91(9):617-624.Borza L.Cognitive-behavioral therapy for generalized anxiety.Dialogues in Clinical Neuroscience. 2017;19(2):203-208. doi:10.31887/DCNS.2017.19.2/lborzaSouth African College of Applied Psychology.What is high functioning anxiety and is it real?Hohls JK, König HH, Quirke E, Hajek A.Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies. Int J Environ Res Public Health. 2021 Nov 16;18(22):12022. doi: 10.3390/ijerph182212022. PMID: 34831779; PMCID: PMC8621394.Smith JP, Book SW.Anxiety and Substance Use Disorders: A Review. Psychiatr Times. 2008 Oct;25(10):19-23. PMID: 20640182; PMCID: PMC2904966.Deboer LB, Smits JA.Anxiety and Disordered Eating. Cognit Ther Res. 2013 Oct 1;37(5):887-889. doi: 10.1007/s10608-013-9565-9. PMID: 24443615; PMCID: PMC3891781.Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC.Anxiety disorders and cardiovascular disease.Curr Psychiatry Rep. 2016;18(11):101. doi:10.1007/s11920-016-0739-5Sareen J, Jacobi F, Cox BJ, Belik SL, Clara I, Stein MB.Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions.Arch Intern Med. 2006;166(19):2109. doi:10.1001/archinte.166.19.2109National Institute of Mental Health.Generalized anxiety disorder: When worry gets out of control.Anxiety and Depression Association of America.Integrative behavioral health.Anxiety and Depression Association of America.Types of therapy.Anxiety and Depression Association of America.Medication options.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Anxiety and Depression Association of America (ADAA).Did you know?National Institute of Mental Health.Any anxiety disorder.Locke AB, Kirst N, Shultz CG.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.AFP. 2015;91(9):617-624.Borza L.Cognitive-behavioral therapy for generalized anxiety.Dialogues in Clinical Neuroscience. 2017;19(2):203-208. doi:10.31887/DCNS.2017.19.2/lborzaSouth African College of Applied Psychology.What is high functioning anxiety and is it real?Hohls JK, König HH, Quirke E, Hajek A.Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies. Int J Environ Res Public Health. 2021 Nov 16;18(22):12022. doi: 10.3390/ijerph182212022. PMID: 34831779; PMCID: PMC8621394.Smith JP, Book SW.Anxiety and Substance Use Disorders: A Review. Psychiatr Times. 2008 Oct;25(10):19-23. PMID: 20640182; PMCID: PMC2904966.Deboer LB, Smits JA.Anxiety and Disordered Eating. Cognit Ther Res. 2013 Oct 1;37(5):887-889. doi: 10.1007/s10608-013-9565-9. PMID: 24443615; PMCID: PMC3891781.Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC.Anxiety disorders and cardiovascular disease.Curr Psychiatry Rep. 2016;18(11):101. doi:10.1007/s11920-016-0739-5Sareen J, Jacobi F, Cox BJ, Belik SL, Clara I, Stein MB.Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions.Arch Intern Med. 2006;166(19):2109. doi:10.1001/archinte.166.19.2109National Institute of Mental Health.Generalized anxiety disorder: When worry gets out of control.Anxiety and Depression Association of America.Integrative behavioral health.Anxiety and Depression Association of America.Types of therapy.Anxiety and Depression Association of America.Medication options.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Anxiety and Depression Association of America (ADAA).Did you know?National Institute of Mental Health.Any anxiety disorder.Locke AB, Kirst N, Shultz CG.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.AFP. 2015;91(9):617-624.Borza L.Cognitive-behavioral therapy for generalized anxiety.Dialogues in Clinical Neuroscience. 2017;19(2):203-208. doi:10.31887/DCNS.2017.19.2/lborzaSouth African College of Applied Psychology.What is high functioning anxiety and is it real?Hohls JK, König HH, Quirke E, Hajek A.Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies. Int J Environ Res Public Health. 2021 Nov 16;18(22):12022. doi: 10.3390/ijerph182212022. PMID: 34831779; PMCID: PMC8621394.Smith JP, Book SW.Anxiety and Substance Use Disorders: A Review. Psychiatr Times. 2008 Oct;25(10):19-23. PMID: 20640182; PMCID: PMC2904966.Deboer LB, Smits JA.Anxiety and Disordered Eating. Cognit Ther Res. 2013 Oct 1;37(5):887-889. doi: 10.1007/s10608-013-9565-9. PMID: 24443615; PMCID: PMC3891781.Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC.Anxiety disorders and cardiovascular disease.Curr Psychiatry Rep. 2016;18(11):101. doi:10.1007/s11920-016-0739-5Sareen J, Jacobi F, Cox BJ, Belik SL, Clara I, Stein MB.Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions.Arch Intern Med. 2006;166(19):2109. doi:10.1001/archinte.166.19.2109National Institute of Mental Health.Generalized anxiety disorder: When worry gets out of control.Anxiety and Depression Association of America.Integrative behavioral health.Anxiety and Depression Association of America.Types of therapy.Anxiety and Depression Association of America.Medication options.
Anxiety and Depression Association of America (ADAA).Did you know?
National Institute of Mental Health.Any anxiety disorder.
Locke AB, Kirst N, Shultz CG.Diagnosis and management of generalized anxiety disorder and panic disorder in adults.AFP. 2015;91(9):617-624.
Borza L.Cognitive-behavioral therapy for generalized anxiety.Dialogues in Clinical Neuroscience. 2017;19(2):203-208. doi:10.31887/DCNS.2017.19.2/lborza
South African College of Applied Psychology.What is high functioning anxiety and is it real?
Hohls JK, König HH, Quirke E, Hajek A.Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies. Int J Environ Res Public Health. 2021 Nov 16;18(22):12022. doi: 10.3390/ijerph182212022. PMID: 34831779; PMCID: PMC8621394.
Smith JP, Book SW.Anxiety and Substance Use Disorders: A Review. Psychiatr Times. 2008 Oct;25(10):19-23. PMID: 20640182; PMCID: PMC2904966.
Deboer LB, Smits JA.Anxiety and Disordered Eating. Cognit Ther Res. 2013 Oct 1;37(5):887-889. doi: 10.1007/s10608-013-9565-9. PMID: 24443615; PMCID: PMC3891781.
Celano CM, Daunis DJ, Lokko HN, Campbell KA, Huffman JC.Anxiety disorders and cardiovascular disease.Curr Psychiatry Rep. 2016;18(11):101. doi:10.1007/s11920-016-0739-5
Sareen J, Jacobi F, Cox BJ, Belik SL, Clara I, Stein MB.Disability and poor quality of life associated with comorbid anxiety disorders and physical conditions.Arch Intern Med. 2006;166(19):2109. doi:10.1001/archinte.166.19.2109
National Institute of Mental Health.Generalized anxiety disorder: When worry gets out of control.
Anxiety and Depression Association of America.Integrative behavioral health.
Anxiety and Depression Association of America.Types of therapy.
Anxiety and Depression Association of America.Medication options.
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