What is High Functioning Anxiety? Causes, Symptoms and Treatment

high functioning depression

Anxiety disorders are one of the most prevalent mental illnesses in the U.S. According to the stats released by the Anxiety and Depression Association of America, around 18.1% of the country’s total population suffers anxiety every year (1).

Anxiety is the root cause of many other disorders, including social anxiety disorder, phobias, panic disorders, obsessive-compulsive disorders, and many others. A person with anxiety typically struggles with concentration, keeping calm at work, rational thinking, decision-making, etc.

Most people suffering from anxiety disorders are often left under-treated due to the unrecognizable characteristics of anxiety.

According to the Anxiety and Depression Association of America, only 36.9% of sufferers receive anxiety treatment.  Treatment of anxiety is prescribed when great despair and irritability are evident in an individual (2).

The treatment gets harder to administer when the patient masks his anguish and appears to be at his finest while enduring anxiety. This is what happens in High Functioning Anxiety.

What is High Functioning Anxiety?

high functioning depression
Image Courtesy – Rachel Montañez via Forbes

While you might not find the term High Functioning Anxiety (HFA) considered a recognized mental disorder, it breathes below the veil of success.

Unlike other anxiety disorders, where the patients readily exhibit the symptoms of irritability, lack of concentration, and panic attacks, HFA sufferers don’t show any signs of anxiety.

A person with high functioning anxiety is often seen as a paradigm of perfection and success. For the world, you are always succeeding.

  • Meeting deadlines,
  • coming to the workplace earlier than everyone else,
  • perfectly dressed,
  • communicating impeccably,
  • offering a helping hand to everyone,

– are a few of the traits that make the diagnosis of HFA even tricky. People do not believe that a person so good at his career would be suffering in silence. It is the irony of the society we live in, where everyone judges you on what you appear to them.

On the inside, a person with high functioning anxiety is fighting his own mental battles and propelling forward, generally resulting from fear. The fear of failing!

High functioning anxiety ignites the fear of disappointing the people around you. You are focusing more on your tasks because you do not want to be rejected by your community. The constant need to seek validation and acceptance drives a person with high functioning anxiety to succeed.

Based on the dual personality a high functioning individual possesses at work and in-person, high functioning anxiety characteristics are both negative and positive.

Negative High Functioning Anxiety Traits

Below mentioned negative characteristics manifest high functioning anxiety in a person. However, these characteristics are conveniently overlooked and regarded as normal personality traits of a person.

An individual experiencing high functioning anxiety typically –

  • Talks nervously and more than he usually would. They are most popular as a chatterbox.
  • Overthink a lot. They are more commonly found immersed in past events or overestimating their future.
  • Exhibit nervous behavior. You will find the HFA person biting nails, constantly shaking legs, biting their chapped lips, cracking knuckles, etc.)
  • Fears abandonment. They don’t want to displease their friends, family, boss, coworker, or spouse. Commonly known as people-pleasers, HFA individuals fear hurting or disappointing anyone around them.
  • Repeat patterns (leg shaking, nail-biting) unknowingly out of anxiety.
  • Arrives in meetings or events earlier than others. While it can be regarded as a positive trait, it is actually a negative one because HFA people are poor at time calculation.
  • Procrastinates more than ordinary people, which further augments anxiety and panic.
  • Needs validation from loved ones for their satisfaction.
  • Struggles with refusing a task.
  • Has messed up sleep patterns.
  • Needs to be assured now and then.
  • Frequently compares his life with others and underestimates himself for not being good enough.
  • Extraordinary loyal to those who are manipulative and evil intentioned.
  • Doesn’t live in the moment.
  • Keeps a small social circle.


Positive High Functioning Anxiety Traits

Unlike generalized anxiety disorder and other anxiety issues, high functional anxiety has some positive traits too.

This means if you happen to be a person with high functioning anxiety, you might find your career-graph shooting its highest peaks.

On the one hand, you are struggling with a negative self–belief on the inside. On the other hand, your professional career is flourishing.

A few positive traits of high functioning anxiety are jotted down below. A person with high functioning anxiety–

  • Is punctual and tends to arrive everywhere on time.
  • Never misses the deadline.
  • Looks so organized and composed that people might idealize his work ethic.
  • Has a considerably cheerful personality, often found cracking jokes and enjoying people’s company.
  • Is a remarkably high achiever.
  • Plans ahead of time paving the path to success.
  • Possess the eye of an eagle. Impeccably observant and detail-orientated.
  • Is extremely helpful to people.
  • Is loyal in his relationships. (3)

Symptoms of High Functioning Anxiety

The negative and positive traits discussed above clearly explain how high functioning anxiety can affect an individual.

However, symptoms are usually what a person feels from the inside. Some of the symptoms experienced by people with high functioning anxiety are listed below –

  • You are constantly discontented with your efforts, regardless of how hard they may be.
  • You seek perfection, and the slightest flaw turns your obsession on.
  • You can’t do without working or sometimes even overworking.
  • You feel like people in the outside world can’t understand you, so you better cover it up.
  • You quickly get guilty over things that bring disappointment to other people.
  • You held yourself responsible for the happiness of the people around you.
  • It’s difficult for you to express what you truly feel.
  • Worry never stops! You worry about the past and the future but never really live in the present.
  • You’re indecisive! It takes you ages to reach a decision without verifying it from others.
  • Despite being extremely self-critical, you are afraid of social criticism and social rejection.
  • The fear of unwanted future events keeps haunting you.
  • Other symptoms include irritability, disturbed sleep patterns, eating disorders, frustrations, rapid mood swings, and frequent display of nervousness.

It is crucial to realize that people with high functioning anxiety remain in self-doubt and continually criticize themselves for not being sufficient to outshine others. So, they immerse themselves in work and try to compensate for their low self-esteem by achieving one goal after another.

Consequently, they appear as a high achiever in the public eye. Simultaneously, on the inside, every achievement brings about a brief dopamine rush followed by another intense phase of high functioning anxiety. (4)

Life with High Functioning Anxiety

People living with high functioning anxiety would know how terrible and satisfying it is to live with it. Like any other mental illness, it is encouraged to seek professional help to live the life you deserve without stressing yourself out for the people and community. To provide you a deeper insight into how living with high functioning anxiety actually looks like, let’s see what Redditors with High functioning anxiety have to say –

Hard for people to believe

“Being high functioning sucks. People don’t believe you have “real” depression because you can get out of bed. The only reason I am high functioning is because of my anxiety. If I don’t do all of my work, I’ll fail, etc. Just because I am productive, it doesn’t mean I don’t wish I was dead.”

Ignorance of the symptoms –

“That’s the thing about HF anxiety, so many people suffer from it and assume it’s just how life is, and it is just part of their personality, but it’s NOT. Having insomnia, biting your nails, and always stressed isn’t okay. If you don’t burn yourself out, you’ll end up with a plethora of somatic symptoms (skin problems, gastrointestinal issues, etc.).” (5)

Masked anxiety –

“ I’m a person lots of others sometimes refer to as having a “calming presence.” I always laugh when I hear that because I know that I’m a wreck inside, and seek out alone space asap so I can break the facade in peace.”

The “All is well” syndrome –

“High functioning Anxiety is like when your room looks squeaky clean, but you actually hid all your mess under your bed and inside your closet.” (6)

More worried about the community–

“I’ve been on the edge of burning out for a year now and have just kept it together to not make a problem around me and make my coworkers work more.

I go to work and then go home and lay in bed all day. Even how exhausted I am, I can’t sleep…”

Confession of a teenage Redditor –

“I am a people pleaser, afraid of letting go of my friends, overthink a lot of stuff, my mind is always racing, thinking about future way too harshly like my failures in the past. I get even worried about thinking about my retirement days. I get nervous around people, overly conscious of myself, how I walk, sit or talk or how I look with my friends or in front of strangers. And I always hid these insecurities so people won’t leave me. Some did leave when I told them who I am underneath, and they told me I get too clingy. I am just afraid to lose people. I really am a bad decision maker cause I depend on other people’s decisions and copy them, and when they fail, I get really frustrated.” (7)

All the above statements that you just read are from individuals who are suffering from high functioning anxiety. This is how they feel living with this disorder. Although it is sad to hear about their day-to-day struggles, it is possible to live a better life even with high functioning anxiety.

How is High Functioning Anxiety diagnosed?

Since high functioning anxiety is not a clinical diagnosis, there is no standard established to determine the existence of HFA. Diagnosis of high functioning anxiety is probably the most challenging part in seeking its treatment.

However, the way high functioning anxiety is different from other forms of anxiety disorders determines its existence. The significant difference is that high functioning anxious person tends to hide the symptoms behind a façade of success. On the contrary, people suffering from other forms of anxiety are unable to hide the signs.

Despite not being recognized as a clinical disorder, mental health practitioners can easily detect high functioning anxiety just by understanding the patient’s symptoms.

Do I have High Functioning Anxiety?

If you think you’re experiencing similar feelings and have no prior idea if it’s a mental illness, you need to visit your psychiatrist’s office.

It is evident from the lifestyle of HF anxious individuals that they often take it as a way of living and don’t really find it problematic. If you, too, are of the same school of thought and consider that it’s just you who is failing in coping up,

You certainly need to see a psychotherapist!

However, if treatment is delayed or not taken appropriately, high functioning anxiety may evolve into severe physical and mental abnormalities.

How is High Functioning Anxiety Treated?

Once you are diagnosed with high functioning anxiety, the next step is seeking and implementing the appropriate therapy plan.

Like other forms of mental illnesses, one kind of therapy alone barely works. Mental health professionals often advise their patients to combine psychological and pharmacological treatment with possible lifestyle modifications to get optimal therapeutic outcomes.

Lifestyle modifications –

Eat healthy!

high functioning depression

A study conducted on university students in 2019 revealed the relationship between unhealthy eating and increasing anxiety disorders in young adults (8), which shows that eating patterns have a close connection with our mental health.

The healthier you eat, the fewer chances of mental illness will there be. It is recommended to add more fibers and proteins to your diet to alleviate high functioning anxiety symptoms. (9)

Better your sleep

high functioning depression

Research is evident that the relationship between sleep and anxiety is interdependent.

Lack of sleep may precipitate the incidence of anxiety in healthy people. Especially insomnia due to stress causes more intense anxiety disorders, as stated in a study published in 2019. (10)

To improve sleep patterns, maintaining a journal is advised to write down your daily tasks and the time required to finish them. This way, you will be able to perform your tasks in time and sleep early.

You can also add a melatonin supplement to your diet to improve sleep. There is sufficient research on how melatonin can be beneficial in regulating sleep. (11)

Make rules for work

Modify your working schedule and try wrapping up your work in the office timings. Do not bring the work and STRESS home!


Exercise has significant benefits in up-regulating mood and behavior. Studies have shown the positive impact of exercise on anxiety and depression. (12)


Cut down on alcohol as soon as you possibly can! Alcohol alters the neurochemicals, including serotonin, in the brain and plays a part in worsening anxiety-related disorders. (13)

Psychotherapy –              

More effective treatment for high functioning anxiety is psychotherapy. Talk therapy has proven therapeutic outcomes when it comes to mental health.

For high functioning anxiety, psychotherapists prefer Cognitive Behavioral Therapy to be administered.

Cognitive-behavioral therapy mainly focuses on identifying the root cause of high functioning anxiety and ruling out the negative emotions stemming from it.

It helps the patient overcome his fears and express what he exactly feels. A qualified psychotherapist must be booked for a condition as intimidating as high functioning anxiety.

Pharmacotherapy –

Selective serotonin reuptake inhibitors – are the drug of choice prescribed by mental health professionals to combine with psychotherapy and lifestyle modifications.

How to deal with High Functioning Anxiety?

It is pretty challenging for someone living with high functioning anxiety to perform day-to-day tasks without getting affected by the environment.

You might feel helpless at times about your habit of caring too much. It is understandable that someone who has suffered so much in life knows the pain of being mistreated and doesn’t want anyone else around him to feel the same. But at the same time, your mental health should remain intact.

Let’s have a look at a few tips to reduce your high functioning anxiety.

Learn to say NO

Refusing a task that would bring discomfort to you is OKAY! In fact, it is an ideal practice.

What is not okay is the unnecessary forgetfulness of your comfort and going overboard to help people. Saying No doesn’t mean you are disrespecting anyone. It instead shows how respectful you are towards yourself.

You can’t keep everyone happy

Get over your fear of abandonment. There are 7.9 billion people in this world right now [14], and everyone has their own mess to clean.

You don’t need to seek validation from people who are not living your life. Whatever you do, do with the intention of your satisfaction and not to please everyone around you.

Remember, you can’t keep everyone happy you are not a doughnut! 😉

Let go of people, sometimes

Sometimes, it is essential to know your shortcomings to overcome them and evolve into a better human. However, constantly getting affected by people is not healthy.

Try letting go of them at times when you know they are unreasonable. Don’t doubt your potentials every time.

Love! With your eyes wide open

With high functioning anxiety, there are fair chances that you give Too Many Chances! Avoid loving blindly.

Do not hesitate to seek help!

high functioning depression

High functioning anxiety is real, even though it is not clinically recognized as a mental illness.

The symptoms you experience are actual and not a part of your everyday life. You can lead a better life with proper treatment from a well-learned psychotherapist.

Throw the fears away and reach out for help.

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