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6 Top Symptoms of High-Functioning Anxiety in 2024

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All of us know people who, on the surface, appear to have it all figured out. They are always on time, personable, organized and seem to have mastered the work-life balance.

While it appears they are always put together from the outside, they might tell you a different story. What might not be so obvious is that beneath a seemingly ideal exterior, that person we view as a model of excellence may be struggling with anxiety masked as overachieving, what experts refer to as high-functioning anxiety.

Mental health experts do not recognize high-functioning anxiety as a distinct condition. Rather, the term is used to describe people who live with well-concealed anxiety and self-consciousness while managing daily life astoundingly well.

Stealthy uneasiness

People with anxiety are typically nervous, restless, shy and prone to worry. The National Institute of Mental Health says about 19% of adults in the United States have an anxiety disorder. Often, it can be fairly easy to spot them.

That’s not exactly the case with high-functioning anxiety. People who struggle with it tend to not only be fully functional, but often highly successful. The do their jobs well, balance their responsibilities, maintain good relationships and appear to be happy and well-adjusted, but all while they’re struggling with anxious feelings and thoughts that they somehow manage to keep under wraps.

Research on high-functioning anxiety and how it affects people is limited, but experts believe its symptoms mimic those of generalized anxiety disorder. According to the National Institute of Mental Health, they include:

  1. Feeling restless, wound-up, or on-edge
  2. Being easily fatigued
  3. Having difficulty concentrating
  4. Having headaches, muscle aches, stomachaches or unexplained pain
  5. Difficulty controlling feelings of worry
  6. Having sleep problems

Some experts believe people with high-functioning anxiety often endure their symptoms in silence, thinking their symptoms are not significant to warrant help, or fearing that they may appear out of control of their lives if the condition becomes known to others. Tendencies among those with this type of anxiety also include overthinking, striving for perfectionism, and the need for reassurance from others.

While more research is needed on the issue, there may be a potential link between high-functioning anxiety and depression. According to the National Alliance for Mental Illness, 60% of people with anxiety will also have symptoms of depression.

Experts say some people tend not to seek treatment for high-functioning anxiety until it morphs into depression.

Causes and treatment

Experts believe the causes of anxiety, including high-functioning anxiety, are related to some degree to genetic and environmental factors such as:

  1. Family history of anxiety disorders
  2. Exposure to negative or stressful life events
  3. Certain physical health conditions like thyroid issues
  4. Substance or alcohol abuse
  5. Shyness or nervousness traits from childhood

Doctors typically don’t diagnose high-functioning anxiety since it’s not a recognized disorder. But as with other forms of anxiety, treatments are available. They typically include therapy, prescription medications or a combination of the two. Cognitive-behavioral therapy is considered a gold-standard treatment for anxiety conditions and assists in developing healthier thinking patterns along with counteracting avoidance behaviors that can contribute to worsening anxiety over time.

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