When someone suffers from an anxiety disorder, such as Generalised Anxiety Disorder (GAD), the associated stress can disrupt daily activities and affect the person’s relationships, work productivity and general happiness. Often, if we conjure up the picture of someone with anxiety, we might imagine a sense of nervous energy, poor attention and an inability to concentrate, or even panic.
What is high-functioning anxiety?
The term ‘high-functioning anxiety’ is not classified as a mental health diagnosis on the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). Rather, it’s evolved as a catch phrase referring to people who live with anxiety but identify as functioning reasonably well in different aspects of their life. And for the most part, it’s difficult to conjure up a picture as it is not as detectable. This is because in general those living with it continue their day-to-day life and appear to be fine on the outside. The symptoms are in fact veiled behind the appearance of composure and success.
Internally, however, things are often much more complicated with struggles of unwanted anxiety. The inner suffering may be so overshadowed by their outward performance that the person either doesn’t recognise it or is afraid to let it go. According to the National Institute of Mental Health (NIMH), around 19% of adults in the United States have an anxiety disorder. According to the Anxiety and Depression Association of America, anxiety disorders affect 40 million adults in the United States every year. That’s 18.1% of the population. And, while anxiety disorders are easily treatable, only 36.9% of those affected receive treatment. The remaining 63% comprises people usually dealing with symptoms of high-functioning anxiety.
Well-known public figures such as Barbra Streisand, Donny Osmond, and Ricky Williams, have all been forthcoming about their experiences with high functioning anxiety.
What are the symptoms of high-functioning anxiety?
Someone with high functioning anxiety is quite often the picture of success – a typical Type A personality who is proactive, detail-orientated and excels at work and life. They are often termed overachievers. However, beneath this calm, successful exterior of “togetherness”, the person may be driven by nervous energy, fear of failure, and being afraid of disappointing others. There is in fact a constant churning of anxiety. If this sounds familiar, consider if the following characteristics of high-functioning anxiety are true for you:
- You are punctual, usually early to work, organised and exceed beyond expectation.
- You are always impeccably dressed and groomed.
- You usually not only want to meet targets but go beyond them, and will do so at any cost.
- You feel bad saying no to someone.
- You have racing thoughts.
- Falling or staying asleep often proves difficult.
- You have bad habits like nail biting, frequently twirling your hair or cracking knuckles.
- You frequently feel exhausted.
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The sad dilemma is that someone with high-functioning anxiety usually becomes extremely adept at presenting a false persona to the world and never showing their true feelings or worries and concerns. Instead, these are bottled up and compartmentalised. In people struggling with anxiety, the drive toward performance and achievement will trump acknowledging the inner struggles. And usually, the person will not seek help. The double whammy is that no one will suspect there is anything wrong because the person portrays themselves as being fine.
Consequences of high-functioning anxiety on the mind and body
So, when feelings are bottled up, particularly feelings of anxiety, nervous energy and so forth, they get stored in the body. These can begin to manifest as physical problems, including panic attacks, body aches, stomach ulcers and more serious conditions of ill health. They can also take route in the form of poor mental habits which can result in depression. These include rumination and a tendency to dwell on the negative such as past mistakes, an inability to relax and enjoy the moment. There is usually mental and/or physical fatigue.
When these issues and the symptoms of anxiety are not addressed, there is also the potential for alcohol or substance abuse as unhealthy coping methods. This may ultimately result in damaged relationships and reduced overall quality of life.
How to deal with high-functioning anxiety
Part of holding the “perfect” façade may lead to attempting to cope on your own and holding things together. And because of this, sufferers may be in denial or be more reluctant to discuss their concerns. However, living with fear and anxiety is not something that anyone has to accept. It is important to understand that high-functioning anxiety is just as important to manage and treat as any of the anxiety disorders that have been formally diagnosed.
From a medical perspective, a person can seek treatment with a psychiatrist or psychologist and be treated with cognitive-behavioural therapy (CBT) or medications such as selective serotonin reuptake inhibitors (SSRIs). In addition, lifestyle changes such as limiting caffeine, eating a healthy diet, getting regular exercise and ensuring good sleep hygiene may need to be applied.
How to use mindfulness to cope with high-functioning anxiety
Another important modality is that of mindfulness training. Here are some tips to get you started:
- Implement a daily meditation practice.
Explore the many types of meditation and the apps that are available to find what works best for you. Commit to starting with just 5-10 minutes per day.
- Switch off.
Before you go to bed, institute a ritual for “switching off” – from social media and your over-analysing thoughts. This may involve reading an enjoyable book, taking a bath, or spending time focussing on your breathing and relaxing your body.
- Learn deep calming breathing techniques.
Deep breathing is associated with reducing blood pressure, regulating sleep and decreasing anxiety.
- Identify negative thought patterns.
Begin to identify your self-talk in order to identify thought patterns. You may need to use a journal to do so. You will likely find that anxiety involves a lot of negative predictions such as “What if I don’t make this deadline?” or “I know I will do something stupid during this presentation” or “I can never get this right”. Once you have noticed a negative thought, try to treat yourself with the same compassion that you would treat a close friend. Respond with positive, realistic and helpful thoughts, such as, “I always make my deadlines, and even if I miss this one it won’t be the end of the world”; and “I have had good success in the past and it’s important that I know I am always growing”.
- Explore other mindful modalities and see what works for you. There are many options available, such as yoga and tai chi.
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