It’s not hard to find mental health information online, and one topic that many people like to cover is what’s known as “high functioning anxiety.”
Let’s talk about it.
These days, most of us are familiar with the general idea of anxiety. But it’s also a bit of an enigma. *Everyone* feels nervous sometimes. *Everyone* experiences stress now and then. We can all find ourselves in situations where we’re nervous or anxious for an extended period of time.
Some people are so anxious, however, that they are disabled by it. It affects and touches every part of their life in an overwhelming way, making it challenging to engage in any tasks.
Still, for many, anxiety is not like that.
Many people can “function” very well with anxiety. They can handle most of the tasks they have to do throughout the day, such as work, parenting, even potentially spending time with friends or family (depending on social anxiety). But they still have anxiety, and it still touches every part of their life.
Some refer to these individuals as having “high functioning anxiety.”
High functioning anxiety is not a formal diagnosis, but it is a commonly used term to describe someone who appears successful, organized, and calm on the outside, while experiencing intense internal anxiety. It is especially common in individuals who are achievement-oriented, responsible, or perfectionistic – those who are often seen as dependable, yet rarely express personal distress.
In many cases, those with high functioning anxiety are able to complete tasks, maintain routines, and meet expectations. They may even exceed them, though personal success is not necessary to be called “high functioning.” High functioning simply refers to the ability to handle most tasks in life, while still struggling with anxiety on the inside.
Those with high functioning anxiety *are* functioning. But it can all come at a cost.
How It Looks from the Outside vs. How It Feels on the Inside
Because of how well it can be masked, high functioning anxiety is frequently missed or ignored. Individuals with this type of anxiety often appear to be handling their lives. But their anxiety may be driving them in unsustainable ways.
Those with high functioning anxiety may experience:
- Excessive worry that feels difficult or impossible to turn off
- Perfectionism, even in areas where it is not required or expected
- Difficulty relaxing or resting, even after a productive day
- A constant sense of internal pressure to perform or please others
- Overthinking past conversations or future plans
- Sleep issues, such as trouble falling asleep or waking up with a racing mind
- Physical symptoms like muscle tension, fatigue, or gastrointestinal discomfort
Unlike more visibly disruptive forms of anxiety, these symptoms are often dismissed not only by others, but by the individual themselves. After all “I need to see a therapist for my anxiety” can be difficult for someone to feel like they can justify because they look at their life and they see someone that is getting through it – someone that is handling external responsibilities. But they are still struggling with anxiety all the same.
Why High Functioning Anxiety Often Goes Untreated
People with high functioning anxiety frequently do not seek treatment, in part because they may not recognize that their experience is related to anxiety at all. They may see their worries as a normal part of being productive or successful. It is also common for people in this group to fear that addressing their anxiety will make them less effective at work or in their personal life, or they feel like it’s a stigma that is not meant for them – that they don’t want to feel labeled by anxiety because they don’t feel like they deserve it or should.
There can also be a belief that “things aren’t bad enough” to warrant therapy or support, especially if daily functioning has not declined in a visible way.
But over time, untreated anxiety can worsen, contributing to burnout, physical health problems, and difficulty in relationships. High-functioning anxiety may not stay manageable forever and, in many cases, early intervention can reduce the long-term mental and physical toll.
Even if this type of anxiety *didn’t* get worse, it is still anxiety. You only live one life, and that life should not be affected by or controlled by untreated anxiety, especially when it responds so well to psychotherapy.
Addressing High Functioning Anxiety
Therapy for anxiety is effective. It can help someone develop healthier ways to manage stress and perfectionism, improve self-awareness, and create internal space for calm rather than constant forward motion.
Support may involve:
- Cognitive behavioral therapy (CBT) to identify and reframe anxious thought patterns
- Learning how to tolerate rest and stillness without guilt
- Boundary-setting strategies for relationships and workload
- Identifying internal narratives that are reinforcing pressure or fear
- Exploring the roots of achievement-based self-worth
Those with high functioning anxiety are often deeply introspective and capable of change—but only if given a space where anxiety isn’t minimized, and productivity isn’t mistaken for peace. It’s important to recognize that, no matter where you are now, life could potentially be better if you have ways to control it.
When Anxiety Is Hidden
High functioning anxiety often exists in plain sight, yet rarely gets acknowledged. For many, it’s not until stress becomes unbearable – or until the body begins to show signs of strain – that they begin to see their anxiety for what it is.
But anxiety does not have to be debilitating to deserve attention. It is okay to get support even if everything looks fine. Therapy can help you function in a way that is not only outwardly successful, but internally sustainable.
If you need a therapist for anxiety, reach out to Audrey Jung, today.