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High Functioning Anxiety: Understanding, Identifying, and De-Stressing


High Functioning Anxiety

You may find yourself juggling your work and personal life flawlessly, and yet a deep-seated sense of anxiety persists. You are seemingly successful in the eyes of others, but constantly nervous, worried, or on edge. This could be a case of High Functioning Anxiety (HFA) - a not yet officially recognized mental health condition that needs to be addressed due to its potential long-term impact.


High Functioning Anxiety often goes unnoticed because people with this condition are typically successful and seem to have everything under control. However, the constant internal struggle and fear of failure can lead to severe mental and physical health issues down the line.



What is High Functioning Anxiety?

High Functioning Anxiety is not a diagnosable condition in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), but it is a term often used to describe people who live with anxiety but can still perform their day-to-day responsibilities. The characteristic feature of HFA is the disconnect between an individual's outer achievements and inner turmoil.


People with HFA often portray a picture of competence and have high achievement levels. On the inside, however, they may constantly worry, fear failure, or obsess over perfection. It's their anxiety, in fact, that can often drive their success. You are calm and collected on the outside, while inside, panic and stress have taken over! Anxiety does not discriminate, it can happen to a stay-at-home parent, any level of employment, relationships, and so forth.



What Does High Functioning Anxiety Look Like?

People with high-functioning anxiety might not exhibit overt or observable symptoms, which can make it challenging to identify. That being said, here are some common signs associated with high-functioning anxiety:


  • Perfectionism: Individuals might set excessively high standards for themselves and be overly critical of their own performance.

  • Constant Worrying: They might constantly ruminate and worry, often about future events or past mistakes, even when things are going well.

  • Difficulty Saying No: They may have a hard time declining requests or obligations due to fear of disappointment or judgment from others.

  • Restlessness or Feeling On-Edge: There can be a constant feeling of being "on the go," or a persistent sense of unease.

  • Physical Symptoms: These can include muscle tension, headaches, stomachaches, and fatigue. High levels of stress might also lead to sleeping problems.

  • Overthinking and Overanalyzing Situations: They might continually replay scenarios in their minds, often imagining the worst-case outcomes.

  • Procrastination or Overworking: Some might procrastinate due to fear of failure or inability to start a task unless it can be done perfectly, while others might work excessively to distract from their anxiety.

  • Avoidance of Uncertain Situations: They might avoid situations that provoke uncertainty or are outside of their control.

  • Highly Self-Critical: You expect yourself to achieve high expectations but may struggle to recognize success when it happens and instead you criticise the smallest of things.


It's important to remember that these signs aren't a definitive diagnosis of an anxiety disorder. Only a qualified healthcare provider can make a diagnosis and suggest treatment options.



The Potential Impact of High Functioning Anxiety

If left unaddressed, High Functioning Anxiety can take a toll on an individual's mental health over time. The persistent worry and fear of failure can lead to burnout, mental exhaustion, and even physical health issues such as chronic pain, sleep problems, and immune system suppression.


Moreover, long-term untreated HFA can also increase the risk of developing other mental health conditions like depression, substance abuse, or severe anxiety disorders. Hence, it's crucial to recognize and address HFA early on, to prevent potential long-term consequences.


What do I mean by going untreated? I mean not addressing the stress and anxiety that goes along with HFA. See what things you can do next…



Strategies for Coping with High Functioning Anxiety

While it can be challenging to manage HFA, there are several strategies to help cope with this form of anxiety:


1. Mindfulness and Meditation: Practicing mindfulness helps bring attention to the present moment, and can alleviate feelings of anxiety. Meditation also promotes relaxation and reduces stress, which can lessen the impact of HFA. This has a physiological impact as well from a decrease of stress hormones and improved nervous system regulation.


2. Regular Exercise: Physical activity can significantly reduce anxiety levels by boosting your mood and acting as a natural stress reliever, signaling your brain to release the “feel good” hormones. Try to incorporate some form of exercise into your daily routine, even if it's just a short walk.


3. Balanced Diet: Certain foods may have the ability to exacerbate anxiety, at the very least, does not help. Limit your intake of processed food, caffeine, and alcohol, all of which can trigger anxiety symptoms. Instead, focus on a balanced diet rich in fruits, vegetables, lean proteins, and whole grains.


4. Seek Professional Help: A mental health professional can provide you with the tools and strategies to manage HFA effectively. Cognitive Behavioral Therapy (CBT), for example, is a type of talk therapy that can help you understand and change thought patterns leading to harmful behaviors or distressing feelings.

This is where I am able to step in and help. As a licensed therapist and having clinical training in stress and anxiety, we will work together to identify strategies to use and overall decrease your stress.


5. Social Support: Reach out to loved ones for support. Sharing your experiences with others can help alleviate feelings of anxiety and provide a sense of belonging and understanding. Feeling connected can also help in sharing your experiences.



You are intelligent, hardworking, and driven. Let’s also channel that with your mental health!



Blog Disclaimer - These posts are not meant to treat, diagnose, or serve as a replacement for therapy. If you or someone you know is experiencing a mental health emergency, please contact your local crisis center or dial 911. Here are more immediate resources as well.


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