High functioning anxiety – a condition where sufferers appear organised, in control and thriving, always perfectly presented, on time and upbeat on the outside while simultaneously struggling on the inside, plagued with anxious thoughts and spiralling worries and feeling utterly unable to cope – can be tricky to spot, for obvious reasons.
Scientifically speaking, high functioning anxiety is not officially recognised as being its own mental health condition, but rather a sub type of anxiety. So what exactly is it and how can you spot the signs? Essentially, it’s anxiety but totally not obvious. The sufferer is able to maintain the illusion that they are functioning well and mentally healthy, which might look like excelling at work, being an attentive friend or keeping a Pinterest-perfect household. Indeed, they can hide their anxiety symptoms so well that they appear to be unaffected.
On the outside, they may appear organised and detail-oriented, on the inside they may have trouble saying no, overthinking, and setting unrealistic expectations for themselves. Often high-functioning anxiety is paired with burnout.
“When a person presents as capable, functioning and even excelling (such as in work, social, family or educational settings), but are actually hiding and internalising the fact they are experiencing all the chronic and debilitating symptoms of anxiety disorders, including fear, impending doom feeling, over worrying, hyper-vigilance and importantly the physical responses such as high heart rate and blood pressure, insomnia, gastro-intestinal issues (including diarrhoea, nausea and changes in appetite),” Dee Johnson, an accredited Priory psychotherapist tells GLAMOUR.
According to mental health charity Mind, in any given week in the UK, 6 in 100 people are diagnosed with generalised anxiety disorder, the most common form of anxiety. So where does high functioning anxiety fit in to that and how can you deduce whether you have it? We break it down…
What does high functioning anxiety look like?
Due to high functioning anxiety being characterised by a degree of pretence and keeping up appearances, signs can look to be unrelated to anxiety on a first glance. A common one, Dee says, is presenting as a “perfectionist” and someone that is “always fearful of not being good enough or getting things wrong”. Those suffering can also be workaholics.
At the more troubling end of the spectrum, she warns: “This can manifest as controlling behaviour when actually its fear driven rather than ego based, but when you are at the receiving end of such behaviour, it’s really difficult to see anything other than control and power. People will try to avoid allowing themselves to feel their emotions and find ways to block them out (in case their emotions will inhibit them).”
Other signs can include but are not limited to: restlessness, being irritable, an inability to put assert boundaries, always being busy and full-on, insisting they are happy in difficult times.
“These people may have a history of depression, trauma in their past, low confidence and feelings of unworthiness, fear of rejection, substance use disorders (addiction) or an eating disorder – these are all examples of things that can drive high-functioning anxiety,” Dee adds.
What can cause high functioning anxiety?
As with any form of anxiety, there are all sorts of factors that can cause the onset of high functioning anxiety, though experts generally believe that genetic and environmental factors are responsible. Some of the causes may include: