By Dr. Jamie Long

An example of high functioning anxiety in action: Pilates class was just getting started and a group of us were settling onto our individual reformers. For those of you that don’t speak Pilates, the reformer is a piece of exercise equipment that resembles a sort of Frankenstein operating table with a sliding carriage, springs, ropes, and pulleys.

To allow exercisers to focus on the workout, phones and gadgets aren’t allowed during class. Yet today, a fellow Pilates goer was convinced that she needed to stay within arms length of her phone. “I could be getting a very important phone call,” she tensely explained. Hesitantly, the instructor let it go.

Sure enough, the phone went off just as we started the warmup and phone lady snatched it up to answer with earnest. She didn’t get up to take the phone call outside as one might think is most appropriate. Instead, she kept one eye on the instructor, keeping up with the exercises, while she gave work instructions to the person on the other end of the phone. It quickly became clear to everyone in the room that this conversation was clearly non-urgent. The administrative matter could have easily been addressed after class or even several hours later.

To phone lady, her issue at work could not wait. To her, the issue was urgent and needed to be dealt with the instant it arose. So, when a work issue came up while she was taking care of herself, she decided to multitask.

What motivated this person to bring her phone to Pilates class? Maybe she’s just rude and socially unaware. Or, to be fair, sometimes emergencies do happen. Another explanation is that maybe she couldn’t contain her worry. Perhaps she was concerned that if she wasn’t available to put out whatever that “fire” was, something bad would happen. That would be terrible!

What happens if every single thing becomes urgent and important? So urgent that you cannot meaningfully engage in self-care or in your life for that matter? When our minds tell us that something awful, something urgent, something so life-shatteringly-important needs to be controlled right now, we might be dealing with high-functioning anxiety.

What is high functioning anxiety?

High functioning anxiety is a mental health issue in which a person experiences high levels of stress, tension, worry, and a need for control over perceived threats (heightened threat sensitivity). A person with high functioning anxiety may personally experience some symptoms commonly associated with an anxiety disorder, however, the symptoms don’t cross the threshold to be considered a diagnosable condition. In high functioning anxiety, unlike an anxiety disorder, a person is largely able to function in their daily tasks without significant impairment.

The emotional turmoil of high functioning anxiety may largely go unnoticed by peers. This is because individuals with high functioning anxiety do not typically display vulnerable emotions. Rather, they often appear confident and calm. On the surface, this person seems to have it all together. Often, they’re lauded for their success and organizational skills. However, just beneath the surface, the high functioning anxiety individual is truly hurting emotionally.

One in five people are diagnosed with an anxiety disorder so it stands to reason that high functioning anxiety impacts an even larger number of people. Even though a person with high functioning anxiety may not meet full criteria for a psychiatric diagnosis, it’s still a serious mental health issue.

15 signs of high functioning anxiety

An intolerance of uncertainty and a need to control
Feeling that everything is urgent
Multitasking at inappropriate times
Social withdrawal or isolation
Overanalyzing, overthinking
Difficulty allowing self to be vulnerable; perceived as hard to read or “intimidating”
Hardly asks for help
Overextends self in an effort to avoid disappointing others (does too much)
Seeking reassurance by asking for validation or obsessively researching
Difficulty staying in the moment
Probability overestimation: overestimating the probability of stressful or bad things happening
Jumping to conclusions without sufficient evidence
Nervous habits (hair twirling, nail biting, skin picking)
Difficulty falling or staying asleep or voluntary sleep depravation to get things done/have a break
Perfectionism, fear of failure

What does high functioning anxiety feel like?

Urge to micromanage others; a need to know what’s going on with everything
Difficulty letting go, delegating or trusting others to carry out tasks
Feeling like you need to be the one to complete tasks
Muscular tension, headaches, GI upset, or other physical pain
Frequent nervousness, worry or feelings of dread and doom
Feeling overwhelmed or burned out
Irritability or anger
Tearfulness or crying spells
Exhaustion, fatigue, and never feeling rested
Boredom and loneliness from all work and no play
Feeling like you are never good enough

The function of anxiety

All emotions have an important function and serve a valuable role in our lives. I’ll give three examples. One, sadness signifies the loss of something important. In other words, if we didn’t experience sadness after losing something we loved, then it would mean it wasn’t very important. Two, the emotion of anger signals that an important boundary has been crossed. Without anger, there is no justice or self-defense. Three, anxiety is an emotion that we need to help us prepare for important things in the future.

In its most adaptive form, the experience of anxiety signals our need to be pay attention and anticipate a potential challenge, threat or catastrophe. Anxiety is a future-oriented emotion and it organizes our physiological responses to the perceived unpredictability of, or lack of control over, impending, potentially negative or challenging situations. Without a healthy amount of anxiety, we might be unprepared or caught off guard when something goes wrong. When the emotion fits the facts of a situation, meaning the emotion is justified, the emotion serves a very important function. Emotions have a very important role in optimal psychological functioning.

Unhealthy anxiety or an anxiety disorder is detrimental to our optimal functioning. Ineffective anxiety isn’t justified by the facts, or the context, of a situation. Further, the intensity of anxiety is disproportionate to the prompting event. This type of anxiety isn’t helping you prepare for the future, rather it is impairing your ability to face the future and destroying the ability to be in the moment. Read more here about anxiety disorder signs and symptoms.

Treatment

Talking to a licensed professional can be very beneficial for those experiencing high functioning anxiety. Contrary to popular belief, psychotherapy (another word for therapy) isn’t just for those with debilitating mental health concerns, rather, therapy is a very healthy habit. Therapy is often utilized to gain clarity, support, and self-discovery. A therapist can show you effective coping skills to manage the high functioning anxiety.

A few tips:

Repeat after me: “No is a full sentence.” Whenever we say yes to someone or take on a new commitment, we are saying no to something else, and it’s usually self-care. Say this instead, “I’d love to help, but I can’t commit to that at this time.”
Delegate, delegate, delegate. Challenge yourself to generously look past the small mistakes and imperfections of jobs done by others. Remember, a job completed imperfectly is still better than the exhaustion caused from doing everything yourself.
Let your guard down and accept help. Although you may be the first person to recommend that someone take care of themselves, take a vacation, or talk to a therapist; you may hardly ever take your own advice. The sooner you can let go of the “I’ve got it all together” persona and embrace your own humanity, the sooner you can get the care and support you really need.
See the value of being flexibility and going with the flow. Some things can be left undone with little negative consequence. This is especially true if you’re letting a task go in order to enjoy something pleasurable.
Stay in the moment. One can practice this with mindfulness, meditation, and creative hobbies. Practice being still and engaging the five senses. For example, adult coloring books are a fantastic way to get out of your head and into the moment.
Practice challenging overly negative or judgmental self-talk. Learn how here. When our interpretations of a situation don’t fit the facts, we are causing unnecessary pain for ourselves. Here is information about coping with repetitive anxious thoughts (rumination).
Practice Boundary Budgeting. Be clear on what you can psychologically afford based on the time and mental resources you have available. Chores, responsibilities, and work are debits from our emotional bank account. Self-care, exercise, sleep, good food, and play are deposits into our emotional bank account. Consequently, if there are more withdraws than deposits, then you are in psychological debt!

For more information about receiving therapy for high functioning anxiety, general anxiety therapy or another issue that is limiting your life, contact Dr. Jamie Long at 954-787-6800 or send a message below for a complimentary phone consultation.

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What is High Functioning Anxiety?