Hey! My name is Diana Garcia, and I’m a Licensed Mental Health Counselor in Florida owner of a Private Practice called Nurturing Minds Counseling. 

You’ve most likely heard the term ‘High Functioning Anxiety’? Are you curious if you may have high functioning anxiety? Or maybe you already know that you do but are feeling like a slave to your anxiety. Read this blog to break down what exactly high functioning anxiety is and more importantly how to treat high-functioning anxiety. If you want to increase your chances of reducing the impact of high-functioning anxiety, get the High Functioning Anxiety Companion Workbook.

Table of Contents

Read Blog : “Treatment for High Functioning Anxiety”

What is High Functioning Anxiety?

I feel like the term High Functioning Anxiety has been thrown around a lot lately. There is a book called the DSM, or Diagnostic and Statistical Manual of Mental Disorders, which is a reference manual to determine a mental illness based on the symptoms. To be determined to have a particular mental illness, one must have X number of symptoms for a specified period.

One big criterion for all mental health disorders is that it’s causing some type of functional impairment. It’s impacting your ability to function in one or many areas of your life. This can be different for every person. Maybe it impacts your ability to engage in relationships, or you struggle with handling work, or school tasks. You’re the one that would know how it’s impacting your functioning, but there must be some type of impact for us to say you do meet the criteria for a specific mental health disorder.

The label High Functioning Anxiety is not an official disorder. It’s not in the DSM, and I honestly don’t even know where that term came from. I think it was popularized by ‘Pop Psychology.’ This high functioning part means that you may have some symptoms that are consistent with other anxiety disorders, but you’re high functioning meaning you’re still doing well at hitting all the areas in your life that you want to hit. You’re still achieving, accomplishing, meeting your goals, and doing well in other areas that are important to you.

To learn more, you can watch this video below on “What is High Functioning Anxiety” or scroll down to read more.

Watch Video: “What is High Functioning Anxiety?

Common Signs of High Functioning Anxiety

When it comes to High Functioning Anxiety, a lot of people tend to associate it with being high functioning in general. Maybe you’re someone that seems to be more of a high achiever type or an organized type, and you are on top of your things at work or school. You’re someone that people can depend on in general, so that piece of High Functioning Anxiety can be happening internally. You could be having some symptoms of anxiety, and you possibly tend to overthink, over-analyze, catastrophize, or think of worst-case scenarios. But you do a really good job of not showing your anxiety, but internally you’re struggling.

Another sign is feeling tired, exhausted, or burnt out. One of the reasons could be that you continue functioning and not listening to your needs. You could be so accustomed to the go-go-go lifestyle, and you can keep that high pace of that high functioning lifestyle, that you could be very good at ignoring your needs or recognizing that you must build in time for self-care. The High Functioning part isn’t always the best. It comes at a cost to your well-being, which could be associated with your High Functioning Anxiety.

Additionally, growing up you could have internalized the need to achieve and produce. You were possibly the one in the family who did well and didn’t cause issues. So, you continue to function highly because it’s just part of your identity. There’s possibly a story or narrative that, since you can achieve and accomplish, you’re good at putting on a brave face. You continue to do that even if you sometimes need to set boundaries and limits, or it would behoove you to put your needs first. This is just one example, and it can be entirely different for you.

I want to be clear that High Functioning Anxiety doesn’t necessarily have to look the same for you. High Functioning Anxiety is when you experience specific anxiety symptoms, but you’re still good at functioning. Sometimes that works well for you when you can continue doing what you want to do, and you don’t necessarily get into crisis mode or anything like that.

Another component of high functioning anxiety may be that you’re good at masking or swallowing your emotions. Because you’re so accustomed to functioning, producing, and working, you can pull out all the stops. Meaning that maybe you’re good at hiding your needs, not asking for help, or letting people know what’s internally going on for you. Which can further add to the feeling of overwhelm, because you believe it’s all on you to figure how to cope with everything.

How to Treat High Functioning Anxiety

If you relate to any of the signs of high functioning anxiety, then it best to start considering how to treat high functioning anxiety. You can watch the video below or scroll down to keep reading.

Watch Video: “How to Treat High Functioning Anxiety?”

Identify Your Signs of High Functioning Anxiety

The first step is identifying the signs and symptoms of your High Functioning Anxiety. Whether that’s any of the signs I listed above or any other specific sign that you can relate back to your high functioning anxiety. Do you have a worst case scenario type of thinking kind where you catastrophize? Do you struggle to ask for help even though you’re really feeling overwhelmed? Do you continue to put other people’s needs before your own? Do you tend to have more of a type A personality or focus heavily on achievements versus really enjoying the process?

To learn how to treat High Functioning Anxiety, you have to have a clear sense of how it’s showing up in your day-to-day life. Once you’ve identified what the signs of your High Functioning Anxiety are, I would like you to get out of sheet of paper, Word doc, or Google doc and start to list all the signs and symptoms of your High Functioning Anxiety. Take your time with this step.

Explore Payoffs/Costs of High Functioning Anxiety

What’s the payoff of engaging in these behaviors? If you are someone that tends to really focus on achieving, some payoffs maybe that you’ve been able to really move up in your career or maybe that your boss really relies on you. Make a right column next to each sign and symptom. I want you to list whatever those payoffs are for you for each kind of symptom behavior that you listed in the previous section.

Next, I want you to do a third column. I want you to write down what the cost of each behavior is, which might be hard. You may be someone that tends to focus on achieving and you tend to really push yourself, so the payoff is that you’ve been able to advance in your career, but the cost may be that you’ve had to sacrifice your well-being and time with friends and family. I want you to be very clear on what the behaviors of your High Functioning Anxiety are, and then list off what the current payoffs and costs are.

Analyze the Costs of High Functioning Anxiety

Now that you’ve seen the payoff and the cost, I want you to analyze if some of these costs are way too high. There are instances where you’re no longer willing to pay the cost and acknowledging that if you are going to start to shift these behaviors that some of the payoffs might go away.

However, that means that the trade-off is going to be that some of the costs are going to go away. That’s the piece that’s important with any of these behaviors. I’m not telling you to completely get rid of them, but I want you to be clear when it’s working for you as in when it’s really paying off in a way that the cost isn’t too high. Even if you can possibly function at a higher pace, you have to recognize that sometimes there is a cost for you to do that. The one way to start to shift that is to be clear what those costs are.

Now that you’ve identified the behaviors that you want to change due to high cost, we’re going to take it a step further and become clear on what’s maintaining these behaviors.

What’s Maintaining these Behaviors?

This step is all about understanding what are your barriers to treating high functioning anxiety? Maybe you’ve never analyzed the costs, maybe it’s the first time you’re recognizing that there’s a cost to these behaviors, or maybe this is the first time you’re exploring this. However, if you’ve had some understanding that there has been a cost throughout the last couple of months or years, but you’ve been really stuck, the next piece is to identify what it is that’s getting in the way from you making changes.

Are there certain thoughts that are getting in the way? Are there certain feelings, or avoidance of certain feelings, that are getting in the way? Are there certain memories, childhood experiences, or messages that are getting in the way? When you think about making a change, do you begin to feel anxiety including experiencing some physical symptoms of anxiety? Do those internal experiences stop you from taking effective action?

There could also be external factors of anxiety that are getting in the way as well. For example, maybe there is a person in your life that really benefits from your High Functioning Anxiety, and maybe they don’t really want you to change. So when you’ve tried to make a change, this individual gives you some push back. That’s an external barrier but it then might also turn into an internal barrier because then you start to feel guilty and that prevents you from sticking with your desired goal.

Identifying any internal barriers and external barriers is key because once you understand what’s stopping you from changing you can start to do the work to change. You can even further break these down into categories such as :

  • Internal Barriers:
    • Thoughts
    • Emotions
    • Physical Sensations
    • Memories
    • Urges
  • External Barriers:
    • Other Individuals
    • Lack of Resources

Slowly Make a Plan of Action

Now that you’ve identified the barriers for each behavior, you’re going to slowly start tackling what change looks. I’m going to use one example to guide you: Maybe your high functioning Anxiety is that you don’t really show your emotions and you don’t really ask for help. The payoff is that other people really depend on you, people look forward to talking to you, or they can unload on you. The cost is that you don’t turn to people, and you feel overwhelmed, lonely, or even resentful. Now you have identified what the barriers are.

Maybe some internal barriers are the thought that you are the dependable or stronger one, and you can handle more, or other people can’t meet your needs. You also may not know how to be vulnerable or express your needs, and there could be this thought that you don’t know how to ask for help. Or externally there may be another person in your life you feel wouldn’t really be open for you changing this behavior. Once you’ve identified all these barriers, you have a better chance of problem solving for each and figuring out what change looks like.

The key here is to start small. So, if you have difficulties letting people in letting them know when you’re feeling overwhelmed, the solution could be starting really small. The next time your partner asks you to do something, but you’re really overwhelmed, you could communicate “I really want to help, but I’m feeling so overwhelmed lately. Can we sit down and talk about what I’m feeling?” This might be difficult for you if you’re not accustomed to engaging in these behaviors.

Ideally, if you express this to your partner, your partner can understand, acknowledge, and validate you. Maybe they’re even grateful that you’re finally opening up and sharing! You two can sit and discuss how it feels for you and problem solve with ways to help you feel less overwhelmed. If your partner doesn’t feel that way and you start to feel angry, resentful, or think that you shouldn’t have opened up, you need to be able to remind yourself that this is the work it takes to change and why you’re doing it.

I encourage you to take it very slowly, and start to identify what change looks. When I say change, I want to be clear on what a behavior change would look. Meaning what is something I could actually see you doing differently with your hands, feet or words. Don’t just identify what you won’t do, turn that into an actual behavior.

  • For instance, if you’re trying to set limits with how much you can take on. Next time, your kids teacher asks for volunteers and your automatic instinct is to want to volunteer.
  • Instead of saying, I will not volunteer.
  • I’d even encourage you to consider, what will you do instead?
  • I will intentionally take a deep breath, pause, and give myself 2 days whether I can truly take this on.

It’s helpful is to translate not just what you will not do but what behavior you will do instead. Once you’ve identified the different behaviors based on the different signs, start to slowly tackle them. Do a hierarchy and think about the easiest behavior to start to change. By doing this, you can build some of that internal confidence and resources that you can do this!

Reminders

As you’re going through this process, I want you to focus on one behavior at a time. Don’t look at this entire list and say “Oh! I’m going to change all five behaviors at the same time!” If you do this, you’re going to set yourself up for failure, become overwhelmed, and it’s going to be too much. I’d encourage you to focus on one behavior and, once you feel you’ve gotten a little bit better at that one, then you can focus on the next one.

The other reminder is working on these doesn’t mean that you’ll never engage in these behaviors again. Honestly, I don’t necessarily want you to never engage in some of these behaviors because sometimes they really work for you. Sometimes they’re really work because the payoff is high, and the cost is low. Or, if the cost is a little bit higher, it’s still worth it to you because you acknowledge that cost but in this moment the payoff is more important and is more aligned with your values.You’re not completely getting rid of these behaviors; you’re only getting rid of them when they’re not working or serving you.

Once you identify why you’re making these changes, and acknowledge that you’re going to hit some roadblocks, remind yourself of why these changes are important to you. Linking them back to some of your own personal core values, and these could be values in terms of your relationship with yourself. Maybe you value taking care of yourself and self-care, and you want to model that for your kids. There must be some type of internal reason that you’re saying these changes are important, consider:

  • How is your life going to shift once you start to make these changes?
  • How is that going to make you feel different or better?

Expect roadblocks and don’t let them steer you towards “giving up”: Also remember that as you’re making these changes, you’re going to hit roadblocks whether those are internal or external roadblocks. That doesn’t mean that the changes aren’t working or that you failed. Anytime we’re doing something new or different, it’s normal to expect there’s going to be some bumps on the road. The more you can problem solve and predict some of these potential barriers, the more you’re going to be in a better situation when you’re confronted with them. When you do hit those barriers, be mindful of staying away from this ‘all or nothing’ mentality. “That it’s! I’m done. I’m never going to do this!” Steer clear from these kinds of rigid perspectives when you’re making these changes.

Another reminder is that just because you can function at a high pace, doesn’t mean you have to, or you should. Sometimes it’s important for you to do that but, doing that all the time isn’t really working for you anymore. Your needs matter! Its important to have that top of mind when you’re doing the hard work to change.

Seek out support/accountability. It’s also helpful to get some type of support, accountability or help through this process. That could be from a close friend, a trusted family member, or someone you trust in a group (book club, gym, volunteer organization) your part of.

If you don’t necessarily have that, then this might be a good indication that you need to increase your support system. Brainstorm ways that you can increase this, i.e. join some type of group, reconnect with old friends, or even seek online groups for support. You get to figure out what type of support works for you. Also consider how you can support yourself through this process.

If you notice you’re getting stuck that doesn’t mean anything! This can be a good clue that seeking treatment for high functioning anxiety from a professional could be beneficially for you. Some of these patterns and behaviors are a bit more ingrained, and you may just need an outside perspective to help you look at where you’re getting stuck.

Check out these other resources to continue working on treating high functioning anxiety: 

I hope this blog was helpful for you as you start exploring your relationship with anxiety and how to treat high functioning anxiety. As always, I encourage you to continue nurturing your mind, body, and soul whatever that looks like for you guys!