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Do I have high-functioning anxiety?




Signs of High-Functioning Anxiety

Organised, outgoing, ‘on it’. These aren’t the characteristic we think of when we think of anxiety but (as the saying goes) you can’t judge a book by its cover. Jenna’s* story is a common one. Outwardly she was the friend/colleague/mum at the school gates who had it all together. She always looked the part, organised, outgoing, dependable. A high achiever with a killer attention to detail. She seemed to be nailing it. People often describe these characteristics as a ‘type A’ personality or put it down to being confident. We might look up to her and wonder ‘how does she do it?’ What others didn’t see and would never have guessed is that Jenna was the typical swan. She looked controlled on the surface but underneath she legs where frantically spinning trying to stay afloat.


The ‘dependability’ was really an inability to say no to people through fear of letting people down. The high achievement was constant striving to prove herself worthy (although she never got to feel that way). The organisation and attention to detail was over-planning and perfectionism that came from a fear of getting things wrong and being judged or criticised. These behaviours that seemed desirable and admired were fuelled by fear and anxiety.


Jenna struggled with what is now termed as high-functioning anxiety (HFA). HFA isn’t a separate diagnosable condition, rather it describes the way someone reacts to their anxiety. It is a different way of trying to manage the feelings of fear and often goes unnoticed by others.

Common behaviours for people who experience high-functioning anxiety are:

· People-pleasing tendencies (difficulty saying no) and taking on too much/fear of letting people down

· Over-preparing

· Overthinking

· Bottling-up feelings/coping alone

· Raking over conversations to check you didn’t say/do anything wrong

· Perfectionism and high or rigid personal standards

· Procrastination and then bursts of intense work to catch up

· Comparing yourself to others


Why is High-Functioning Anxiety different?

Most people have heard of the fight or flight response when dealing with anxiety. The image people often have of anxiety are people who use ‘flight’ as their primary response. They might avoid feared situations to avoid the intense feelings that they create and as a result life can shrink. They may appear visibly anxious, lacking in confidence or ‘shy’. In contrast, people with high-functioning anxiety tend to engage in more of a ‘fight’ response. The nervous energy created by their anxiety pushes them forward. They try to beat the anxiety by proving themselves and working hard. “If I achieve/be perfect/always have it together THEN I will be ok”. All the effort goes into controlling their ‘output’ how they look, what they achieve, how they perform. However, even though high-functioning anxiety might look different from general anxiety on the outside the internal experience (thoughts, feelings, sensations) are very similar.


Symptoms of High-Functioning Anxiety

Of course, not everyone who is detail-orientated, organised and a high-achiever is experiencing HFA. However, people with high-functioning anxiety will often report experiencing some or all of the following:

· Difficulty sleeping

· Self-criticism/hard on yourself

· Self-doubt (and/or imposter syndrome)

· Excessive worry

· Over-active or whirring mind

· Difficulty with decision making – wanting to get the ‘best’ choice

· Struggling to recognise your achievements

· Difficulty relaxing or switching off

· Stomach complaints/digestive issues

· Fatigue, exhaustion and burnout


If these seem like familiar issues to you, you might be experiencing High Functioning Anxiety. Even though others don’t see it, you probably know that it is holding you back and limiting your ability to live your life in the way you would like to. You aren’t alone.


How to manage High Functioning Anxiety

It can be frightening to let your guard down and might be unthinkable to consider easing up on some of the things you do (even though you know they aren’t helpful). Go easy on yourself, you have probably been doing this for a long time and it takes time, patience, and support to learn to do things differently.

There are many ways of managing anxiety from evidence-based therapies such as Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT) or Compassion Focused Therapy (CFT). There are also many mind and body interventions to regulate and balance the nervous system including mindfulness, relaxation, meditation, breathwork, exercise, diet and lifestyle factors etc. People often find a combination of different approaches and techniques works for them.

As with anything the first step is noticing what is going on.

· Make a note of any of the behaviours you recognise from the first list above.

· Over a few weeks try to notice when you are doing any of them. Silently note that your anxiety is at play and briefly question what the fear is underneath.

This will give you lots of information to begin to change things.


*Jenna is not a real person but a composite story of many people's experiences

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