High Functioning Anxiety: How Do You Know When It’s Time to Get Help?

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It goes without saying that periods of sadness and anxiety are an inevitable part of life. Bad mental states can weigh on us for weeks or even months, and the stress of the modern world is something that is hard to avoid. But for those with high-functioning anxiety, these normal feelings have slipped into something more difficult and profound, and knowing when it’s time to get help for high functioning anxiety is vital to long-term wellbeing.

It isn’t always easy distinguishing exactly when our feelings, worries and experience of life indicate a mental health issue. When does grief slip over into depression? Can we say for sure when extreme tidiness is a sign of OCD? At what point does a “worrier” personality type become a person living with an anxiety disorder? Doctors may have diagnostic criteria, but it’s an undeniably complex issue – especially for the individual in the midst of it all.

What is High-Functioning Anxiety?

While high-functioning anxiety isn’t an official mental health condition, it an increasingly recognised phenomenon and something that many people identify with. Outwardly, those with high-functioning anxiety appear to cope well with life and are even very successful. On the inside, however, they experience a near-constant state of anxiety, feeling beset by catastrophic thinking and nagging worry. The clinical psychologist Inna Khazan, PhD, explains:

“People with high-functioning anxiety push themselves to get things done, with anxiety constantly holding a ‘stick’ over their heads,” adds Khazan. “Fear of what might happen if they don’t move forward keeps them moving forward. And because these people are often high achieving, no one thinks that there is anything ‘wrong’ with them.”

We tend to expect people with anxiety to be visibly paralysed with fear and to withdraw from the world. This is true of some people, but others respond to anxiety by becoming as busy as possible, working hard to maintain their public face. The likely result is that the problem becomes compounded – if a person seems fine, they are unlikely to be advised by friends or family to look after themselves, or seek help.

When Does It Become a Problem?

The topic of high-functioning anxiety is something that can prompt questions about how we define mental illness, and how much we put down to personality, circumstances or low mood. As we don’t have a window into other people’s minds, we can struggle to know what is “normal” everyday stress and worry, and what we should go to our doctors about. As philosophers, religious leaders and creatives have mused for centuries, life inevitably encompasses a certain amount of suffering – but at which point is that suffering indicative of illness?

By operating well in life – turning up to work, picking their kids up from school, navigating social events with apparent ease – the characteristics of anxiety disorder that high-functioning people experience are generally considered to be at “subclinical” levels. However, the fact they can maintain their professional and personal life with relative success doesn’t mean that their anxiety doesn’t have a great personal cost.

Constantly managing worries, having difficulty sleeping, pushing down fear, suffering with headaches and digestive problems – those with high-functioning anxiety may come to believe that feeling pretty awful for much of the time is simply the reality of life, forgetting what it’s like to live without that knot in their stomach. 

This can be pretty isolating, and extremely exhausting. It can even exacerbate other health issues, and people struggle through without outside support or proper self-care – because, of course, they’re “fine”, why should they need it?

Help for High Functioning Anxiety

So how do you know, if you’re a person with high-functioning anxiety, when it’s time to get help; and what kind of help might be best for you? Here are some ideas which could be the first steps towards a less anxious and stressful experience of life.

Trust your feelings 

Just because you don’t necessarily have a diagnosable mental health issue, (although only a doctor and/or psychiatrist could tell you for sure) and your life appears to be a successful and functional one on the surface, doesn’t mean that you should discount the feelings of fear, stress and worry you experience. If anxiety is something you experience a lot of the time over a period of months or years, it isn’t something you need to accept – and going to a health professional for a chat should be your first port of call.

Take steps to understand your emotions

If anxiety is your default state, it may well have affected your perception and experience of life. You might have developed several coping mechanisms that you barely notice, or repeat patterns of behaviour because you are always in a vaguely panicked state of mind. Keeping a diary – even if it’s just a dry run-through of your day and how you were feeling at the time – can be a great way to gain more insight into your life and see patterns which otherwise may go unnoticed.

Give yourself permission to practice self-care

Even for those with a generally sunny outlook and who naturally don’t worry too much, life can be very difficult at times. If you are at the opposite end of the spectrum and tend to find yourself worrying about everything, it can be even more so. We all need to practice self-care, and it is especially important for those who tend to push down their feelings and work at 100% effort to keep everything in life running smoothly.

You may think that, compared to others, you are actually OK and should just get on with things. But you can vastly improve your experience of life simply by allocating a little more time away from professional concerns and looking after others to looking after yourself.

Whether it’s meditation, making more time to pursue your hobbies, doing less overtime at work – doing what you can to soothe and help yourself can transform your experience of high-functioning anxiety to something more manageable.






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