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Life With High-Functioning Anxiety: Can You Relate?

Life With High-Functioning Anxiety: Can You Relate? | Annie Wright, LMFT | www.anniewright.com

Constantly busy. Perfectionistic. Juggling a hundred different projects and responsibilities. Constantly scanning the future and laying the plans and groundwork for what you want or don’t want to happen. Feeling motivated and pulled forward by the hot energy coursing inside of you. Being described as super Type A. Having a mind that races and obsesses over your to-do list if you accidentally wake up at 4 in the morning. Covering up your daily anxiety with overthinking, overdoing, overperforming, over-preparing, over-everything…

These are just some of the ways someone might describe life with “high-functioning anxiety.”

Life With High-Functioning Anxiety: Can You Relate? | Annie Wright, LMFT | www.anniewright.com

Life With High-Functioning Anxiety: Can You Relate?

While “high-functioning anxiety” isn’t an actual clinical diagnosis, it’s a phrase that’s become increasingly popular in the past few years and includes a cluster of symptoms that, in my opinion as a therapist, most closely aligns with Generalized Anxiety Disorder (GAD), a diagnosis that is found within the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Affecting roughly 40 million adults, anxiety disorders are the most common mental health issue in the United States. And “high-functioning anxiety” may be particularly common for ambitious, young, professional Millennials and Gen-X’ers living here in the Bay or in other major urban areas.

The tricky things is, those of us living with “high-functioning anxiety” may not recognize that it’s a problem that needs support because it doesn’t look like more “textbook” anxiety disorders where daily life is a lot more noticeably impaired.

After all, you’re still getting a ton accomplished and holding it all together, right? So it’s easy to assume that the kind of anxiety you personally experience may not be a legitimate concern that requires support. But it is.

Indeed, while GAD affects 6.8 million adults – with women twice as likely to experience it as men – only 43.2% of folks are receiving treatment to support it. And this is an issue.

Because the reality is that “high-functioning anxiety,” like any other anxiety disorder, has considerable potential side effects and impacts on your physical and emotional well-being if left untreated. And, like other anxiety disorders, it’s also highly treatable.

So my goal in today’s post is to introduce you to the idea of “high-functioning anxiety” and its accompanying cluster of symptoms described in a way you may be experiencing them and to walk you through ideas of supports to help alleviate these symptoms if you think it may be time to get some help.

Common Symptoms of “High-Functioning Anxiety”:

1) Excessive anxiety and worry most of the time.

Call it apprehensive expectation, anticipatory anxiety, worry, rumination, etc., it’s mental state that you experience more days than not for 6 months or more.

This worry can and likely includes everything from worries about your career to your love life, the size of your thighs to the viability of your eggs, to not having saved enough for retirement to wondering how you’re going to cope with the family at Thanksgiving this year, etc. etc..

And, often, the amount and intensity of the worry you have is likely disproportionate to the event itself. In other words, everything feels like a really big deal when it, perhaps, isn’t. And even when you tackle and try to solve the thing that worries you, it never feels good enough.

2) You find it really HARD to control your worry.

You know all the tricks — three deep breaths, making lists of your worries, releasing it all on the yoga mat, meditating, etc. — and still, it falls short.

You live with worry daily and a lot of the time it seems to get the best of you because you have a hard time controlling it despite your self-care practices.

3) Your flavor of worry and anxiety comes with a side order of:

  • Restlessness, feeling on edge, keyed up, tensed up.
  • Feeling constantly tired, like no matter how much sleep you get you still feel an underlying level of exhaustion.
  • Trouble concentrating whether it’s at work, on what your honey was saying, or finding that you had to re-read that page of your book three times because your mind wandered. You may find yourself in the future worrying about this or that or just going a bit blank. Bottom line: you may sometimes have trouble concentrating on what’s happening now right in front of you.
  • Irritability. You’re living with a low capacity for stressors so the small stuff — the things you’re not “supposed” to sweat — really does make you sweat. Your patience is thin and your grumpiness is high.
  • Tightness, constricting, and general tension in your muscles, in your body. If you’re emotionally and mentally wound up in knots, your body is likely holding onto the tension leading to a general feeling of tightness, etc..
  • Problems with sleep. Whether that’s falling asleep, staying asleep, having restless or unfulfilling sleep, etc.. You may rely on a glass or two of wine or a Tylenol PM to mask it temporarily, but basically, you have sleep issues.
  • You may also feel a heightened “startle response.” In other words, when you live with anxiety, your nervous system is on overdrive so when ambulance sirens flare up or someone accidentally slams a door at work, you jump or startle easily.

4) This anxiety is interfering with your daily life.

Not in the “can’t get out of bed about to lose your job because of it” way, but you definitely notice that your anxiety is making it harder for you to feel secure and competent at work or in your romantic relationship, your friendships, etc.. Others around you may not be able to see it, but inwardly, you’re living out a high-drama movie each day and it’s starting to wear on your quality of life.

So Why Is “High-Functioning Anxiety” A Problem?

Often, I find that those who live their lives with anxiety, particularly “high-functioning anxiety,” are like fish being asked, “How’s the water?” If water is the only thing a fish has ever known, how could she possibly know any different or what a contrast experience may be?

So it may go for those of us who have grown accustomed and acclimated to living life with “high-functioning anxiety.” It’s possibly become so normalized and so much a part of you that it’s hard to imagine how it might feel different or what else might be possible.

But something else is possible.

And, as a therapist, I think it’s important that those who identify with “high-functioning anxiety” recognize that it is an issue because, if left untreated, the accompanying cluster of side effects and symptoms can take a toll on your overall well-being both physically and emotionally.

Let’s face it: All of the symptoms of “high-functioning anxiety” can be uncomfortable. Really uncomfortable.

Not only that, but attempts to self-cope with those uncomfortable symptoms can lead to maladaptive behaviors like regular use of substances or addictive actions — such as multiple glasses of wine on the weeknights, nightly smoking, regular Netflix and Youtube binging, endless social scrolling, etc. — all in an attempt to self-soothe and tolerate the intolerable feeling states that may be brewing inside you.

But the compulsive use of those coping mechanisms isn’t healthy and can often lead to greater feelings of anxiety and contribute to the development of comorbid conditions such as depression, sleep disorders, eating disorders, substance use disorders, etc..

So How Can We Treat “High-Functioning Anxiety”?

The good news is that “high-functioning anxiety,” like with many anxiety disorders, is highly treatable.

The news that may not feel quite so good? Treating it often requires an investment of time, energy, and effort through a variety of means and modalities.

“High-functioning anxiety” likely developed over time through a confluence of genetic, lifestyle, biological or social factors in your life. So it will take some time, effort, and support to help you find different ways of living with and treating your anxiety.

Below are some of the top modalities you may want to consider in treating “high-functioning anxiety”:

1) Psychotherapy:

I may be biased, but psychotherapy – or talk therapy – is still roundly considered a primary support for helping to treat anxiety disorders, including “high-functioning anxiety.”

Talk therapy helps address the roots of the issues that led to the anxiety disorder in the first place such as unresolved trauma, unprocessed grief, low self-esteem, etc..

Therapy will certainly help you develop some immediate coping mechanisms to deal with your anxiety, but most therapists will also place an emphasis on helping you to understand and help heal the roots of your anxiety, leading to more integral and sustainable long-term change. If you’re curious about starting therapy, check out this free guide I wrote about “10 Important Things To Know When Considering Therapy.”

2) Medication:

As a therapist, I have a moderate approach to medication. I completely understand that the choice to pursue medication to treat anxiety may not right for everyone, but sometimes it can be a terrific support to help bring your nervous system back into a “window of tolerance” and allow you to do the work you need to do inside and outside the therapy room to truly transform your anxiety. So talk to your doctor or psychiatrist about medication to alleviate your “high-functioning anxiety” if this feels right for you.

3) Diet changes:

I’m not a nutritionist and it’s outside the scope of my clinical license to give dietary advice, but, anecdotally, I’ll say that there’s a growing body of research connecting the gut and our brain that highlights how directly our diet and gastrointestinal health can correlate to our mental health. So, when appropriate, I often give my clients referrals to nutritionists I trust here in the Bay to help with this aspect of their overall anxiety treatment plan.

4) Behavioral changes:

As part of an overall anxiety treatment plan, I help my clients identify and focus on reducing, eliminating, or getting creative with the behaviors that contribute to their anxiety, whether this is reducing emotionally painful visits to family members, changing dysfunctional work environments, reducing time on social media, finding different ways to commute to work, cultivating different living arrangements that will feel more supportive, etc.. Anxiety treatment can be greatly supported by creative implementation of real-life actions that are designed to support your overall well-being.

5) Developing a new relationship with your anxiety:

Finally, another way you can support your anxiety treatment is to develop a different kind of relationship with your anxiety.

For instance, perhaps shifting from seeing your anxiety as a sign that “you’re broken” to a viewpoint that sees your anxiety as something inside of you that needs your attention and attunement. A sign you need to listen to yourself and get the supports you need. There’s no such thing as a “bad” feeling, all feelings contain clues for us, and so when I invite you to develop a new relationship with your anxiety, I’m inviting you to shift your attitude compassionately towards it and look at it as something to get to know and live with versus a problem within you to be “solved.”

It may be that you’ll never love your anxiety, but can you at least accept it and find creative ways to live with it?


These are just some of the top ways I recommend beginning to work with to treat your “high-functioning anxiety.”

And if you’re interested in more ideas about how to treat your anxiety, please feel free to reach out to me at annie@anniewright.com or book a session directly online.

Now I’d love to hear from you in the comments below: Did you see yourself in this article? What’s one tip or insight that’s helped you in living with “high-functioning anxiety”? Leave a message in the comments below so our community of blog readers can benefit from your wisdom.

If you would like additional support with this and you live in California or Florida, please feel free to reach out to me directly to explore therapy together. You can also book a complimentary consult call to explore therapy with one of my fantastic clinicians at my trauma-informed therapy center, Evergreen Counseling.

Or if you live outside of these states, please consider enrolling in the waitlist for the Relational Trauma Recovery School – or my signature online course, Hard Families, Good Boundaries, designed to support you in healing your adverse early beginnings and create a beautiful adulthood for yourself, no matter where you started out in life.

And until next time, please take very good care of yourself. You’re so worth it.

Warmly, Annie

Medical Disclaimer

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  1. Jill says

    It’s so relieving and comforting when you come across an article or a blog post such as this one that really just “gets you”. This is me in a nutshell right now and I hadn’t been able to put my finger on really what was going on. I’m a 33 year old woman who’s constantly “on”. I work in advertising so the industry in itself promotes this type of go-go-go lifestyle. But, I know I need to break a part from this when I can to find my balance where and how I can. Just yesterday I removed my Facebook, Instagram and Snapchat apps on my phone and already do I feel like I’m breathing easier and finding more productive things to do. Social media addiction IS a problem! I found myself reviewing pictures and profiles of celebs and friends of friends that depicted this ‘most perfect, wonderful’ lifestyle, which I know is certainly not, but I found myself getting soaked into that too much and I was comparing what my life and what my appearance was like to thers. Thank you, Annie, for writing such an awesome post this morning. It was just what I needed upon waking up today! Sending gratitude and a warm thanks from Minnesota. (I’ve recently just came across your blog and page on FB and I’m already looking forward to your next post each day!)

    • Annie says

      Hi Jill,

      Gosh, I so appreciate your message! First of all, I’m really glad you found my blog and the article resonated with you.

      And I think soooo many of us could relate to what you’re describing about social media use and the thought spiral that can happen! Good for you for removing it from your phone – that’s so smart! The most important thing we can remember is that social media is a highlight reel; it doesn’t capture the pain and struggle most of us wake and walk with on a daily basis.

      Again, thank you for taking the time to write and share your experience with me. Let me know how the social media detox goes!

      Warmly, Annie

  2. Christy says

    After three years of therapy my anxiety has escalated and it is very much affecting the quality of my life. Although I am very bonded to my therapist I recently stopped seeing her because I don’t seem to be able to communicate to her and suffer for days after our sessions. Although I know this is a good decision, the pain of detachment is adding to my anxiety. I’m weary of therapy yet do need help managing anxiety. Your 5 modalities to help anxiety helped… especially looking at it with compassion. Thank you.

    • Annie says

      Hi Christy,

      Thank you for sharing your thoughts on what my article brought up for you.

      It sounds like you’re trusting yourself in your decision to end therapy and I can absolutely understand how detaching from your therapist would add to your anxiety levels right now.

      If you do decide to seek out therapy again, I think you need to seek out a therapist who you genuinely like and can feel comfortable sitting in a room with. Credentials and specializations don’t always make for good therapy; liking and trusting your therapist will.

      So definitely check out Yelp, Psychology Today, or ask for local referrals and make appointments with a handful to meet them and experience how they work. And talk to them about medication if you feel like that’s something that may make sense. They can either provide you with a referral to a psychiatrist or encourage you to speak to your general doctor.

      I hope this helps, Christy, and I’m wishing you all the very best. Warmly, Annie

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