7 Silent Signs of High-Functioning Anxiety

Updated: Oct. 20, 2020

Your anxiety may be affecting your life—and your general health—more than you realize. Here are the warning signs.

What is high-functioning anxiety?

When we talk about people with high-functioning anxiety, we are talking about people who, at least on the surface, seem successful at school, work, or home, explains Boston clinical psychologist Inna Khazan, PhD. On the inside, however, they are experiencing a near-constant state of anxiety. “People with high-functioning anxiety push themselves to get things done, with anxiety constantly holding a ‘stick’ over their heads,” she says. “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.”

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You worry excessively

It’s normal to ruminate over things and have brief periods of worry. But if this is the mental state you experience 15-plus days a month for six months or more, you have an anxiety disorder, says Annie Wright, a licensed psychotherapist with a private practice in Berkeley, California. Specifically, this could signal generalized anxiety disorder.  Wright explains that such worries can run the gamut from your love life to your retirement savings. “And, often, the amount and intensity of the worry you have are likely disproportionate to the event itself. In other words, everything feels like a really big deal when perhaps it isn’t.” Try to assess the severity of your worries and while you’re at it, consider these 18 everyday things that can trigger anxiety.

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You can’t control your anxiety (but nobody realizes this)

Even if you know all the calming tricks—deep breaths, magic phrases to calm yourself down, jotting down your thoughts—you still live with your worries on a daily basis. Despite your self-care practices, your anxiety may still get the better of you because you simply cannot control it, says Wright. And while you’re aware of these feelings, chances are, others might not be. “People who experience it do not look like what we expect a highly anxious person to look like—frozen, unable to make decisions, failing to get things done,” she says. “Also, people with high-functioning anxiety rarely allow themselves to ask for help or admit that there is anything wrong.” 

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Nothing is ever good enough

People who have anxiety disorders often feel a constant pressure to perform at top-notch standards across all areas of life. But after a while, this can wear on you. (Be aware of these clear signs of perfectionism.) Generally, a person who we might classify as having high-functioning anxiety is ambitious, perfectionistic, and set in their way of doing things,” says Khazan. Interestingly, she explains that anxiety is often about feeling unsafe. “These structured rituals and certain ways of doing things provide people with high-functioning anxiety with a sense of safety,” Khazan says. “They may become quite upset if they are knocked out of their routine because the lack of familiar structure feels overwhelmingly unsafe.”

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Your anxiety is interfering with your daily life

You may be aware that it’s becoming harder to feel secure and competent at work and in your relationships with partners, relatives, and friends, says Wright. In other words, you appear calm and in control on the surface, but it’s a different story on the inside. As Wright puts it, “inwardly, you’re living out a high-drama movie each day and it’s starting to wear on your quality of life.” 

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You can’t sleep

It’s not uncommon to have trouble falling or staying asleep, or to have a restless sleep. “You may rely on a glass or two of wine or a Tylenol PM to mask it temporarily, but basically, you have sleep issues,” warns Wright. In addition, because your nervous system is in overdrive, you may also have a heightened startle response. This means you may jump or startle easily, such as when ambulance sirens go off or a door slams shut. Neither Tylenol PM nor wine are long-term solutions and may even worsen your sleep issues. Some people find taking melatonin helps with their nighttime anxiety, but ultimately you should talk to a medical professional about solutions for the long haul. In the meantime, here are some tips if you’re waking up with anxiety at night.

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You can’t concentrate

Concentration issues go hand-in-hand with anxiety, says Wright. For example, it may be hard to focus at work or you may have to re-read a page of a book several times because your mind wandered. Instead of concentrating on what’s happening in front of you right now, you may find yourself worrying about the future. Or, you might feel as though your mind is blank. 

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You’re irritable and tense

Living with anxiety means living with a low capacity for stressors, says Wright. In other words, you sweat the small stuff, your patience is thin, and you feel grumpy. But it’s not just your mind that’s tense; many people with anxiety disorders experience tightness, constricting, and general tension in their muscles. “If you’re emotionally and mentally wound up in knots, your body is likely holding onto the tension, leading to a general feeling of physical tightness,” explains Wright. Take caution not to add to a friend’s irritability; make sure you never say these 13 things to a loved one who is suffering from anxiety.

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How to get help

You can take steps to help manage your anxiety by checking out these 10 natural remedies for anxiety. Just make sure you do indeed take care of yourself. “People often think they are fine because they get praise and approval from others about their leadership or accomplishments,” explains Carrie Krawiec, a marriage and family therapist at Birmingham Maple Clinic in Troy, Michigan. “But ignoring it can cause burnout and increase your risk of physical health issues, sleep problems, relationship problems, anger, irritability, depression.” Individual or group therapy, along with medication, can help treat anxiety. You’ll learn to replace worrisome thoughts and behaviors with more beneficial coping strategies. Therefore, you’ll start to feel comfortable about things that previously left you anxious, she explains.