Those you see as ‘perfectionists’ could really be wracked with anxiety driven by their desire to show they have it all together.
While not a formal diagnosis itself, high-functioning anxiety describes a person who overworks themselves to deal with persistent feelings of stress, self-doubt, and fear of not measuring up.
Nearly 7 million Americans have been diagnosed with generalized anxiety disorder, of which high-functioning anxiety is a subset.
However, the actual number is likely much higher, given that not everyone can access professional help.
People with high-functioning anxiety are often high-achievers with successful careers – but at the same time, they contend with near-constant self-criticism. No amount of positive feedback or rewards can remedy it.
Dr Neha Chaudhary, a child, adolescent, and adult psychiatrist at Massachusetts General Hospital and Harvard Medical School, told Fortune: ‘They might still excel in their careers, have many friends, and have strong relationships.
‘But inside, they might be struggling with common symptoms of anxiety like restlessness, excessive worrying, trouble sleeping, or fatigue.’
High-functioning anxiety can manifest in several ways. Individuals may overwork themselves and feel reluctant to take breaks, often finding it difficult to slow down or take time off.
People with high-functioning anxiety are often high achievers with successful careers, but they struggle with constant self-criticism. Despite receiving positive feedback or rewards, they find it difficult to overcome these feelings
They might experience intense guilt or shame over minor failures or setbacks and resist delegating tasks to others, believing they must handle everything themselves.
This can lead to irritability, frustration, and constant negative self-talk. Micromanaging becomes common as they strive for perfection in every detail.
Additionally, trouble sleeping is another sign, as their anxious thoughts often prevent them from fully relaxing.
Dr Michael Louwers, associate medical director at Reset Medical and Wellness Center, said: ‘The same personality traits that drive individuals to perform at the highest level often fuel the symptoms of anxiety.
‘It often begins with good intentions, such as goal-setting and rigorous planning. However, those experiencing this type of anxiety usually establish incredibly high and unrealistic goals, resulting in procrastination or constant worry.’
People with this subset of anxiety may often experience physical symptoms as well, such as sweating, muscle tension, lightheadedness, migraines, racing heart, and numbness in the toes and fingers.
It can affect anyone of any age or gender, but women are twice as likely as men to be affected by generalized anxiety disorder in their lifetimes.
It’s essential to pay attention to signs of high-functioning anxiety. Ignoring it is a recipe for overwork and burnout, as well as worsening anxiety in other parts of life and depression.
Dr Judith Joseph, psychiatrist and author of the book High Functioning: ‘People with high functioning anxiety and depression will have the symptoms but may overextend themselves to appear functioning.
‘If we wait until these people lose their functioning, we could be too late. Many of them burn out, develop clinical depression or anxiety, abuse substances, or develop medical problems if untreated and unsupported.’
To combat high-functioning anxiety, it’s important to give yourself some grace and accept that not everything will get done every day.
Recognizing when anxiety is elevated and taking breaks, whether from work or social commitments, can help manage the stress.
Incorporating diaphragmatic deep breathing into your routine, where you inhale for four seconds, hold for four, and exhale for four, can also be beneficial.
Nourishing your brain with foods rich in omega-3 fatty acids, B12, Vitamin D, and magnesium—like berries, nuts, and fish—can also help reduce inflammation and boost your mood by sustaining energy.
Experts recommend setting aside at least 30 minutes daily for yourself, whether for a walk, listening to music, or chatting with a friend, to calm your nervous system and interrupt the cycle of anxious thoughts.
Lastly, learning to delegate tasks and say no when needed allows for more time to care for yourself and engage in activities that bring you joy.
Therapy is a crucial tool to beating anxiety, often talk therapy specifically, which works by helping people reframe their unhelpful thoughts about life and transform their coping mechanisms and behaviors that may feed their anxiety.
Often times, people in therapy are taught not to consider anxiety as a negative emotion, but rather an ‘unhelpful’ emotion that should be acknowledged but not dwelled on.
A licensed therapist might encourage a person to say, ‘I have anxiety, and that’s ok. It doesn’t make me a bad or innately flawed person.’
Instead of being self-critical and looking for what could go wrong, a person dealing with high-functioning society is taught to seek solutions that ameliorate their symptoms and follow through with their obligations with less self-doubt.
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Mindfulness exercises, including guided meditations and breathing exercises, are commonly used tools to quell people’s worry about the future and the unknown, sometimes called ‘future-tripping.’
Concentrating on one thing or moment can increase feelings of calm and peace.
Profound and measured breathing also regulates the parasympathetic nervous system, which is responsible for the ‘rest and digest’ response – the opposite of the anxiety-inducing ‘fight or flight’ response triggered by the sympathetic nervous system.
There are benefits to anxiety, though. Many people with anxiety are empathetic and natural peacemakers and rule followers. They often have a strong desire to overcome obstacles and prove nonbelievers wrong.
